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Aging at Home with Live-in Care

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Graham, 82, demonstrates increasing signs of dementia and is reluctantly taking medication to help slow its progress; he is also on medication for high blood pressure. Ethel broke her hip several months ago and it never healed properly, which means she requires increasing doses of pain medication, and they have installed a stairlift to allow her access to the second-story bedroom and bathroom. Medication is delivered pre-filled in a blister pack from the pharmacy, so their permanent part-time PSW Cora only needs to remind them to take their pills; sometimes when she arrives in the morning, the dinnertime and bedtime doses have not been taken. So far, they’ve managed to pay for these extra costs from a savings account Graham had kept in reserve.

Graham and Ethel clearly need more constant management of their daily care and household operations. Banking, bill paying, decisions about house and car expenses and any variance from the routine seem to overwhelm Graham, and his sons are becoming more involved.

The prospect of affording Cora for eight-hour days is daunting—from $125 to $200 a day—and Graham and Ethel’s sons are concerned about their parents being home alone at night, given Graham’s recent habit of nocturnal wandering. The cost of Cora’s type of care around the clock would reach over $200,000 per year, completely untenable for them.

The cost of hiring a live-in caregiver

Safety: Many seniors have not updated their homes in years, and usually without regard to safety. A full safety audit should be done from the front door through to the basement, focusing on good lighting; sturdy non-slip floor surfaces; updated and grounded wiring; reliable, energy-efficient appliances; grab bars and handrails; an accessible laundry area; an alarm system for home and/or personal alarm lanyards; and cordless phones. Many of these items can be critical for safely aging at home.

The idea of a live-in caregiver sounds great, but this option comes with one big consideration: Graham and Ethel will be their caregiver’s employer.

At a time when both of them are facing increasing health challenges, they must now supervise a live-in caregiver and manage all of the paperwork.

This includes keeping a record of their live-in’s regular and overtime hours on a weekly or monthly basis. This information will be needed for the live-in's application for permanent residence.

Graham and Ethel must also pay for:

• The $3,000 placement cost. (This is what they pay to the agency that finds the live-in caregiver).
  
  It could take up to four months to process everything, including visa and immigration papers and health and criminal record checks.


• Mandatory benefits for the live-in include workplace safety insurance for the duration of their employment, and medical insurance coverage until they're eligible for provincial health insurance.


• Transportation costs to bring their live-in from their home country to Canada.

Their sons suggest hiring a live-in assistant through the overseas Live-in Caregiver Program offered by Human Resources and Skills Development Canada.

But the placement would cost $3,000, payable to an agency, it would take up to four months to complete, and the caregiver’s approximate salary for a 44-hour week would be $1,954. On top of that, Graham and Ethel would also be her employers, responsible for her benefits and insurance.

This look at home care vs. retirement living was last updated in 2017 - ed. 

Other articles in this series

• Aging in Place vs. Moving into a Retirement Home
• Aging in Place is free, right?
• Aging at Home with Community Support
• Aging at Home with Agency Care