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The doctor says mom should no longer be by herself. She refuses to go to a nursing home and quite frankly I think they do less there than the assisted living facility mom lives in. I went ahead and hired some caregivers to be companions/sitters and assist her with some things so that she could recover and get stronger. The CNAs at the assisted living facility aren't able to be with mom all the time and she often is dizzy and can't get out of her chair by herself.
I ran into a situation now that I have been told that I cannot hire unlicensed, uninsured caregivers at the assisted living. I also have been told that by their nurse that they would not take mom back unless she had more help! They are trying to force me into hiring agency employees that will cost much more. They are claiming that the people visiting mom are strangers to them and do not wear badges. I think there are lots of people around the building coming and going that people do not know. I think that is unfair that they are forcing me to use an agency. If Mom had a friend or family with her, it would not be an issue. It's because we are paying someone to stay with her. I think they will be forcing us to terminate our extra help. I realize it could be a conflict of interest legally if I hired a CNA AS A CNA; but I'm not. These are just companions. What are your thoughts about this and how can I continue to get mom help outside of what the assisted living facility provides so she does not have to go in a nursing home?

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In the future, just tell the ALF that these visitors are friends who want to spend time with your Mom. If they are not doing anything medical or offering aid...they are just companions. It is none of their business where these "friends" are coming from.
Remember, ALFs are businesses and, of course, they want you to spend your money there.
Also, start looking into alternatives. My Mom's new place offers more services than the standard ALF and they have "buzzers" that she can ring if she is feeling dizzy or cannot get up...they are very accomodating.
I would be concerned, too, if the rules became to restrictive....you are paying a lot for your Mom to be there. You are not breaking any rules. They just need to back off.
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I would ask to see the rules. Read any restrictions on who can be hired carefully. If it is spelled out in the rules that all outside help must be through a licensed agency, and you (or your mother) signed a contract agreeing to abide by the rules, I don't see what resource you have. However, if only certain kinds of outside help have to be through an agency, then you may be able to point out that your hired help is not in those categories.

Since going through an agency may not profit the ALF at all (unless they own the agency) I think the most likely motivation for them is their liability.

Were you thinking of 24/7 companions? If the doctors think she should not be alone, and the ALF says more personal help is needed, they probably weren't thinking of a few hours during the day. Perhaps it is time to look for alternatives to the ALF.
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My daughter-in-law used to be a caregiver for a lady that lived in asst living, so I know it's possible. Maybe you've just got the wrong place for mom to live in. It's probably only about money anyhow. If you're hiring someone other than the people they say is ok, then maybe they're losing money through kickbacks or something. I'd call them on the carpet about that if it's true. But like Jeannegibbs said, take a look at their 'rules' and see for yourself.
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My question would be this "why does your mom need 24 hr care"? If she is requiring assist with transfers or lifting, feeding or med management this can be a tricky area for the AL. If she is dizzy and needs just stand by assist to keep her from falling, I don't see why a non licensed person can't help her. I see lots of variation from AL to AL in terms of companions but the bottom line is that they are responsible for her and they are concerned about their liability. How about setting up 24 hour care in an independent apartment? There are no rules if you are living in an apartment and arranging 24 hour care on your own. Good luck!

LuAnn
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As Jeannie & LuAnn have said & I agree, this is probably about their liability. My guess would be that there has been problems with this exact situation in the past.
If say, the sitter fell back and broke her hip while transferring your mom to the toilet, then who is responsible sort of issue. It is their facility and you have to abide by their rules or find another facility.

It might be good for you to meet with social services(rather than with the DON) to get a bead on what they feel is needed for your mom specifically, e.g. sitting up, getting dressed, cleaning herself. She may be at the grey area of not really needing skilled nursing level that a NH does (or should do) but is more work than what her AL allots for care.
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Great advice igloo. A social worker will look at this much differently than the DON. Your social work should be able to find a good solution for everyone. In the county I live in, our area agency's ombudsman program assist in the area of AL. You may want to google your county name, ombudsman and contact them for assistance.
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yes any friend or well wisher can visit your mom or stay with her to help her.she can call friends and relatives.
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These are not "friends or well-wishers", they are really contract labor paid for by a resident's family. If they are getting paid more than $ 599 a year, then Breitone needs to be issuing a IRS 1099 to the caregiver(s) too.

The issue for the ALF is that they are "unlicensed, uninsured caregivers" coming into an assisted living facility that has specific accountability standards to the state & licensing boards. What if a resident says 'Mrs Breitone's mom's sitter took my pain medication, watch, magazine.......whether it's true on not, whether the resident has dementia and not grounded in reality.....whatever the case, this is a real problem for a ALF.

Where I am (deep South) a lot of the residents have sitters. Not to do anything skilled per se but really for companionship (read to them, change the TV, most of them worked for the family in the past, & often their kids work for the family still,so they know the stories). The NH that I know allows this, requires that the sitter be bonded, has a visitor ID clipped on them at all times & takes their meals with the staff following the NH schedule, all which the family pays for (so no bringing in food). Perhaps that could work.
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I hired a retired nurse to come in and spend time with my Dad. As long as you are paying them out of your own pocket you can have anyone come in there. If they are so concerned about out side help with no insurance ask them which would be more expensive, being sued by you for neglect or injury or having a companion there to do the job they are unable to provide. My Dad is in assisted living in Massachusetts. I can't tell you how many times I have to speak to the staff about his needs and checking in on him. For the money I pay you would think this would never happen.
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Yes. My mom was in assist. living and a Snif and both allowed it since YOU pay for them unless of course they are friends or family.
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live with LOve peace and harmany
will change ones life
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As long as you are paying them out of your own pocket you can have anyone come in there -- that sounds logical, and it is, in an independent living apartment. But you sign a contract and agree to terms in a long term care facility. Just because one place accepts certain practices doesn't mean another one will. You need to start by looking at the specific contract for the specific facility in question.
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I worked for over a year in a retirement community and although we had nurses and CNA's available, residents and their families were still allowed to hire anyone they wanted or needed to hire ALTHOUGH those who came into the building were required to sign in so that we knew they were in the building. Check the rules and regs of the facility your mom is in and see if there is anything in the policies that 'forbids' hiring outside help. There may be a legal issue with medical aide being offered from someone who is not licensed, but otherwise, I don't believe the facility can bar you from hiring help for your mom. You may need to consult with the managers of the facilty or the licensed nursing supervisor. Unless you or your mom signed an agreement to use ONLY the facilities nursing facility or employees, you can hire whom every you wish. Don't let them "just say so", respectfully request to see it in writing.
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Just remember to be careful about who is chosen to sit with your parent at the facility. Having someone who is properly trained and knows what to do in case of an emergency is very valuable.
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Seriously, they can do what they want. If they have in their contract no uninsured or unlicensed CNA's, then that is what they want. They are private businesses.They could be afraid of liability, state laws may mandate or they could be looking at the bottom line. Whatever, they do have the right to set their own rules. You can find another AL if their rules do not fit your situation. I would shop around. And I personally wouldn't hire an uninsured or unlicensed person for my home. I know they are cheaper, until they get hurt. Then suddenly your savings go out the window.
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I am actually in the process of starting a business for this very thing, I work in a 5 star facility and I feel there is a great need for this,not a CNA or Private duty aide but more just a long visit with someone to help them through the day, interact and sing and read and the list goes on.
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Be sure you look at your state laws. Here in NY, even a volunteer in a facility has to be background checked.
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Activitiesgirl, my Dad had a caregiver from a licensed Agency while he lived in Independent Living and when he moved to Assisted Living. It really helped keep his day in a normal routine. And the caregiver was an excellent match for him.

The place where my Dad lived, the caregiving Agency had to be licensed, bonded, insured, have workman's comp for their employees, and show that the caregiver had passed their TB test and had proof of a flu shot. The facility didn't want outside caregivers roaming the halls if they didn't know who they were and what Agency.... it would worry the residents if they saw an unfamiliar face.
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My residents families have hired outside "visiting" for their loved ones, I think if families want this service they should have the right to it without resistance. I agree visitors hired should have TB and CPR certif , but its more about finding the rignt fit.
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