Does anyone do private duty care anymore?

Queen Tiye, RN · Aug 9, 2019

There are lots of people who want private duty jobs. Are you wanting a CNA? If so find a reputable agency, request an excellent CNA, pay the agency fee for about a week. If you like her, offer to pay her more than the agency but less than what the agency charges. If you pay the agency $30/ hr, she probably gets $10 — offer her $18-$20/hr. Best wishes.

caliotter3 · Aug 9, 2019

Look at the various employment websites, such as indeed dot com and monster dot com and see what their criteria are for a private party to run an ad. I have seen private parties advertise on indeed and on craigslist for example. I am surprised that the nursing school would not take a flier for their bulletin boards. Mine used to post such material all the time. Go to each of the local schools that teach CNA/HHA courses. My very first trainee CNA job came from my instructor's recommendation at such a school. If need be, run an ad in the local newspaper. Post fliers at local churches and at the local food stores that have public bulletin boards. Go to the employment department. There are many possible places to seek employees if you do some brainstorming about it. Good luck.

amoLucia · Aug 9, 2019

Are you NOT getting any responses, or are prospective applicants declining the job? Or just are NOT working out?

What kind of responsibilities are you expecting? You post about 'lifting' your Dad. Is that too formidable a task that should have assistive tools like a hoyer? Do you have plenty of personal care items avail, ie linens, wipes, bluepads, GLOVES, GLOVES and more GLOVES, etc? Are the hours flexible? Are the responsibilities really manageable or are you expecting too much? Is your Mom part of the care?

Since April, I've been receiving homecare from HHAs thru an agency. My HHAs provide domestic services and assist with my personal care. Agency hours are mucho EXPENSIVE, but I've been blessed that my HHAs are really good. I would really hate to lose them so I've tried to make the job as workable for them. I've heard the horror stories. And one can easily read horror stories here on AN. Your quest for assistance going private route doesn't seem to be panning out. So maybe to go thru an agency temporarily for a short time might be your best recourse.

I do ask if you have something like a local county Board of Social Services or Office on Aging that could help? I tapped into mine and found they have some services that might be avail for your folks. It's worth a try.

And maybe their healthcare insurance provider may provide Case/Care Managers that could offer assist. I would STRONGLY, STRONGLY suggest you contact them.

I know it's frustrating as I've been experiencing similarities myself.

Good luck to you.

Dr.J · Aug 10, 2019

So, in answer to your questions, my mom placed an ad in the Pennysaver. She called at least a dozen agencies and they said none of their aides would help him out of bed. Since writing the last post, I wrote a list of his diagnoses on a paper and my mom presented them to the Hospice. The doctor accepted him. But, guess what. No CNA's are available! I find this perplexing, since the CNA is tantamount to providing good hospice care. They sent out an RN, but she does no direct patient care. She is kind and attentive to the emotional needs of my mother, but not helpful to my father, who can no longer perform any adl's. My mom is still independent and changes my dad about 4 times a day when I'm not here. She cooks, cleans, and still works. All I am expecting is ADL care, which apparently is rare to fine. We have all the supplies- my mom has every type of diaper available, boxes of gloves, pads, wipes, commode baggies, etc. The room is like a warehouse of disposable supplies. All we want is someone to come and bathe/dress him in the morning and evening. The hours are totally flexible. I thought it would be easy to find, but evidently not. I will follow your suggestions on the different agencies. They might be helpful.

amoLucia · Aug 10, 2019

Thank you for your comeback. As I said, I know the frustration you're facing. I opted to go the commercial Home Care Agency route.

Are you seeking only CNAs or might HHAs be an option? I utilize HHAs. Good choice on my part. And I lucked out on the Agency. In the beginning my hours were split - am & pm. I've had 5 HHAs because my needed hours and their hours were compatible. Its like between them, my schedule is RELIABLY covered. And I trust them. But I did a lot of checking to find one. The biggest downfall is that it IS expensive, which I believe you've learned.

I do think the UNavailability is weird. For transferring your Dad, I question - does he need a hoyer? Hoyers usually require 2 people - could that be the problem? Esp if he's a big man. Hoyers may be rent-able.

Contact those gov't agencies. Also check with the insurance carrier - benefits may be avail. My insurance has some untraditional benefits.

Julie - I didn't notice this earlier, but I suggest you change your screen name here. Ask the moderators for help Anonymity is best.

And I also LOL at your description of 'warehouse of disposable supplies'. Know it well!

Good luck. Hope you can find some help.

Dr.J · Aug 11, 2019

So the reason we don't have a whole year is because I don't think my mom can handle it on her own. As you said it does require two people. My dad is only 135 pounds. But because he has ascending quadriplegic, he is like dead weight. An HHA would be great as well. I gave my mom your suggestions, as well as the others. She will investigate all avenues. I really do thank you for all your insights. It is very much appreciated.

amoLucia · Aug 11, 2019

I feel for you.

Please. I mean my next comments in the nicest way, but I have concerns about your Mom doing the researching/contacting, etc. It is SUPER TOUGH to navigate all the information out there. How well I know!!! I find it extremely difficult, and I'm 20 years younger than she, and with 35+ years nsg incl LTC. So overwhelmingly difficult that most times I have my other sister double check my research or do it herself. I truly hope you Mom is NOT the one doing all that research by herself. Bottom line - I don't know if she is the best person to be doing all that research.

There are also some people out there called Life Care Consultants (or like that) and there are LSWs who also provide independent assistance like case management/consultation. They know a lot of resources as well as the governmental agencies. I've never dealt with them or even researched them.

I'm not surprised now that you've explained your Dad's condition. I can understand the dilemma of his care needs being difficult to manage. Like lifting weights in a gym.

Just to ask - is his Medical Power of Attorney settled? There may be some very difficult decisions soon to be made that are around the corner.

Hope that you & your folks can be helped.

Dr.J · Aug 11, 2019

I've been trying to steer her, but while I am here on weekends, my home is actually in Georgia. The rest of the story: I am a doctor. I used to be a regional medical director of Hospice, I was medical director of 3 nursing homes and my practice was mostly an aging population. My business took a hit with all the new rules and regs and I decided to take a locum tenens job up in Ct. to be close to my parents. When I came up 8 months ago, my dad was walking with a walker. He has declined significantly. So the need for assistance has taken on an urgency. I called several places and had made contact with several agencies, which my mom promptly declined. I knew this would happen, but what do I know? Last week hospice turned him down. I wrote all his diagnoses down and told my mom to give it to the doctor who was going to re-evaluate the situation and she accepted him. But, they have no aides! They say there is a shortage. I can't believe this- down south we have a great hospice team: CNA, RN, MSW, Clergy, music therapy, volunteers, respite, and a Dr. We all rallied around the families to give them the best transition we could. You would think the North had more resources, but that is not the case. It is very disillusioning. It really makes me want to scream. It did make me think,though- all the robotics they are designing should focus on PCA's for the disabled and infirmed. Ones who could lift and bath and assist in homes. Wouldn't that be nice?

Kitiger, RN · Aug 11, 2019

It is not necessary to have two people to operate a Hoyer Lift. I've been doing it singlehandedly for some 30 years, doing private duty home care through several agencies.

The idea of using an agency to find aides that you can then hire as private pay is not going to work. Most agencies require their staff to sign no-compete forms. The staff person (HHA, nurse, etc.) who works for one of the agency's clients may not then go work for the client unless the staff person first goes 6 months without caring for that client through the agency.

You need to connect with your local agencies.

Find your local Agency on Aging (AAA) by visiting Eldercare.gov or calling 1-800-677-111

BeenThereGoingThere, BSN, RN · Aug 12, 2019

I think all the above suggestions are good. You don’t say where you live. But, if your Dad is on medicare, he might qualify for a OT evaluation at home. Ask your doctor. They have to order it. They can evaluate what you may need in your home to assist with transfers. Even at 135 lbs, dead weight is difficult. Some states provide the Life Services eval, but sadly not all do.

Care.com has some leads, but you have to do the screening. If you need skilled nursing, most home health agencies have HHA who help with bathing. Medicare dictates the frequency.

Eph · Jan 13, 2020

On 8/5/2019 at 5:06 PM, Dr.J said:
Years ago, it was easy to find qualified private nurses, assistants, personal care personnel. What has happened to the private duty skilled nurses? I have a father who is 93 and slowly dying. He is alert and oriented, but his legs and arms have gotten so weak, he can't get out of bed on his own. My mom is almost 89 and is not strong enough to get him up and out of bed. Hospice won't take him because he is too healthy. The VA won't help because he is not indigent. Medicare won't help because he is not skillable. Medicaid won't help because he is not indigent. I suggested to my mom that she contact the nursing school to see if they had a job board for posts and they gave her a number for a service in Manhattan. My parents live in Massapequa Park, about 15 minutes east of Nassau Community College. They are willing to hire the right person, but there does not seem to be anyone who is willing to help lift my dad into a chair- literally 2 feet away from the bed. I am 64 and go down every weekend to help. I wash his hair, help him brush his teeth and dentures, help feed him, dress him, change him. But during the week, there is nobody to help. So my dad lies in bed, a prisoner to his own weakness. Surely there must be someone out there who is in need of a part-time income. Can anyone help us?