Here in L.A., the costs for private home health care is prohibitive, through an agency it is $28 an hour. Many friends have had experience hiring otherwise, for $15-20 per hour, from recommendations or ads in the paper, but then you are the employer, not the agency, and have to abide by government rules, pay their social security, carry liability for them, and maybe a few other things. And in neither case can they give meds. For that you need a higher level aide, and the costs goes up from there. Medi-Cal allows Mike a certain number of hours a day for a care-giver, at this point he is almost at the max, and the three girls share the job.
Some of my friends have aides who are wonderful and become part of the family. And yet the Parkinsons organizations I've talked to about the situation say to be very careful, that it is best to go through an agency who vettes them and who may be responsible. It's been a while since I look into it, so this is just off the top of my head. One of the fellows who speaks often at our meetings is from Bright Star, I think that is the agency our Parkinsons group recommends.