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Here is our situation. My daughter has terminal cancer but at the moment she does not need full time care. We (my wife and I and our son-in-law) can look after her between ourselves most of the time. At the moment, our needs are for someone (and this person doesn't have to be a nurse, just an empathetic understanding caregiver) who can come out occasionally to spell us off. Thus far, all the commercial services seem to require a minimum commitment of 4 hours / day, 5 days / week at 50 / hour. Do the math and that's over 4000 / month. I wouldn't have a problem with that if it were necessary but at this stage of her cancer we don't need this much care. Where can we find someone in Marin County, California who can come out on an as needed basis?

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You won't find anyone to come as needed. You will have to schedule the caregiver.

Talk with everyone you know and ask if they know anybody that is an independent caregiver. This will be as close to "as needed" you will find. They will still need to schedule the time but, they won't require 5 days a week.
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ttibsen Jul 2022
How depressing to learn that this particular niche in home care is not addressed. You would think that at 50 / hour, there would be folks taking advantage of providing their services in this area. As for talking with everyone that we know, none of them have anything remotely serious to deal with in the way of health issues as we have, so it would be an excercise in futility to canvas them.
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Is your daughter on Hospice. If not you may want to check it out. They usually provide an aide 2x a week to bathe the person. You can see,if a Hospice in your area can provide more aide time.

If she is not on Medicare, check with her health insurance to see if they cover Hospice.
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ttibsen Jul 2022
Thanks JoAnne - yes she is enrolled in the Hospice program and yes there is an aide who comes not twice but once / week. As helpful as this is, we still need someone who can show up on an occasional basis but as you have seen from "Isthisrealyreal"'s reply, it doesn't look like we're going to get such a person. There is no problem with Hospice being covered in her case so that's a plus. It looks like we'll just have to soldier on as a family until such times as her situation worsens to the point where the 4/day, 5 days/week does make sense.
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Check to see if your community up there has a Facebook page and ask for recommendations for private caregivers.
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ttibsen Jul 2022
Thanks for this lead ! I never thought of putting the problem out there on Facebook but that's an excellent idea ! For me to inquire about my problem with acquaintances would, as I have said before, a waste of time. This however is a much better approach - so thanks, I'll follow up on it.
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If your daughter is on Hospice they can provide a Volunteer that can come. This is in addition to the Nurse that has to come at least 1 time a week and if you want a CNA will come at least 2 times a week. Also optional are the Social Worker, Chaplain and if the Hospice offers it therapies like music and art.
There is a Medicare requirement that a % of volunteer hours are provided the hours can be direct patient care of office volunteer work. So the Hospice HAS to have volunteers.
They can not do hands on patient care. but they can do a variety of other things.
Talk to the Hospice Social Worker or Nurse and see how long it would take to get a Volunteer set up. It could be occasional or it could be scheduled (I was sitting with a patient from 1 to 3 every Tuesday for a while. But I also have an occasional Volunteer sit with my Husband on 2 or 3 occasions. So whatever is good for your schedule.)
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tt, the 50 bucks an hour doesn't get paid to the caregiver, unless you private hire.

Think about this, you will pay me 50 bucks an hour but, I can't plan on anything else because you want me to be available as you need me. So, how much am I really making an hour to be available "as needed"?

I can't imagine how gut wrenching your situation is. I hope that you find someone that is precious to your precious baby girl and you can have some breaks.
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ttibsen Jul 2022
Isthisrealyreal - I never envisioned having someone around at my beck and call, always available whenever I called. Of course that would not be a viable model for a professional caregiver. I was thinking of home care being provided by persons for whom it was not a career - just a way to make a few extra dollars on an occasional basis when they had free time. Ideally the model would be exactly the same as driving for Uber. Those care providers who wished to participate, would enroll with a central agency of some sort. Then, when someone like myself calls the agency wanting someone to come out to the house from (6 - 11)AM next Monday, all participants would be aware of the posting and those who could handle the assignment would then be matched with me, the person who needs the service. It seems like such a useful service that I was sure that something like it already existed - but on checking into it, it was disappointing to find that this isn't the case
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Another idea besides Facebook, might be a local church or community group. You could offer the money to an individual, or even split between them and the group as a fundraiser. The advantage of getting a few people who know each other, could be that you phone one of them and if they can’t do it, they can check with the others who are involved.

A fair number of people would prefer not to ‘just spend time’ with a very elderly person with dementia. Be clear about your daughter’s age and mental togetherness. My 'with it' mother dying of cancer aged 78 was a very different proposition from a 97 year old.
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Contact the Marin Community Foundation.
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I hired someone while I was recovering from rotator cuff surgery to mostly help replace me as my husband's caregiver.
My friend had someone from hospice keep her company during the time that she was needed.
You may know someone who is currently hiring someone for their infirmed relative.
All this to say -
While these people are around delicately ask them if they know someone that they would highly recommend but can't commit to any more time than what you may need as well.
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Tibsen, there’s a number for Marin health services dedicated to the older caregivers taking care of their children. https://www.marinhhs.org/community-based-contractors
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You might try looking for someone who is a “companion” rather than a health care worker. A companion will assist with dressing, driving, ordering online, doctor appointments, scheduling all appointments and getting to the hairdresser. They often do a bit of laundry and cooking. They might stop short of toileting, but maybe not.
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