How to monitor home health care from a distance?
February 7, 2022 1:10 PM   Subscribe

How do we make sure in-home health care/assistance is going ok for elderly parents?

My older stepfather (in Monterey, CA) is in the process of dying, the situation came on very, very suddenly. He was my elderly mother's sole source of support, as she has grown more infirm and forgetful over the last few years.

The end-goal (which has not been settled, not by a longshot) is to get her into assisted living / memory care somewhere close to my brother in Oregon (I'm in Seattle). The short-term solution is going to be to get some home assistance for a number of hours a day until we can figure out the long-term situation. Neither my brother nor I can stay nearby and check in on her regularly.

What options/ideas are there to make sure that the home care is being executed well, that the work is being done, that our mother is actually being cared for? I don't believe there are neighbors/friends in the area that are appropriate, but I'm not 100% sure.
posted by Gorgik to Health & Fitness (7 answers total) 2 users marked this as a favorite
Best answer: You can literally monitor with WiFi baby monitors that upload to the cloud. They are all video and motion activated now. Ours were less than $30 a unit.
posted by DarlingBri at 1:22 PM on February 7, 2022

Best answer: I am very sorry.

Perhaps this is an obvious suggestion and/or you've ruled it out, but is there a local faith community institution (church, mosque etc.) that can check in? Even if they are not members, it has been my experience (with churches, at least) that they may do home visits with community members in need.
My church has visited and helped provide nonmedical care for several community members throughout pandemic, and had done it long before, as well. From what I understand, some people just called/emailed for help, others were known through church members, although the "clients" themselves were not members.
It could be beneficial to just have another person come around, so that it is known your loved one has local support and is not alone.
posted by fies at 1:26 PM on February 7, 2022 [1 favorite]

Best answer: Maybe social worker? I'm not sure how you get connected up with a social worker. We have always done so automatically through or after a hospital visit. They are usually very useful with regard to resources though disappear quickly when/if they feel like you have things in hand (as they have others who probably don't). Maybe try getting to a social worker through whoever is caring for the stepfather. Especially if hospice is involved, they often (always?) have social worker on the team who can help with all family issues including connecting resources up for the remaining family.
posted by RoadScholar at 4:08 PM on February 7, 2022

Best answer: I went through this recently for my own parent. Are you or your brother able to stay with/near your mother while the in-home care is being set-up? If you go through an agency there should be a care manager who will help evaluate what level of care of your mom needs, but obviously they should make that plan with input from you and your brother. In my family's case, that manager was my main point of contact for managing the quality of my mom's care. We talked somewhat frequently, maybe every couple of weeks? The care manager will likely have opinions about the various caregivers employed by the agency. The agency also had an online interface for viewing the caregivers' daily reports. The reality of paid in-home caregiving these days is that there are likely to be multiple caregivers involved, and you'll get a sense of their personalities, skills, and attentiveness from the daily reports.

I was not living close enough to my parent to physically check-in on a daily basis. So I monitored how things were going by calling my parent every day. Often I would call during the scheduled caregiving shift - occasionally the caregivers themselves would answer the phone for my parent and that would give me a chance to chat with the caregivers. (Also my parent was not in control enough of their mental faculties to edit themselves in the moment, so it actually gave me a good sense of the quality of care.) I made some unscheduled visits, at different days/times, when caregivers were scheduled to be there. The most important thing I did was use the eyes and the ears of the neighbors and welcomed their help -- there is NO WAY I repeat NO WAY I could have managed this situation for my parent (who wanted to die at home) without the help of the neighbors.

I'd urge you to get your mom into a facility ASAP if that's your goal. Honestly, it is hard work to manage caregivers from afar. At some point a caregiver is going to call out on a shift and the agency will not be able to find a replacement in time. There is a lot of employee turnover in caregiving and the wages aren't that great. There were a few times in the last year when I and a neighbor had to scramble to arrange some "babysitting" of my parent, including me dropping everything and driving out to parent's home to be the caregiver for the day. (Leaving behind my own children and job.) You may need to expand your definition of "appropriate" for someone outside the family to help monitor the situation. It may be some friend of your parents whom you don't know too well.

Frankly given the amount of time I was on the phone regarding caregivers, I wouldn't have had the time to monitor a nanny cam.
posted by stowaway at 4:39 PM on February 7, 2022 [1 favorite]

Best answer: So sorry for your complicated situation and your impending loss. If you have some money to use to help with this, you can hire a geriatric care manager to coordinate your home care workers and anything else your mom and stepdad need. Your local Area Agency on Aging should be able to help you with referrals. You can also contact your local Alzheimer's Association office.
posted by assenav at 6:02 PM on February 7, 2022

Best answer: Have you thought about (or are you able to take advantage of ) FMLA, the Family Medical Leave Act? This is an option for most Washington residents (but not for your sibling in Oregon until next year). It might allow you to take a few weeks of paid leave visit your parents to help manage health care workers. Of course, it would be a major disruption to your life, though not especially to your income, but it might be something to think about.

Good luck. I'm sorry you're having to go through this!
posted by lhauser at 6:30 PM on February 7, 2022

Response by poster: Thanks for the suggestions. And sympathy
posted by Gorgik at 9:47 AM on February 10, 2022

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