Most families start looking for a caregiver after a fall or a hospital stay, when every decision is rushed. Lindsay explains what to do before that point, with real numbers on what in-home care costs and the questions to ask before anyone walks through your door.

Frank sits in the interview chair and asks what families want to know. Is a license more important than experience? When does helping with a pill count as medical care? Can you handle the medical side yourself to save money? Lindsay also tells the story of a 101-year-old client with Alzheimer's whose daughters, both in their late 70s, were providing care around the clock, and why a few hours of outside help each day changes things for everyone in the house.

Timestamps and Topics

• 00:00 Intro and Don't Wait for a Crisis
• 01:06 What a Good Caregiver Costs
• 02:22 Resumes, References, and Interview Questions
• 03:57 Where Non-Medical Care Ends and Who Holds the Liability
• 06:26 You Don't Have to Do It All Yourself
• 09:03 The Family Talk About Money and Time
• 10:52 Paying and Scheduling Caregivers Fairly
• 13:28 Why Dementia Care Needs the Same Faces

Key Takeaways

• Bring in help when you first notice mobility problems. Waiting for a fall often means a hospital stay, then rehab in assisted living.
• Hire for skill, not the lowest rate. Lindsay puts the going rate in San Diego at $25 to $30 an hour, and a $15 to $18 listing rarely comes with dementia or transfer experience.
• Ask for a resume and professional references from past employers or families, not friends. Ask about punctuality, call-outs, driving record, and experience with your loved one's specific condition.
• Non-medical caregivers can't handle medication or wounds. Crushing a pill into applesauce already counts as medical, and if you direct a caregiver to do it, you hold the liability.
• Decide with your siblings who pays and who gives time before anything happens. Then take regular breaks so you don't come back to your parent resentful.
• Pay caregivers well and rotate weekends between at least two people. Short shifts of about four hours should pay $40 to $50 an hour so the caregiver stays, which matters most for someone with Alzheimer's or dementia.

Quotes

• "Don't wait for the crisis. Why are you going to wait till they fall and break a hip?" (Lindsay)
• "The cheapest caregiver is not always the best caregiver." (Lindsay)
• "You need to be the advocate and the adult here." (Lindsay)
• "That break is actually helping the parent. And it's okay. Don't feel guilty." (Frank)
• "Caregivers live paycheck to paycheck. Pay them well. They're taking care of your loved one." (Lindsay)

Call to Action

New episodes of Unfilter Caregiver come out every two weeks on Apple Podcasts and Spotify. Subscribe so you catch the next one, and leave a review to help other families find the show. If you have a sibling who keeps putting off the care conversation, send them this episode.

Links and Resources

Find care options and more from Lindsay at findinghomecare.net.

Listener Questions

Is there a caregiving situation we haven't covered yet? Send your questions, reactions, and topic ideas through findinghomecare.net, and we may build a future episode around them.

Apple Podcast Tags

hiring a caregiver, in-home care, home health care, caregiver cost, elder care, aging parents, Alzheimer's care, dementia care, sundowning, family caregiver, caregiver burnout, respite care, senior care, caregiver interview questions, Unfilter Caregiver

If you ended up on a ventilator tomorrow, would your family know what you want? Connie, a social worker with about 20 years in healthcare, including home health and hospice, says that conversation should start at 18, and she had it with each of her own kids. She explains what an advance healthcare directive does and who California puts in charge when you don't have one. She also covers how hard it gets when a patient has no reachable family at all.

Lindsay shares the accident that left her father intubated in a coma and the decision she and her brother made three days later, based on what he had told them he wanted. From there the two get into siblings who aren't speaking, parents with dementia who still insist on independence, and families in hospice who can't accept what's happening. Connie closes with the POLST form and how to update a directive you signed decades ago.

00:00 Intro and Meet Connie
01:10 What an Advance Healthcare Directive Is and Why to Start at 18
02:51 Lindsay's Father and the Decision to Honor His Wishes
04:39 Who Decides for You in California Without a Directive
06:42 Family Conflict, the Holidays, and Getting on the Same Page
09:41 Dementia, Independence, and Stepping In as the Advocate
13:14 POLST and Do Not Resuscitate Forms, Plus Updating an Old Directive
15:38 Final Thoughts

• An advance healthcare directive is for every adult. Connie points to car accidents that leave young adults on machines with no record of what they wanted.
• In California, if there is no directive, the decision goes to your spouse first and then to your adult children. For people with no family nearby, tracking down relatives can stall care. Connie describes patients from England whose families had to be reached overseas.
• A directive on paper keeps medical decisions out of family arguments. Connie describes siblings who weren't speaking and were fighting over the house, while their mother's care was already settled by a directive she had signed three years earlier.
• The holidays put the whole family in one room, which makes them a practical time to agree on a loved one's care.
• When a parent has dementia, repeating "I want independence" doesn't mean they can still make safe decisions. Someone in the family has to become the advocate.
• A directive can be changed at any time. Connie compares it to life insurance: have something in place now and revise it as your life changes.

"You gotta tell people your wishes." (Connie)

"We're not here forever and we have to at least have something in place." (Connie)

"Death is scary, but it's also a part of life." (Lindsay)

"Mom, it's our turn. It's our turn to take care of you." (Connie)

"It's like life insurance. At least you have something in place." (Connie)

If this episode got you thinking about your own paperwork, follow Unfilter Caregiver so you don't miss the next one. A rating and review helps other caregivers find the show. Share this episode on social media, or send it to the sibling or parent you need to have this conversation with.

findinghomecare.net

Have a question about advance directives, a reaction to this episode, or a topic you want covered? Send it in through findinghomecare.net and it may come up in a future episode.

Timestamps and TopicsKey TakeawaysQuotesCall to ActionLinks and ResourcesListener Questions

Mourning Someone Who Is Still Alive

My mom was diagnosed at 52 and given eight months, so we knew by August she would be gone, and I spent every one of those days grieving her while she was still sitting across from me. She wrote me a journal before she died, and in it she told me I ruined some of her last holidays.

This one is personal. I talk about the eight months between my mom's diagnosis in November and the August we were all counting toward, the baby blankets she made for grandchildren she would never meet, and the journals she left for each of us. I read what she wrote to me about the holidays I made miserable, and I have carried that ever since. I also compare it to losing my dad, which happened in a matter of days, and why watching someone disappear slowly was harder for me than the loss that came without warning. My co-host comes at it from the caregiver side, the client she had for a year who cycled on and off hospice, the photos and silly videos she still cherishes, and the families she has walked alongside who all cope in completely different ways. Some children want to be there constantly. Some need distance. Neither is wrong. We get into what it means that caregivers are often the ones present for the last month, picking out the outfit, hearing the music someone wants at their own funeral. I tell the story of my first client, six years with that family, and the tombstone they asked me to choose three weeks in. If you are grieving someone who is still here, this episode exists because we know that is real and we know it is hard.

CHAPTERS

0:00 What mourning someone who is still alive means

0:30 My mom's diagnosis at 52 and an eight month countdown

1:14 The journals, the baby blankets, and what she wrote to me

1:55 It is not only terminal diagnoses that start this

2:45 Losing my dad overnight versus watching my mom decline

3:37 How caregivers support a family through that stretch

4:05 A year with one client and the hospice cycle

5:02 There is no right or wrong way to cope

6:41 Six years with one family and picking out the tombstone

7:23 Why we wanted to put words to this

KEY TAKEAWAYS

Grieving someone before they die is common and it does not mean you love them less or gave up on them.

A timeline turns ordinary holidays into last holidays, and that pressure changes how people show up at the table.

This is not limited to terminal diagnoses. A dementia diagnosis or a progressive illness can start the same process.

Coping looks different in every family. Some people hold it in, some let it out, some need distance, and none of that is a failure.

Caregivers are often present for the final stretch, handling comfort, last wishes, and details families are too depleted to face.

Take the pictures and the silly videos while you can. They become what you keep.

QUOTES

"I was watching my mom disappear for eight months." - Lindsay

"Everybody has their own way of coping." - Lindsay

"We know that you have to go through all of these last holidays and events." - Lindsay

"There is no right and wrong." - Caro

"As caregivers, we're usually the ones who are there." - Caro

If this episode put words to something you are carrying, share it with someone who is in it right now. We are here to educate, have some fun, and answer the questions about the senior arena that are hard to ask anywhere else. #AnticipatoryGrief

Website: findinghomecare.net

Company: Finding Home Care LLC

Listen: Spotify and Apple Podcasts

LISTENER QUESTIONS

Have you found yourself grieving someone who is still here, and what helped you carry it?

If you are a caregiver, what is the moment with a client you still think about? 1