Sorry you are going through this and though I hate to say this... but sometimes you cannot really find the help as good as you want it.
I tried both routes for my aunt - off the books and agency-based - and I am sorry to say but I did have success in either arena.
Off the books proved too unreliable for us - I needed to be sure that at least SOMEONE would actually show up, and only the agencies could ensure that for me. They always did ensure that SOMEONE showed up.
The ones from the agencies often spent half the time trying to convert to off the books! Often I was disappointed in their lack of professionalism, other times there would be someone professional and she just wouldn't hit it off with my aunt and then she'd want someone else. The one she loved the most took blatant advantage of her (I think your mom is beyond that point tho) including money-wise.
I ended up putting nanny cams and that is something you could do so you can look in on her during the day.
Sometimes IF the caregivers KNOWS that she is being watched she will stay on her toes. I always told them up front even tho by law where I live in a private home you are not legally obligated to do so, because my goal was not to catch them goofing off but to encourage them to do a good job.
I could check the live video stream (no sound, just picture) from anywhere where I could get to a browser to make sure things seemed OK.
You can also most definitely instruct them to NOT empty the dishwaster and to remain quiet; that is not too much to ask. You can relay your detailed requests through the agency and repeat them in person as needed. Problems like that might just need a 'get acquainted' period to be worked out, although it is always a bit awkward having someone else in the house.
I think if they are not capable of / comfortable with the basic skills you should report them as well; a reputable agency would want to know. If the agency is overselling their skills you should complain about that too.
Obviously keep trying different agencies, you might just "hit on the right one."
But it is quite a task.
And even if you do find a "right one" keep the other agencies as backup in case there are emergencies along the way!
Plus, it is very expensive and at no point does anyone else kick in the costs (of course there are legitimate ways for home caregiver to get paid from the person but I mean where I live at no point does Medicaid pay for it; it is always private pay). My aunt had money to pay it but otherwise, as you mention if not it basically takes your whole income to pay for it.
Whether it is fair or not, you cannot expect the help of others; especially if he did not buy into her coming home, I think it is not reasonable to expect your brother to carry much of it.
I don't know your financial arrangements (if your mom pays, family pays, or you pay) but if your mom is not paying, you could always ask your brother to contribute but since it was not his preferred solution he might push back on that.
To be honest I found the paid help pretty useless and not affordable, and when you need it daily or more than a few hours a day, the cost - wow!
All of these are some of the reasons I am glad my aunt is in the NH. She gets better care than I ever could ensured for her at home, and at least I have the assurance that if she runs out of money she can stay where she is.
I know you really want to keep you Mom home and that her needs are unique, but all I can suggest is keep looking and investigate every resource to find the help you need.
Originally Posted by all4mom
I'm pretty new to this "hired caregiver" thing, but I MUST work and keep my job (boss has let me go part-time as it is), and brother -- still miffed that I pulled Mom out of what would've been long-term in the SNF after she was d/c from rehab -- is visiting now all of ONE hour a day (be still my heart), so needs must hire help. I had a total of FIVE lined up before she was released; one by one, these private caregivers (most of whom wanted to be paid in cash under the table roughly the equivalent of my take-home pay, and I'm nearing retirement) flitted away to take other jobs after promising to wait on Mom. So I decide that route is unreliable and use agencies. My mother is 180 lbs. and a huge fall risk: the first woman they sent was maybe 5' and 100 lbs. and had no clue how to assist with ADLs. The second was a smoker who had to run out for smoke breaks every five minutes. The third (or so said my mother, and how do I know whether or not to believe?) entertained her boyfriend on the side porch while leaving Mom alone indoors. The fourth seems nice enough and is hefty enough to handle Mom, but she TALKS TALKS TALKS TALKS and drives us both crazy (and I'm with her only as she's coming and going). They all seem obsessed with finishing some task I've started (emptying the dishwasher of clean dishes or dryer of clean clothes) and putting it all away in the wrong place so I must conduct a search-and-rescue of these items and put them where I keep them, thus doubling my work. None seems to know how to bathe/shower a person properly. Few seem comfortable with toileting her OR humoring her dementia-related symptoms, although all claim to specialize in this. AND they cost a fortune (literally). What do you all do for respite; where do you find good help? Ah, feel better!