In our particular case me and my wife are paid staff now. When he was a child we could not be paid staff. We did receive minimal PCA services then. We had a couple of them unofficially adopted into the family.

Thankfully things have changed now. Parents, siblings, spouses can now be part of the paid staff. My wife and I have other work we do too. So we cover what we can. There are specific positions that are allotted for the different cares. Basically Personal Care Attendant, In Home Services, and Night Supervision. However all staff is PCA certified.

He has 1 guy/peer who does a lot to get him out in the community and activities. Sports games, pet shop, fishing, etc. and his nephew does a lot of gaming stuff with him too.

Since we have had many modifications to our home for him, and now updating it, we are looking into having it become a home for him and we may relocate eventually. Possibly have some live in staff too.