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We've decided it is time to place dad in nursing home. We have been blessed with super human caregivers for dad. They are retired RN's who work for very little pay. One has been with us for over 6 years and started a few hours a week. She is extremely flexible and generous with her time and has become invaluable through our journey. She even did 24/7 for a short time while we scrambled to find help when our needs changed. I moved across the street to take 12 hr shifts until we found our second angel about 3 yrs ago. Now I was able to stay evenings and weekends. Mom and I were able to manage until Jan of this yr. But mom is physically unable to take care of him by herself and I am 60 and disabled (back) so while we could manage with the 2 of us, neither of us should be doing it and it has come to a point that we are both in so much pain and his mobility is severely limited so it takes 2 people to get him out of bed or a chair or the toilet (which he only uses occasionally now). We hired a weekend nurse for 12hrs a day so I could take a break but I still am there 3hrs every nite and 12hrs at nite on weekends. Even the nurses now need help to change him, the bedding, and the showering or bed bath. That means mom has to help them when I'm not there. In addition to all of this, she lost 2 sons since this caregiving and the last remaining brother is in his final days or even hours (all 3 my brothers). My only remaining sibling is a sister who lives thousands of miles away. She comes as often as possible, but she has a demanding job and is not in very good health and has grandchildren with serious health issues as well. We have all agreed that it is time for dad to be placed in a facility. We have done all we can and feel that we have kept him home as long as possible.
Our angels are, of course, emotionally invested and very attached to the family. They work so hard for so little because they know that is all we can afford. They cover for each other and for me and we know they will be devastated. The one who has been with us for 3 years is also completely dependent on the income. She does the day shift and the majority of the work. They all live in the same complex as us. I think they think we have money and they know we have long term insurance but that only covers about 1/2 of their pay. The rest is out of pocket for my mom which is why I was covering about 70 hrs a week. The nursing home will cost much more and the insurance max will be reached very soon. Then Medicaid will kick in. We want to do right by these women. What would be appropriate for severance pay? I wish we could give them a million dollars but the truth is whatever we do will be out of pocket and that pocket is no longer very deep. Paid caregivers please advise me.

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i don't know how many paid caregivers there are on the forum now but i do know they are frequently treated very shabily when the time come to let them go. they just get told one day we no longer need you and we will send a check for the days you worked this week. It would be very nice if you could afford a months pay for these exceptional caregivers.
You may not know exactly the date dad can go to the nursing home it depends on the bed availability. i would sugest you find out how long the waiting list is before you say anything then tell the caregivers. let them know the approximate date and promise them whatever you can afford if they stay till Dad is placed. You can confide that LTC will be running out soon and Mom is worried about her future when she no longer has Dad's income to depend on due to Medicaid.
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I think a 30 day notice would be nice or sooner. Anywhere I worked it was 2 weeks severance but one month would be really nice.
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I can tell you that it is quite usual in terms of redundancy for that is what they effectively will be it is calculated as follows (subject to a maximum 20 years' service) in the UK
1.5 weeks' pay for each complete year of service after reaching the age of 41;
1 week's pay for each complete year of service between the ages of 22 and 40 inclusive;
0.5 week's pay for each complete year of service under the age of 22.

so about 9 weeks for 6 year service PLUS their notice period -

NB This is what they would get if they were in a government paid position in the UK

HOWEVER The US has no such statutory rights and there is no requirement to pay severance pay as I understand it therefore you might want to pay them a month in lieu of notice
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Joan, since they have been with you so long and have done such a good job, I would give as much notice as I could and one month severance. This is if you can afford it, of course. I hope that they continue helping until your father is placed, but know they may have to move on if the opportunity presents itself. You were so lucky to have such good help when you needed it.
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BTW, I am not a paid caregiver, so please ignore. :)
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I think the UK calculations are more like a pension. In the US that would be a buy out. Companies in US don't give that kind of severance. Depends if u have a contract otherwise they give enough to help till unemployment kicks in. I think a month is reasonable and maybe a personal gift. Being his caregivers they r aware of his decline and realize this day would come.
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The calculations are only used for redundancy - ie where the post is removed. That applies to all companies where contracts have been issued - just for clarification
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You should give at least 2 wks notice, 4 wks is better however you run the risk that she finds another job before 4 wks...and then you have no help....It would be great if you could pay severance of 2 wks or more, but, the Medicaid application process prohibits gifting, so any type of severance may be viewed as such (which makes me sad). I wonder if you could purchase gift card to their favorite grocery store (oh that sounds so lame, I know) but perhaps that would pass the Medicaid sniff test? I hope someone here can offer more pleasant prognosis Re Medicaid but it seems you would end up paying 2x for the gift of severance, once now and another time when Medicaid denies assistance for that month's worth of severance they say is a gift. Tough situation!
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On the positive side I am sure that the paid caregivers must also realize their patient needs nursing home placement so they won't be "surprised" when you give them the news. You could also give them 2 written things -- 1, an excellent recommendation letter & assurance you can be used for reference, and 2, a brief outline of the finances and impending Medicaid application so they know you're not being cheap but just cannot offer severance. I don't think you can risk it.
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Thank you all for your advise. I do plan on telling them as soon as we have a date or at least 2 weeks or more. My mom is a bit frugal, so my sister and I may try to come up with severance without telling her. She sees it as paying double as she would have to pay the nursing home as well. My sister is much better off financially than I am so it will come down to how much she will kick in..she is, however, very generous so I am hoping she will agree to a month. I know most are treated shabbily at this time and I really do not want to look cheap, but I also have to be realistic because it is not my money. We also have our youngest brother dying imminent so it is all so emotional. I know the right thing to do, I was just trying to make sure it is not insulting to the angels who have sacrificed so much for us. We realize that at least one of them may have to leave as soon as she knows because she needs a job. We will keep her as long as possible, but understand we owe her the opportunity to take advantage of another position if she can get one. Thank you all so much for your support during these last years. This site saved me on so many occasions and I wish you all the best. I will continue to come to this site for a long time to come.
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One thing, these are private independent contractors. They were approved for our long term insurance purposes but there are no contracts. They won't be eligible for unemployment. Although we gave them small bonuses of cash on the side throughout the years, they didn't get paid like we were their employer. Unfortunately, they would probably have to sue us to get unemployment and while I suppose they would win (and then overtime pay, etc would come into it) I really don't think any of them would do that.
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One thing, these are private independent contractors. They were approved for our long term insurance purposes but there are no contracts. They won't be eligible for unemployment. Although we gave them small bonuses of cash on the side throughout the years, they didn't get paid like we were their employer. Unfortunately, they would probably have to sue us to get unemployment and while I suppose they would win (and then overtime pay, etc would come into it) I really don't think any of them would do that.
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Its nice that u feel the need to do something for these nurses and I commend u for it. But, these woman are very aware that "a time will come" that they will have to leave. So don't feel too bad. If they are like u have said, they will appreciate anything u do for them. Good Luck with your Dad and prayers for ur brother.
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