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The caregivers are night-time people who either go to sleep or "step out" for a few minutes. My mother calls them to help her to the bedside toilet, and they don't hear her right away. So then she can't trust them. I think it is a legitimate reason for my mother to not want that caregiver again. I am using two different agencies to try to get consistent caregivers for her, but good caregivers seem to be in VERY short supply. Even our favorite caregivers have last minute situations where they can't come, and the agency scrambles to try to cover with someone Mother likes when they don't have enough people. My husband has had to do some night shifts at the last minute. I can no longer physically handle my mother's needs, so I can't step in any more. Anybody else having these problems with home caregivers?

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It is sounding as though in home care is not working for your mother.
It may be time to consider placement in facility.
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Sounds like placement should be considered, 24/7 care. You can get your life back, just as it should be.
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I have to agree, time to place Mom. She needs more help than you or seems aides can provide. Your DH is a good guy but not fair if he has to help Mom to the toilet.

There is no "aging in place" when that "aging" means you need lots of help to accomplish that. Mom is no longer independent.
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Try private pay caregivers. They often have friends that they can share shifts with. Some have a network of people, all informal. Ask around of friends who are taking care of elders at home, check bulletin boards at retirement homes, etc. Don't hire someone random from online. Rely on word-of-mouth about those who have been successful with others you know.

Or pursue placing her. That way she has a whole team 24/7 and can't fire anyone. That's what I'd want for her. At some point, home care no longer works.

"But Mom won't - " Sure she will, if she has no other choice.
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I did some night time caregiving years ago. Most clients we had a baby monitor with us, a caregiver should never be farther that the monitor works, even if they step out for a minute.

I use to doze but set my phone alarm every hour, to check on them, but mostly so I never got into the deep rem sleep.

Not sure if it's possible to suggest that, or if your mom is complaining because she doesn't want help there
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I dont have experience, because THIS was the main fear I had with my dad remaining home with 24/7 coverage versus placing him in AL, so I placed him in AL.
transitioning to AL was not easy, but better than having this fear of firing caregivers left and right.

For the situation you describe, if the only issue was not hearing her at night - then as others suggested, how about a baby monitor type thing so they should immediately hear her and wake up and respond? or if they are going to nap - why not set up a recliner chair for the caregiver right in her room?

indeed home care agencies are far from perfect but some are better than others. In my experience with them, a good agency should first try to intervene and solve issues rather than just fire the person. If they missed one call for help, they should suggest things like a baby monitor etc? Are there other agencies in the area you can check with?
you can try private caregivers but then oftentimes, if they call out sick, only you are the backup.
otherwise - AL may be the way to go at this stage
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The lack of qualified caregivers can be quite problematic. It may be worth contacting other agencies and actively looking for candidates among friends or through advertisements. Also, discuss with the agency the possibility of expanding your search to other areas or even consider alternative care options such as day centers or participation in a day care program.
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The aide can sit in a chair in Mom's room , or use a baby monitor.
Short term , use other agencies if there are any .
You could try to hire privately from Care,com etc, but you may run into the same problem if they don't show up consistently.

I think it's time to start looking for a facility, so your husband doesn't have to fill in night shifts and your lives at home as a couple can be more normal.
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