View Full Version : My MIL is going to assisted living tomorrow
This should have happened about 5 years ago, but she was stubborn.
Her care has escalated and falls almost entirely on my husband (of 6 kids). I've been watching my husband age before my very eyes. His mother has never been rational, and even more so the last few years. If she could have her way, she'd have my husband move in and take care of her every whim 24/7. She has health issues (but won't do anything on her side to make them any better), poor decision making skills (like not opening her mail for months, her food stamps were cut off because she never responded), and is consumed with anxiety. Its just not safe for her to live alone, she is now on oxygen and just wants everything to be done for her. She told my husband that he's just trying to "dump her", and today she said "tomorrow, I'm going off to jail". It just crushes my husband's spirit, and has been taking every last ounce of energy he has. If he wasn't already retired, he would have had to resign because she is just so demanding.
Not asking for any advice really, just needed to get all that out. I'm just hoping that things will get better for my husband after the month is over. He'll still have to empty out her apartment. She can't quite understand why she can't bring her whole household with her to the rest home where she'll be sharing a room. There is a lifetime of clutter he will have to sort through (semi hoarding tendencies).
For anyone who has been through this with a loved one, any words of advice? How long did it take for your loved one to get used to the new situation (even though they may never have actually "liked" it)?
When we moved my dad (my mom already gone, would have needed dynamite to get her out) it took several months. He was in the mid stages of dementia at the time and kept thinking it was temporary because we were doing renovations on the house. He had been depressed for a long time before this and he actually perked up quite a bit after the move. He enjoyed meal times with the other residents and started eating much better and looked forward to visiting. I still felt a huge amount of guilt for moving him and resentment over the huge job of cleaning the property. It didn't feel good at the time but I intellectually knew it was the right thing to do for his safety and my sanity.
My grandmother never wanted to go to assisted living but once there enjoyed the attention and even got a boyfriend.
early morning
2-8-18, 8:22pm
My mother was determined to die at home - and she was the most stubborn woman I ever hope to know, a trait that did not lessen with her increasing dementia. But in June of 2015 she fell and hit her head - hard. We took her to the hospital, and they would not release her unless it was to 24 hour care. So she went to a nursing home - where she fell again, and broke her hip. Even though she did physical therapy and got back on her feet, she soon gave up and stopped walking. There was no way she could return home, even if one of us moved in with her - which was not really a good option. We moved her to a much nicer care facility. She seemed to accept her circumstances with some creative editing and never really acknowledged that she was living in a care facility - she would often tell us where she was visiting - her nephew's home, a hotel, an amusement park, the fairgrounds - and show us around. Her delusion - or refusal to acknowledge a reality she did not care for -was harmless and kept her spirits up. She wasn't always happy, and she didn't always remember our names, but she never lost her caustic wit and we did a lot of laughing. She died in the fall of 2016, about 18 months after leaving her home, and just a few weeks shy of her 98th birthday. While we hated that she fell, it forced us to move her to a place where she was safer, and it also removed some of the guilt we would have felt by making her go earlier, if that makes sense. I empathize with those who have to care for family elders, and I have to say I'm not looking forward to being one of those elders my self. I'll probably be just as stubborn as my mother was... herbgeek, I can only send my best wishes and cyber hugs to you and your DH. ((( )))
iris lilies
2-8-18, 8:37pm
Herbgeek, I hope this does eqse the vurdon of your hubby.
I'm sorry you and your family are going through this Herbgeek. It does seem like this will be a good thing for your DH once the transition is made. Why did all the care fall on him? Was it a matter of proximity?
I am so sorry. I wonder where those are that have those "great" experiences with their senior aging parents or loved ones when the burden falls on the shoulders of the caregiver??? For my mom the hospital would not release her till there was nursing home lined up and honestly it was a 30 minute choice:( worse way to go. NO she never accepted and got worse asap, told dad she hated him and was sorry she married him over this. I can not think of a sadder thing for a loved one to say or do.
I have not experienced those great moments same as your husband. I am it and am 3.5 hours drive away. Dad too needed to be in assisted living care 3 and 1/2 years ago when mom passed, but no way in h*ll. I quit bringing it up as he points his finger to his head like a gun. Every day now when I make my phone call I take a breath and think: What is the crisis today?. Monday I had 4 checks to put in boxes to make calls on.
How can I make things different for my son not to have the burden? I have plans and thoughts, but have watched every single elderly person make the same mistakes as they are not ready or never ready. I have thought about writing a letter to myself at 70. Oh wait is that too early? Is that too late? Will I say 80 is better or is that too late?
Why did all the care fall on him? Was it a matter of proximity?
Partially proximity, although one brother is even closer (10 minutes away versus an hour for my husband).
The big reason is that there was a lot of dysfunction in this household, and many of the kids are angry or damaged in their own ways. My MIL was an enabler, both for her alcoholic husband until he died, as well as allowing her father to molest the daughters. My MIL allowed/enabled a lot of bad behavior in addition to these big ones, and did nothing to make anything at all better. My husband escaped most of this insanity (was not molested, and the alcoholism only got bad after he moved out at 18). My husband is a decent man, and is willing to put personal feelings aside mostly, to do the right thing. Its driving him crazy that she not only refuses to help herself, but actively does things that make her conditions worse, but he's not going to let her continue to suffer in this awful apartment she's in.
ToomuchStuff
2-9-18, 8:56am
This is a tough one, both for all of you and for me to even read. I grew up with my great aunt in a nursing home, which is NOT assisted living. Assisted living around here are places where they have what might amount to an apartment, that have people that come check on you and assist you as needed a couple times a day. They tend to be next to the nursing facility and require you to have some physical mobility and enough faculties to be safe for yourself and others (not something where your going to light the place on fire). They also require financial planning on the part of the one going in.
We visited weekly and brought my great aunt to my grandmothers house, multiple times a year, for years (typically, once a month). After my grandmother died, my great aunt, kept asking me to kill her (and she was serious). She didn't want to live anymore and physically started getting violent with those around her, and finally had to be medicated enough, she was pretty much a vegetable (I stopped going as I couldn't deal with that, or her in a kill me state). She lived like that for the last few years of her life.
Nursing homes are not nice and even worse when no family comes to visit (it doesn't sound like the siblings do that). Your MIL is moving out of assisted living, however it doesn't sound like she has been assisting her own living. She may never adjust and that will depend on her attitude as well as those in the home and if people visit or not.
My great aunt had polio as a child and was only placed into a nursing home when her mother could no longer care for her (in her 90's). My grandmother took care of her mother and husband, who were both dying and she couldn't care for her sister as well. There was no other family (WWII gold star and other brother died a few years after due to things exposed to in the war). There were periods when the home was better run and people active and it gave her something to do/the mind someplace to be, and there were times that were worse. She resigned herself to it, I am not sure I would say, adjusted. (lived in one for more then 20 years)
My husband is a decent man, and is willing to put personal feelings aside mostly, to do the right thing. Its driving him crazy that she not only refuses to help herself, but actively does things that make her conditions worse, but he's not going to let her continue to suffer in this awful apartment she's in.
Your husband's mother is her own person and can make her own decisions until those decisions start endangering others (and herself, though our society tends to give individuals more leeway on that). If your husband's judgement is that he could no longer supply the level of care that his mother and those around her need to be safe, then finding her help was the right thing to do, even if that meant moving her out of a home which contributed to that peril. Your husband should not feel bad about that. And while he may feel badly that his mother is charting her own course in her self-care, he is not responsible for that, either. She has her own reasons for doing what she is doing, and, at some level, it is what she feels is best for her.
How can I make things different for my son not to have the burden? I have plans and thoughts, but have watched every single elderly person make the same mistakes as they are not ready or never ready.
I think it's more than readiness.
We live in a society that prizes independence. Giving that up -- at any level -- is hard. Relinquishing a driver's license is tough, as anyone who's had to take one can verify. Admitting a need for external assistance, whether it's a hearing aid, or someone who comes in and deep-cleans the house because you no longer can reach it all, or moving to assisted living or even nursing or memory care, is tough to take. I have a 29-year-old relative with a chronic disease that, on some days, is greatly aided by a walking stick. She went without one for a long time -- too long -- because 29-year-olds don't need that kind of assistance. The roots run deep.
And getting our ilves in order is a sometimes-confusing, sometimes-unpleasant task that somehow always falls behind other projects. We grow attached to things that have lots of sentimental value to us. Our energy and strength levels drop so we can't do as much as we used to -- or understand what we could before. It's hard to see, sometimes, until something or someone points it out to us starkly, which is not a welcome discovery, either. We're getting old, which, in our society, diminishes our value and usefulness. Getting old is for the birds -- but it beats the alternative.
I remember when we moved my grandparents into assisted living. Grandmother insisted it was temporary and she was taking everything with her. We had to unload their entire house into a tiny one bedroom patio apartment. We were dealing with a lot of personality changes due to her strokes. The entire living room was stuffed to the ceiling. Only when management came by and insisted they couldn't stay there if all the stuff was staying and definitely couldn't do long-term storage on the tiny covered patio would she allow us to take away some things "on loan". I have her rocking chair "on loan" though she's been gone now 25 years. She never had to deal with nursing home the next stroke took her. Grandfather enjoyed the assisted living but as he aged, especially after being hit in the head by a car, he lost all the appliances in the apartment then had to move to nursing home for final year.
So sorry. It's so stressful to deal with loss in all it's forms. Loss of independence, loss of capabilities, loss of personality, loss of freedom of all involved, loss of life.
BikingLady
2-9-18, 11:16am
I agree SteveninMN. I am 57 well next month:|( I had pipe dreams of running a marathon or a half at 70. I know ladies and men on the trail that do. It is hard for me to accept that I probably won't be running, probably should not have this morning. I refuse to accept this most days. SO fully get why Dad wanted his license OMG, but he has not driven since getting it last year anyhow. I just think we all get stuck in our ways and as we age it must be worse for sure.
Teacher Terry
2-9-18, 12:36pm
Studies show that most people adjust within 4 months. However, I had a good friend with early Alzheimer's that had to go into one when her DH was dying of cancer and within 6 weeks her mind was gone. The neurologist said it was not the disease but that she couldn't deal with her new reality. We were the only friends that ever went to visit for the almost 2 years before she died.
The sentiment "Just shoot me." perfectly expresses my feelings about warehouses for the elderly.
iris lilies
2-9-18, 2:11pm
The sentiment "Just shoot me." perfectly expresses my feelings about warehouses for the elderly.
While you dont intent it, I find this dismissive of the real situation of most elderly in these nursing homes/aka skilled nursing facilities.
My first visit to a nursing home was a shocker, but after several visits I learned to see the social bonds, enjoyable activites, and etc. that make up real life there. a real life going on there. You (the generic you) have to look past the immediate sea of white hair and fraility to see the human activity of life there.
My garden club has an annual show at a Friendship Village senior facility in St. Louis and we love it. They give us a great room and a built in audience. Some of the residents there were once floral designers so we invite them to make a designand display it. The grounds there are lovely, and if the location wasnt all the hell the way out in suburbia, I would consider moving there.
Teacher Terry
2-9-18, 2:50pm
Assisted living is much nicer then a NH but you need the $ to afford it and around here they are super expensive. My DAd was lucky because my Mom cared for him at home for 14 years and I lived next door and helped her. Then when my Mom needed help through her 3 bouts of cancer us 3 kids took turns going home to stay for a few weeks until she would get better. WE all worked for government so were able to get off for a 2 week time period. By the time she was 88 and needed more help both my sibs lived close and were retired so they would move in for a few weeks to help her and then she could be alone again. She died shortly before 90 and only spent a week in a home. Both my parents were lucky and not too big of a burden. My 2 sibs never helped with my Dad but when my Mom needed it I lived far away so they stepped up to help her. If my Mom would have needed full time care she would have had to go into a home but she was determined to stay home and take care of herself. It is really tough when one kid is doing everything and I don't think a child should have to sacrifice their life to take care of a parent f.t.
While you dont intent it, I find this dismissive of the real situation of most elderly in these nursing homes/aka skilled nursing facilities.
My first visit to a nursing home was a shocker, but after several visits I learned to see the social bonds, enjoyable activites, and etc. that make up real life there. a real life going on there. You (the generic you) have to look past the immediate sea of white hair and fraility to see the human activity of life there.
My garden club has an annual show at a Friendship Village senior facility in St. Louis and we love it. They give us a great room and a built in audience. Some of the residents there were once floral designers so we invite them to make a designand display it. The grounds there are lovely, and if the location wasnt all the hell the way out in suburbia, I would consider moving there.
I can speak only for myself, but I would rather be dead than sitting in a circle singing "The Itsy Bitsy Spider," tossing a nerf ball, and eating institutional food. YMMV, as always.
The sentiment "Just shoot me." perfectly expresses my feelings about warehouses for the elderly.
So, how does this sentiment help the OP?
So, how does this sentiment help the OP?
I feel the same way as Jane. :D My nightmare scenario is being stuck in a room with someone who either talks or watches TV all day long and not having any silence. I hope it never comes to that personally but it could.
But my MIL is different from me, and I actually think she will like having people around to talk to, and not having to be responsible for bills, medications, figuring out what to eat and the like. She's going into what in MA is called a rest home: its not a nursing home, but its not separate private apartments. Its basically a group home of about 30 residents. She needs constant reassurance, even the daily calls from my husband with several times a week visits have not been enough.
I feel the same way as Jane. :D My nightmare scenario is being stuck in a room with someone who either talks or watches TV all day long and not having any silence. I hope it never comes to that personally but it could.
But my MIL is different from me, and I actually think she will like having people around to talk to, and not having to be responsible for bills, medications, figuring out what to eat and the like. She's going into what in MA is called a rest home: its not a nursing home, but its not separate private apartments. Its basically a group home of about 30 residents. She needs constant reassurance, even the daily calls from my husband with several times a week visits have not been enough.
I just feel that there are enough people out there who don't have any other options than to "guide" their parents into assisted living, and they feel really guilty about it, for no good reason. In a perfect world, the Powers That Be would realize it costs a LOT more money to "warehouse" elderly people in group homes than it would to provide home health care.
Would I rather die in my sleep hale and hearty in my own home at 92? Yes, of course. But I may well wind up in a rest home, or assisted living, or a convalescent hospital like my mother and grandmother. Who knows?
I really liked the independent (assisted and memory care also) living place where we took my dad. I would have lived there myself. He had a very nice apartment on the third floor with a picture window looking straight at Mt Hood. I loved that they had a restaurant where you could eat at any time you pleased and one of us generally always ate dinner with him and the food was very good. If it wasn't we would have taken him out because he was kind of a food snob. It was a beautiful building and all the employees were kind to him and to us. As he needed more care I hired a companion for the mornings and one of us kids spent the evening with him. We were able to hold that together for about a year and a half. I finally became aware that he was wandering outside in the middle of the night and we needed to move him into memory care. That broke our hearts because we so loved the set up we had. I enjoyed visiting him in that nice apartment so much more than our old family home. It was perfect and much nicer for him than had one of us been able to only give him one room in our homes.
When we moved him to memory care it was in an adult foster home five minutes down the street from me. It was with a wonderful family with young kids. There were only four other residents. The food was all made from scratch. They have a garden with chickens. They let him keep his beloved cat. He and another resident became fast friends and spent each day in each others company. Some days it seemed like I was intruding and that was OK. It relieved the guilt that I should be there all the time to keep him company. I know we were very very lucky. I'm glad he could afford it and I'm glad what we wanted for him was available. Should I ever find myself in the same situation I would be happy with any part of his set up. There was never a feeling of being in a warehouse.
iris lilies
2-9-18, 4:38pm
There are just as mainy elderly warehousing themselves in their creaky old dirty house with the tv blaring 24/7 than in the group homes. We hear about it regularly here.
While you can get that blaring tv in a nursing home if thats what ya want, you can also get guided activities that may promote active minds and social continuity.
My mother did crazy crap when in her own home. She bought everything from any salesman who knocked on her door. She hid magazine labels high up on a shelf in the closet and in a jar of water where she expected them to disintegrate. She hid money. And then she fell and broke her hip, lying for about 18 hours in the garage until she summoned help.
but in the nursing home she got a boyfriend of sorts, gained needed weight, had weekly visits from cats and dogs, had library books ( which she couldnt read) and all kinds of good stuff in addition to the not-so-good stuff.
Make no mistake,
I have 0 guilt for her being in a nursing home. I dont defend it out of guilt. I would not like the bland food of group homes, but I suppose I could always bring my own hot sauce.
I'm depressingly familiar with a number of these places. We managed to keep my mother at home--which was her fervent wish--but we had to install my father at the Veteran's Home for the duration after his second stroke. That's was when I realized how much difference money can make at the end of one's life. You can bet Bill Gates' father won't be cooling his heels in a geriatric group home. (But I'm sure I will.) I'd much prefer the creaky old dirty house with the blaring TV--I treasure my privacy, however imperfect.
There are very few satisfactory solutions to the problems facing the infirm elderly in this country.
Teacher Terry
2-9-18, 5:38pm
Unless you can afford a private room there is no privacy. In some places 4 people share a bathroom. I can't imagine never being alone.
Soylent Green, anyone?
I would have walked out of that movie if I could have. But that would certainly be one solution!
In a perfect world, the Powers That Be would realize it costs a LOT more money to "warehouse" elderly people in group homes than it would to provide home health care.
The State of Minnesota realized this economic fact several years ago. In the county in which DH works (a suburb of the Twin Cities) there have been no new nursing homes built or expanded in more than a decade, and even group homes are not expanding significantly. The story is much the same in other counties around the state. It is much less expensive to have someone come in and assist the elderly in their own home than it is to move them to a facility that must meet different housing codes. Most of the people being served like being able to stay in their own homes, and that resolves questions like favorite meals or the presence of pets. There will, of course, be a need for folks who cannot live on their own even a little bit (memory-care, medical fragility, wheelchair-bound, etc.). But service in homes seems to be the way things are going here.
For now. A lot of the economics rests on finding personal care assistants who are willing to work with the elderly for $10-15/hour and no benefits. That's tough -- no agency around here has "staff on the bench" and I know that my relative with PCA needs has seen several shifts go unstaffed because it's hard to find someone who has the necessary skills (wound care, catheter flushing, etc.) who'll ride a bus for an hour in each direction for a 4-5 hour shift ending at 10:00 pm and gross $50 for the night. As more people age and demand increases, those wages will have to go up. That will skew the economics. But it's unlikely it will change the result -- it still will be less expensive to care for the elderly at home assuming they can safely stay home.
for what its worth: my husband had to go back to The Home after he'd dropped his mother off and spent a couple of hours because she'd forgotten to pack her underwear, and she was happy as a clam in front of the TV she'd brought with her. This was the right decision for his mom. My husband un-aged the 10 years he's put on recently. What a load off.
for what its worth: my husband had to go back to The Home after he'd dropped his mother off and spent a couple of hours because she'd forgotten to pack her underwear, and she was happy as a clam in front of the TV she'd brought with her. This was the right decision for his mom. My husband un-aged the 10 years he's put on recently. What a load off.
I'm glad there's a happy ending to this particular story!
So glad to hear that, Herbgeek!
iris lilies
2-9-18, 8:56pm
Unless you can afford a private room there is no privacy. In some places 4 people share a bathroom. I can't imagine never being alone.
Yes, thatvwould bug me majorly.
my mother had a private room. But Ibwouldnt mind sharing a bathroom, that has never bothered me.
apoarently, now, the newly built places have all private rooms or at leadt alcove thingies. My friends father is on a medicaid paid tab in a nursing home and he has privacy.
My parents are paying 8400 dollars a month for assisted living in a small room and they have to share a bathroom with another two people. I think that is kind of awful.
If they need to go to skilled nursing, we were quoted 25,000 a month. And more if we need dementia care.
We need a market disrupter. Just like Uber and airbnb a company that connects regular caregivers with regular customers without going through the home health care staffing companies with their markups.
iris lilies
2-9-18, 10:40pm
We need a market disrupter. Just like Uber and airbnb a company that connects regular caregivers with regular customers without going through the home health care staffing companies with their markups.
Anyone can hire their own home health care worker.
This is playing out in our family too. MIL absolutely refuses to leave her house and now says only family can come inside as she trusts no one else. SIL is the only one left in the area but has to drive 50 miles each way to check on her every week, buy groceries and take her to medical appts. The woman goes to several doctors each week for what I don't know. I think SIL is still enabling her mother's contrariness because this could go on unnecessarily for a long while. We are all waiting for a bad fall or some other calamity but thus far she is of sound mind and can do as she pleases - so long as family keeps showing up by her command. Oh please don't let me do that to my daughter...
Well said, Steve. (Post #10)
You really understand that "the roots run deep" in all of us, at every age.
Anyone can hire their own home health care worker.
Yes but a go-between can do background checks on the people like Uber does.
BikingLady
2-10-18, 10:44am
Homecare, after 4 years and several aides here is my take of the booming business of these adult sitters. They make very little money just above minimum which kinda says what you are going to get for care, company however charges a lot . The ones I have had for dad are not nurses they are there for comfort as the name implies.
The first one did nothing but sit and talk about her life.
The longest one was nice and dad really liked her, to the point of giving $$$$$$ which with her sad storied she took every time she came, never groceries in house.
The aides become super comfortable Really Fast.
The one he had for the last month and half, wow cleaned, kept inventory, texted me on the status of groceries, I figured my days of driving groceries across state were done!!! Notified me that he offered money and buy items often, which I think I took care of with dad. Then two weeks ago he says he does not like her, she watches tv all the time. COMFORT level was reached.
SO this week a new one, he says is nice.
I think there needs to be more regulations or checks on the clients. I see how these can go wrong super fast. But what are the choices????
These have been glorified sitters at a terrible price, that it is hit and miss if they will take advantage of the elderly.
Simplemind
2-10-18, 9:58pm
I hear you BikingLady. I so wanted to keep my promise to dad and have him in the house but I knew I wasn't going to be able to trust somebody and I would be going out, checking all the time and basically spending as much time as if I was doing it myself. My dad was also giving things away and it was a fine line on it being his to give or whether it was abuse. He was being taken advantage of left and right. I was popping Tums like Pez.
BikingLady
2-11-18, 9:00am
Yes Dad who worked hard is his, never lending money to anyone, never gifting money. Seems to now have no remembrance of that and the $20s seem to disappear in lumps, Three $800 withdraws in August, yep that Aide was going through a divorce and the sad story each time she came over took that money.. The Comfort Company said to me "It is his money". I gasped, but I only have POA Medical.
Chicken lady
2-11-18, 9:40am
Wow.
dh and I were talking about this the other day. A local situation caused him to say “sometimes I think about us being left with one parent. I’m afraid it’s going to be my mother.”
intold him not to worry. His mother is going into the long term care facility where she put his grandfather and it is 9 hours away. This is because:
1) She has stated that this is what she and his father are going to do.
2) When my mother was spending most of her days caring for my grandmother in gram’s home because that is what mom wanted to do (well, I think she *wanted* to move back in, but that conflicted with being married to my dad....) My mother in law took every opportunity to tell my mother what a terrible burden she was suffering and how it was beyond understanding that she didn’t put her mother in a nursing home because OBVIOUSLY that was the best solution and my grandmother was so unreasonable to let her sacrifice her life.... in spite of my attempts to change the conversation, some of the things she said were absolutely cruel and left my mother teary and speechless.
3) I don’t like her.
4) dh loves her, but he doesn’t like her either.
5) if she can’t afford it (unlikely) we can.
if his siblings disagree, they can make any arrangements they like. We will probably even still send money if needed.
my mother will move in with us if needed/possible (if she needs more intensive medical care than she can get in our home, we will find the best we can nearby or near my brother if the care is better.)
in the extremely unlikely event that my father outlives my mother - and doesn’t commit suicide (i’m Really not sure if he’s joking) he can afford to make whatever arrangements suit him. We both know it will not be living here. His best friends are professional nurses close to my age.
i have no idea what we will do about dh father. Unless he has already moved to assisted living with dh mother, he is likely to insist on living his life unchanged until the day he has a heart attack or stroke, or falls from the roof or into the river and dies because he is alone on a farm 45 minutes from town, has no friends, and leaves his cell phone turned off on his dresser unless he knows he is going somewhere where he might want to make a call. And if you told him that, the response you would be likely to get would be something along the line of “sounds like a plan.”
much like my father’s “I have absolutely no intention of outliving your mother.”
SteveinMN
2-11-18, 12:01pm
We need a market disrupter. Just like Uber and airbnb a company that connects regular caregivers with regular customers without going through the home health care staffing companies with their markups.
I'm not sure what that disrupter might be. Uber and AirBnB both took on highly-regulated public-facing businesses with almost-completely-unregulated temporary workers. Not that things were perfect with the taxi and hotel industries. But pretty much all Uber and AirBnB have done is apply advanced logistics and flexible pricing to markets that don't require any particular industry-specific knowledge (How many of us can drive or make a bed? How many of us know how to use a Hoyer lift?).
I can tell you, both from DW's standpoint (she and her co-workers pay home-health-care-staffing companies) and my standpoint (as someone who has a relative using those services), unless the staffing company has a brand name tied to a regional health care system or hospital and works only privately, no one is making a huge markup on health-care staffing. Certainly the markup that exists is no more than it is for other companies that supply un- or lightly-skilled temporary workers (like assembly or office help).
The staffing company hires and fires; pays for background checks, fingerprinting, things like Mantoux tests, and minimal training; manages payroll; and makes sure shifts are staffed. Almost all of the companies I'm aware of are 1-3 person operations in crappy offices with used furniture and with a steadily churning stream of workers who actually visit the homes. And the need for more people is chronic. Nobody has a "bench" of people waiting to work, especially if particular skills (like catheter flushing) are needed. The situation is better for private pay, but for medical assistance/Medicare, the staffing company is not paid enough hourly to offer more than $10-13/hr to the home workers. It's hard to keep people working for $10/hr cleaning up people's poop while they're yelling at you to go back to the country you came from. And it's not like the staffing company can magically offer $20/hr ("surge pricing") for the real PITA clients or because nobody wants to work on Christmas Eve.
I would be happy to see something improve the current situation. But I can't see it as just a logistical issue.
Accurate description. I see it every day. Nurse extenders - as described by Steve - also keep many hospitals running. They do the literal poop work and take verbal abuse for $10-15 an hour.
Powered by vBulletin® Version 4.2.5 Copyright © 2025 vBulletin Solutions Inc. All rights reserved.