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How do I decide if I need an aide?

My mother lives in an assisted living facility. I have my concerns, but I can't move her elsewhere. I am trying to decide whether I should get a private aide in a few days a week. She currently has a nurse, an occupational therapist and an aide coming in thru a home heath care company because the doctor ordered it. The nurse comes in 2 times a week, as does the aide.


They have told me that when they have gotten there Mom's diaper was way past needing changing. I have spoken to the facility and they do better for a whille. She can't get out of bed herself and it take two people to move her. She also spends more time than she should in bed in her apartment. Mom tells me they don't ask her if she wants to get out of bed and go to the dining room for lunch. They say they always ask and she usually says no. I do believe them on that. She was never very cooperative with the aides when she lived at home.


I can't get over to her see her as often as I'd like. Even if I did 3 time a week for a few hours, it's expensive. I don't if it's worth it or how to decide.


I also don't know how to handle certain doctors offices. Mom can't get onto the exam table herself. I can't get her on there and the offices don't have the staff to do so. Do I hire an aide for those visits and hope she and I can move her without hurting her or us?


I know I rambled a little, but I am so anxious about this and just don't know what to do.


Any advise would be so appreciated.



AARP Expert

@markbeth Hi Beth! So glad you reached out. It sounds like you have a lot on your plate and you’re doing a great job juggling it all! You’re thinking through solutions and It’s tricky when your Mom starts to need more care when in assisted living. I know it’s costly just to live there and when you add additional caregivers it can really push the budget, which poses a dilemma for you. 


First - the facility is your basic care. If they aren’t providing the care they promise that has to be dealt with first. It’s good you are talking to the facility. If there are basic standards they have committed to in terms of her care, they need to be living up to them. If they are supposed to check on her at certain intervals and deal with incontinence issues, they need to do so. Never hesitate to speak to the administrator! If that facility isn’t working,is there a better one she can move to? 


Of course the facility might be ok -it might just be a matter of your mother needing care above and beyond the basics they provide. 


A few things you might consider:


  • If she is refusing care, does she respond to you talking to her about it? Could you call her at the times she’s supposed to get up so you are a familiar voice urging her to get out of bed? 
  • You might consider hiring a private aide one or two days a week to start and see if it makes a difference. If you think it’s helping you could increase it. Sometimes even two hours at the right times can fill a gap and make the rest of the day go smoother. 
  • For the doc appts - I used to have that problem with my mom too! Usually I could do it with the help of office staff, but eventually I did have to hire an aide to come along. It made the doc appointment a lot less stressful for all of us! But also her doctor can order physical therapy for her that is focused on also teaching you the safest ways to transfer her without hurting yourself. My pardnts’ Physical therapist was SO helpful to my sister and I. 
  • Another option is home-based care. I eventually had mobile Doctors for my parents - as well as tests. They have had x-rays, ultrasounds, blood draws, swallow tests and more at home. You might see how much of your mother’s care can take place where she lives. It’s harder to find specialists who do home visits, but worth checking. In my experience, many docs aren’t even aware that so many tests can be done at home - we caregivers need to educate them!

Honestly, when I faced what you are dealing with when I was caring for both of my parents at once, I moved them in with me. We couldn’t afford assisted living + the extra care they needed. It was actually less stressful for me as I had more control and could provide more care myself. I hired a live in caregiver to help 5 days a week. That solution won’t work for everyone, but it worked out well for us. My Mom died 5 years ago, and my Daddy just 5 months ago. 


Just a reminder to, to be aware of the stress you are experiencing and the need for you to take some extra care of yourself right now. Your car can’t run on empty and neither can you so you have to do things to continue to fill your tank on a daily basis!


 Your mother is so lucky to have you! You’re doing a great job and remember that the true success as a caregiver is just continuing to try to find solutions, sticking with it, being there for your mom. It’s not going to be perfect but it is going to be your best and that’s all anyone can ask for. There is no such thing as a perfect caregiver! 


 Please let us know how things are going and if you have any other specific questions. Feel free to message me directly as well! 


Take care,

Amy Goyer

AARP’s Family & Caregiving Expert

Author, Juggling Life, Work and Caregiving


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