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Alex123

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Joined
May 31, 2014
Messages
128
Reason
PALS
Diagnosis
05/2014
Country
US
State
California
City
Los Angeles
I am currently taking care of myself during the day, but soon I may not be able to do so and my wife may not be able to take care of me 24 hours a day.
I wonder how much is the average cost of a nurse. (I am in California) At first I may need someone without much preparation, but later on, if I get a tracheostomy I will need more specialized nurses.
I'll appreciate your help,
Alex
 
Let's start with now, pre-trach. A CNA, NAC or whatever they are in Cali ("nursing assistant") would do you fine, or even a nursing student without one. It's a six-week course, after all. Those generally run at minimum wage in your municipality or sometimes a shade higher, esp. if you are in an out-of-the-way spot.

There are some threads on this if you search -- working with an agency vs. your own hiring, degree of difficulty of trach care (if reimbursed by insurance, "skilled," in real life "unskilled" folk are, of course, teachable).

Also see threads on where to post if you hire yourself (e.g. college/trade school campuses, social networking).
 
Thanks Igelb for your information. The first two years of my 4-year undergraduate study I went to what they call here a "community college" I remember there seeing some girls in front of the cafeteria that were studying to be nurses. So maybe that would be a place where I could find someone (to work as a nurse to make it clear:) . One of the reasons I posted my question was because if I get a tracheostomy, I would probably need 3 nurses during the week and that might be too expensive. I did talk with someone at a support group who told me about a place (I don't know how they call it) where they accept people with tracheostomy and they charge US$4000 a month. I would rather stay home if I can. Also, I may consider if some other option is possible in my case to avoid tracheostomy. But that is a different subject. Thanks again Igelb.
 
All the way over here in Chicago, it goes like this (according to my research):

Nurse: $50 an hour shift work.
CNA: $29 an hour if doing shift work.
"Non-skilled" Caretaker (live-in, meaning living at your home): $175/day.*(They must have a good night's sleep without too many interruptions).

From everything I've heard, you don't necessarily need a nurse, nursing student, or CNA. A good "non-skilled" caretaker, especially if they have experience with ALS, can do most or all of the necessary things.
 
Trainable, conscientious civilians, absolutely an option, students most of all -- we had only pre-health professions and health professions students. Some had CNAs, some didn't. Those rates sound like agency rates, Wings. Or else the Windy City is pricier than I thought. I am referring to hiring on your own.

And Alex, since many trach pts are taken care of by family, I think it's a mistake to presume the tab has to jump up at that point unless you are doing by-the-book reimbursed care.
 
Here in Florida a non-agency CNA will work for $10 an hour and there is a large pool of them.
 
Thanks all of your for the useful information.
Probably getting them from an agency guarantees that if one nurse doesn't show up they can send someone else. But on the other hand I can imagine that they may charge perhaps twice as much as I would have to pay hiring them directly.
Something that I didn't think before, is if when you hire someone privately they are considered employees and you have to pay half of their social security, income tax and give them a W2 or they are more like contractors.
 
There may be state law addressing this There was where my mother lived and they had to be treated as employees. You could hire a payroll service for a reasonable amount to take care of all the paperwork. Consider liability insurance as well.
 
The CNA and RN rates I listed were in fact agency rates. The rate of $175 a day I listed was for a non-skilled, private (not through an agency) live-in. Another price I got was $160 per day for a non-skilled, private live-in (with ALS experience).

All the best Alex123.
 
ALS experience is highly overrated. When you've seen one PALS, you've seen...one.

Ingenuity, compassion and diligence cannot be taught, though they can be modeled. Sort of.
 
Thank you. This advice is going to be useful for me in finding a caretaker for my mom.
 
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I know some friends who worked as caretakers while in nursing school. One of them still keeps in contact with their former client to this day. In good situations, real friendships are formed. I find with my patients where I work that making a connection makes care so much more worthwhile and helpful. Trust and being able to say what you need are highly valuable. Ask for references and follow up on them to find out if they'll be a good fit.
 
Thanks a lot for your advice Shepherdnurse. I'll keep it in mind.
 
I have become very good friends with one of the staff that came here to care for Chris. She had never helped with a PALS before, but she had wonderful communication skills, was diligent with care and wanted to learn. She was always our bestest worker, but we had a great team once we weeded out just a couple that were not suitable for our needs.
 
It depends on (1) where you live and (2) whether you use an agency. In the SF Bay Area it is expensive. Agency nurses cost $60/hr or more. But if you post a want-ad on indeed.com, you can easily find licensed vocational nurses (LVNs) for under $20/hr, based on experience. This is because the local nursing homes pay them $19/hr, and many would rather work for you than work in a nursing home. If you live in a rural area, it will cost less.

If you only need help with activities of daily living (transferring, eating, toileting, etc.), you can easily find certified nursing assistants (CNAs) on indeed.com for $12-14/hr. Again, this is how much the area facilities are currently paying them.

When your need for skilled nursing services such as tracheal suctioning or G-tube feeding becomes a big part of the job, you may find it hard to find CNAs who will stick with you, as most of them are looking for easier gigs. Also, unlike nurses, CNAs who want to quit have no legal obligation to stick with you until a replacement is available. So you are smart to plan for eventual nursing care.

Also, if you have a good health policy, your insurance may cover a lot of your care. In California, Kaiser commercial policies allow you to trigger hospice benefits as soon as any doctor gives you a life expectancy of one year or less (that's right--one year--not 6 months). Kaiser's hospice coverage includes 24-hour skilled nursing and home health aide care. Kaiser bean counters will fight to deny this coverage on the basis that you do not need nursing care, but California law requires a nursing license for tracheal suctioning and G-tube feeding, so you can expect to win that fight, as we did. So take a good look at your health policy and see what it provides.

--Dave
 
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