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My father died a month before COVID hit. When the ALF in which they lived was about to quarantine my mom so soon after his passing, she asked to be brought home, which we did immediately, thinking it would be a short time situation. Mom is 91 and went on hospice shortly after Dad died. She isn't "terminal" but she wants no further life-sustaining treatment if she has another heart-attack, etc. Hospice care has been superlative. We should treat all our elderly so well.



We also have an in-home caregiver who we hired some months after mom came home to live with my sister and BIL. Sister had gone back to work (she'd been home during lots of the COVID lockdown season) and BIL is quite disabled himself, so more companionship, meal-prep was needed. We did not think this would be a long-term arrangement but it has become one.



Caregiver is 55 years old. I live down the street and handle mom's financial business while sister handles more the medical/day-to-day stuff and mostly we all manage together pretty well. But caregiver's health is in decline and mom's needs are not going away. Instead, they are growing with each passing week. We have come to love Caregiver, and have always tried to treat her as fairly as possible, and have paid her 50% for sick time. I didn't want her to be motivated to come to work if she was unwell for fear of passing something to mom. But she is now getting to the place where she is sick a lot. I paid her for the month of December at 50% when we didn't see her at all, except when I went to her home to pay her and check on her. We have reduced her hours to try to reduce the strain on her, hired another person to cover some of those hours, and reduced her responsibilities in the home to try to help support her health. Her family needs the income as much as we need her.



But I think (as does sister) that it is probably time to let her go, but boy I hate to do it. She loves mom. Mom loves her. When she is there she manages mom's needs/demands and supports her well. But her well-being is a constant question and her attendance is becomeing more and more unreliable which pushes back on us. She really needs to not be working, but her family is not in a sustainable position without this income. So I am between a rock and a hard place.



She is our employee, not a family member, so I know that I need to have better boundaries. We'd hoped that she would arrive at the conclusion that she can no longer work, but I just don't think she'll do that.



It takes such a village to care for an elderly LO, and our mom is in darn good shape by comparison to so many. I've suggested to sister that maybe mom should return to ALF but she is opposed (as is the far-away sister who calls mom nearly daily and helps meet her social needs from the other side of the country). There are four family members (sister, BIL, me, my husband) plus 2 caregivers on our team, but man, it is hard to manage when even one is out of sorts (and our family has enough challenges without those we employ having troubles). I can't take responsibility for Caregiver's family's survival, but I feel pretty awful making their situation worse, and letting her go will really do that.



I also find that we're the opposite of many of those I see on this board. Sister/BIL live with mom (it is mom's home) and they're the ones who believe they can continue to manage with her there (with our help plus hired help). I'm down the street and it is getting to be too much for me. I do feel like a weakling in that way.



Anyone have any compassionate ideas for how to let this lovely person, who has given us incredible support during this deeply difficult world and personal situation, the word that it is time for us to move on in mom's best interests? How would you all handle this? Maybe this is all TMI and I just needed to vent. Any suggestions are welcome.

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I’d consider a 2000 severence if you can afford, but the message should be the same. Mom now has more care and will be ok.
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Vanistan Mar 2022
Thank you--
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Bottom line is she came into your life as hired help and she knows full well that all caregiving comes to an end, you have been beyond generous and have nothing to feel bad about. I think you have to let her know that since your mom's needs are increasing you have decided to hire more care and that you won't be able to carry on with paying her for no service. If she's as wonderful as you say she already understands this and maybe even feels guilty for taking advantage of your generosity, if she reacts badly then perhaps that tells you a different story. Do let her know that she is always welcome to come and see your mom as a guest.
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Vanistan Mar 2022
Thank you--
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Thank you for what you've done, we'll take it from here.
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Vanistan Mar 2022
Thank you--
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Vanistan;

There is social safety net that your caregiver can apply to for financial help for her family. YOU are not that safety net.

A nice serverence check would be nice if mom can afford it, but don't feel that you need to support this person ad infinitum.
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Vanistan Mar 2022
Thank you. I need to let that take over.
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First off, your mom IS terminal or Medicare would not be paying for hospice care which is incredibly expensive! A patient has to be evaluated and thought to have 6 months or less to live in order to be qualified for hospice; then reevaluated every 6 months in order to REQUALIFY for hospice care once again. My mother's hospice bill for 45 days was over $14K! There also has to be a Medicare approved 'reason' for hospice care before they will approve it. The reason cannot be "not wanting any further life-sustaining treatment'; it has to be a terminal condition such as cancer or heart failure, etc. Unless you have contracted privately with a hospice company & are paying them out-of-pocket without Medicare footing the bill, that is to say.

As far as letting your caregiver go, with compassion of course, the bottom line is this: the woman is no longer doing a job for your family but is STILL getting paid! That is not sustainable for anyone, under any circumstances, for more than a few months. You have been very kind to have been paying her at 50% salary for all this time, and she should be very grateful; I know I would be, if I were in her shoes! You need to just be truthful with her now, and say that your mother can no longer AFFORD to keep paying her, that she is no longer in good enough health to keep working in such a strenuous job, and for those reasons, you need to terminate her employment with you, as much as you like her & appreciate all she's done for you over the years. Thank you so much, but now this situation is no longer viable for EITHER one of us, if the truth were to be said. Of course she's happy to KEEP taking money from you, the woman is not stupid!

I have a neighbor who's been paying her housekeeper at 50% wages since 2020, when the plague first broke out. She's still too afraid to have this housekeeper enter her home to actually CLEAN, but she keeps paying her b/c the woman 'needs the money.' Okayyyyyyy, to me, that's ridiculous. To me, either have the woman clean your home or terminate her employment. That's how business works. This is not a friend or a charity case, but a business arrangement that my neighbor is foolish to perpetuate, but the housekeeper would be foolish NOT to allow to BE perpetuated! To her it's a win, to my neighbor, it's a lose.

You have every right to terminate this CGs employment now, with your best wishes & highest reference, and even a small gift of appreciation to show your gratitude for a job well done. But enough is enough already! I wouldn't give her a severance paycheck either; she's HAD one for all this time, when you think about it!

As far as the 'far away sister who is opposed to mom returning to the ALF but who calls mom nearly daily and helps meet her social needs from the other side of the country' goes, how exactly is she meeting her social needs by calling on the phone 'nearly' every day? That's a joke and being opposed to her returning to the ALF is irrelevant. The social stimulation your mother would receive in the ALF is likely to be SO beneficial to her and to YOU that it would take a load off of everyone to get that ball back in motion. I am totally convinced that my mother lived to the ripe old age of 95 precisely BECAUSE she lived in Assisted Living and had people fawning all over her 24/7 and activities to keep her busy all day long, every day. Even in Memory Care, she thrived as a result. A few family members at home can never duplicate the social environment that takes place in an ALF, and your sister is kidding herself by thinking her phone calls do such a thing! Meanwhile, YOU are living down the street and doing the boots on the ground caregiving, not your sister! Hello? YOU are the one with a bigger voice in the decision making process here!

Wishing you the best of luck with all the decisions you have to make going forward.
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Vanistan Mar 2022
Thanks for this. OR sister at first said that if we think that putting mom back in ALF is the right thing, then we should fly her to OR and let her live with them. I told her that was non-viable. Agree that her input is minimal, but she does call, email, facetime and send pictures. I find that because the sister and I who live here are so busy doing all the business, that the just sitting to visit/interact is more limited. That's why I like ALF. They do the food, the medicine, the activities, and when we're there we TALK! But local sister isn't having that either. Thanks for the moral support! This is hard no matter how it goes!
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I would not give a lot of reasons, in all honesty. It is something I learned from my partner who managed his own business. Giving reasons can get you argument, and can even get you taken before a labor board for discrimination of one type or another.
You say you love this person, but this person is taking 50% salary from you when not showing up for a month. So I am thinking you need to consider if this love is going one way only, because in all honesty THAT IS NOT RIGHT, and this person, were she being upright and honest with you should long ago have come to YOU and say "I love your Mom and I love you and I hope I can still visit, but this is no longer fair to you. You count on me showing up and I am not always able to".
If you wish to give some help and support to this woman, that is up to you if you can afford to do so. But right now this is not a good relationship of employee/employer. When you make friends of those who work for you, outside of bright and sunny politeness, you are muddying waters in a way that can definitely come back to bite you.
I would give written notice that as of (give date) you cannot any longer have her in your Mom's service. That you have enjoyed her and that you hope she can remain friends.
In all truth, if this woman is bringing illnesses into the home this isn't good for your Mom.
If she asks to talk to you I again would not focus on reasons other than to say that you need someone who can be more reliably counted on to be there during working hours and working days and that Mom is in a condition that you can't have her exposed to illnesses. That you are making decisions for Mom's care and her safety, and that it has nothing to do with personal feelings, that you enjoy her and hope she will visit anytime she feels like it and feels well.
Again, don't mix up hiring people and friendships. It makes it so difficult for everyone involved.
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Vanistan Mar 2022
Thanks. She hasn't brought any illnesses in to mom. But during COVID, she was coming and going so we were mindful about that. Her health issues are chronic. Diabetes, heart attack, eye problems, dreadful allergy issues. But you are correct that we've muddied the waters.
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She and her family should apply for government assistance if she is unable to work from being disabled.

You can’t carry her financially indefinitely. So, if I were in your shoes, I would give a final check as generous as I could afford and with a sincere thank for her service.
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Vanistan Mar 2022
Thank you... I expect that's where we are now.
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I agree with the others who have indicated you should place Mom in a facility. My sister and I along with my brother did this when it was apparent that Mom needed more care than we could provide. Mom is also on hospice and her physical health right now has stabilized but with CHF, Afib and other problems, she is 1 incident away from being terminal. Mom is as happy as she can be with her dementia. Every day is a new beginning. We also let our 2 caregivers go and gave each of them a small personal gift along with a handwritten note. You cannot go down the road of feeling responsible for this caregiver. Help her family become aware of the programs that are available to her. Can she qualify as a veteran spouse or veteran? If it is not too late, an elder attorney may be helpful. Describe your situation and perhaps you may receive some free advice. Good luck to you and your family and prayers all around. PS: Take time to take care of yourself. It is critical.
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Vanistan Mar 2022
Thank you for your helpful and kind response. Much appreciated—
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It's always difficult letting someone go, especially if they have been loving and helpful when at their best. Can you help her contact a social worker? She may be eligible for disability benefits, Medicaid, food stamps, etc. if she's unable to work. Is there any possibility that she'll get better and will be able to work again on a regular basis? If so, perhaps you can arrange to hire her back when she's better. It sounds like your sister/BIL need the help and will want to replace her. If that's the case, be honest with her that you need someone to help out with your mother who can work the hours she needs. In lieu of a couple of weeks notice it might be best to give her a month or more of severance pay. Write her a wonderful letter of reference. Tell her how well she did.
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Vanistan Mar 2022
Thank you for this kind response.
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Vanistan: Unfortnately, this caregiver is no longer able to fulfill her employment 'duties,' if you will and she is or was still receiving a wage, per se. This indivivdual should have realized that her health is such that she can no longer perform her duties. However, as she did not, you'll have to terminate her employment. That was VERY generous of you to supply her with pay even though she wasn't well enough to perform. This is certainly not a pleasant decision, but you cannot afford to support her financially, sad as it may be that her health has deteriorated.
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Please schedule a conference with this aging caregiver and let her know that you are concerned that her health issues are making it hard to retain her as a caregiver. Suggest a generous termination date in 1 month(?), severance package, give her an excellent referral letter, and - if possible - suggestions for other employment options that would be less physically demanding and provide an income.
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I've worked private duty in-home care for a long time now. From time to time I've had to bring in additional help on jobs when a client needed more hours or round-the-clock care. I always work with a good crew of caregivers and know all of them personally.
I had a client who at the time also needed someone to come for maybe an hour or so in the PM to heat up dinner for them and the spouse, make sure the couple took their pills which were pre-measured by me and put into cups, and helped the wife wash up and get ready for bed.
I brought in a friend of mine who had never been a caregiver. At the time this was all they needed. My friend needed the extra money. She's decent and honest too.
Well, about six months or so in, the job started to change. The client was no longer using a toilet and was now in diapers. She couldn't walk and now had a wheelchair. Her dementia had advanced very quickly. Now it meant getting her up and in the wheelchair for supper, etc... The husband started needing more help too.
For a little while my friend was managing. She wasn't getting the woman out of bed for supper. She wasn't correctly positioning the client in her bed.
I'd talked to her several times about the work MUST get done and if she was unable to meet the needs of this ever-changing care position, she'd have to go. The family wasn't going to hire another aide to help her. I wasn't going to work more hours to do the grunt work for her so she could stay.
The wife really liked her but she had to be replaced with a caregiver who could do the work and meet their needs.
You are correct that you can't take responsibility for the survival of the caregiver's family. This is what social programs are for.
If your mother's caregiver is unable to adequately meet her care needs she has to be replaced.
There is no wiggle room in the caregiving field. A person has to be dependable because the client care needs have to be met every day whether the hired caregiver is sick or not. The client isn't going to get themselves out of bed or change their own diaper because their caregiver can't physically do it anymore.
Your mother has to have a caregiver who can handle her care needs. The one you have cannot. Give her a severance if you're financially able to and ask if she'd be interested in fill-in work for your mom.
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My state is an "at will" state meaning an employer can let you go at any time for any reason and not give u an explanation and it goes the other way. You can quit with no explanation.

You have gone over and above what u needed to for this employee. When she was out tge whole month of December that is when you should have told her sorry, we need someone here for Mom. I think $2000 is a little steep for someone you have been paying and not doing the job. I may give her one weeks pay but really, I think you have done enough.

Like said, keep it short and sweet. Just tell her its been decided, with a heavy heart, that you can no longer employ her. You need someone you can count on to care for Mom. That is just not happening.
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I once encouraged a good, long-standing employee of mine who turned into a nightmare due to personal issues at home to resign, suggesting she state in her resignation that it was due to family matters. I was stunned how quickly she latched on to it. She needed to work, but apparently didn't want to be terminated (or didn't know how to quit "me,") and she knew her quality of work had been suffering greatly and I had given her plenty of time.

I never liked terminating people or giving any negative observations on their reviews, so it was my habit to address any problems prior to an evaluation so they had an opportunity to correct the behavior(s), receive a better eval.

It's unlikely your caregiver will latch onto a suggestion to resign (but I guess you never really know if they will--I actually had it happen twice over the years).

But have you talked with her about the time she misses at all? You've shown support in ways that are remarkably compassionate and generous, and that either leaves her to believe all is well, OR b/c you've been so kind, she'd feel guilty in quitting. (People don't quit jobs, they quit managers, as it's said, but also, some people don't like to quit a manager, as I previously mentioned.)

My last job was caregiving. I'd become very weary working with the client and their spouse; they were both abusive. When I got sick, they held my spot and pitch-hitted until I could recover b/c they liked my work--------but I really wanted to be let go for obvious and understandable reasons. After two-plus months, I had to resign myself.

I would suggest having a discussion with her. See where it lands. Your generosity has spoken volumes about you, and a reasonable person will be able to understand how their situation creates additional situations for YOU.

Just thought of this: If you were paying her 50%, that's quite a deduction of pay for a person who lives paycheck to paycheck. Maybe not feel guilty letting her go since aside from your unusual sick pay for a caregiver, she was able to make it. Huh.
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JoAnn29 Mar 2022
Liked your response.
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Have a frank talk with the caregiver.
Tell her that "mom's needs are increasing and she is needing more help than you will be able to give. I would like to hire someone else but I would like you to train then and show them how you care for mom." "We do not want you to get hurt caring for mom and we do not want mom hurt if something happens"
Give the caregiver a week, 2 at most to train the new caregiver and if you wish give her 2 weeks salary and a letter of recommendation.
The caregiver is well aware of her health issues and she knows that caring for mom will be more than she can handle.
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Just say you need a higher level of care for your mother than what can be provided in the home. Nothing else. No mention of her disabilities or inability to do the job. Give her a reference letter if you feel she deserves it. No need to pay severance $$$ for not working.
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