Flinders wrote: ... A friend in medicine tells me that to cover a completely an intensive 24/7 job you need five people, allowing for holidays and sickness. So if you employ just one carer, you will certainly need to have other people doing shifts as well. We had a live-in carer fro a relative, but only for three days/nights a week. Family covered the rest. Which was, to say the least, difficult.
If ultimately someone will have to go into a care home, it can be worth considering the possibility that if you keep them at home for as long as possible, it may be too late for them to adjust to the home when they get there.
After (what seemed like) a lifetime of shiftwork, I know only too well how many people you need to cover a post 24/7 and indeed 365 days a year, including B Hols and all the rest of it. My figure was intended to convey a bit of the cost of hourly cover, assuming somebody was able to do it that way. If they employed the people directly, there would be on-costa, hassle etc. OTOH, using an agency means all that's taken care of but the agency needs to make a profit.
Every person is different, of course, but some factors in care seem general. One is that the staff in care homes are at the bottom of the pecking order but subject to every sort of complaint from relatives. The result is that any hint of a health problem - and there are plenty in the elderly - is referred to the GP, whose usual solution is more medication. Care home staffing ratios are low, even in good places, so it's more convenient if residents sit still rather than wonder around. There's an increased risk of falls in the elderly so independent movement tends to be discouraged, increasing dependency and what I called "learned helplessness."
Obviously, people generally are only placed in care when they are deteriorating and this is increasingly so as costs increase. The days of relatively fit, young older men going into a residential home after the death of their wife simply because they are lost without a woman to cook and do the housework are gone. There's a question of cause and effect, therefore, when somebody's health declines rapidly in care.
As homes go, the one where my mother went first was excellent, but the things I've mentioned combined with her great age meant that eventually they could not cope with her and so sent her to A&E then refused to have her back. A few months later, she died a prolonged death when she was so physically tough that she effectively died of thirst. I've no complaint with any of the people who cared for my mother. It's the system, combined with the deterioration of a close family member. Had it been legally possible, if I'd been offered the chance to kill my mother painlessly myself I'd have taken it, in the certain knowledge that had she been asked to plan in her earlier years, that would have been her chosen end.
FWIW, I had no financial interest in my mother's will. The cost of her care was initially funded from her modest capital and the notional value of a shared-ownership housing association flat, but by the last few months her "wealth" was below the disregard and shared among her grandchildren after her death.
