I need help in determining a rate of pay for my nephew and his wife to take care of my elderly mother. My mother is 93 years old and in sound mind. She uses a walker to get around. She is on oxygen and has recently developed other major medical problems. She may need to be put on palliative care soon. She needs assistance with:
-Toiletry and bathing.
-Shopping and meal preparation
-Laundry and maintaining a clean house.
-Medication administered and health needs monitored.
-Communicating with doctors and tracking her medical needs.
-Communicating electronically for online doctor appointments
-Transportation to medical appointments.
-Carried downstairs out of the house in a wheelchair for appointments.
-At night she may need to wake up someone to help her with bathroom needs or need for additional pain or sleeping medication. This may occur 0-5 times a night depending upon her difficulties (Average is about once a night).
-Always have someone in the house in case of emergencies or care needs.
My mother wants my nephew and his wife to care for her at her house and they want to provide that care. The proposal would be that they would be living with my mother at her house rent free with a stipend paid to my nephew and his wife for personal health care and a budget to cover her food.
My mother is currently paying my nephew and his wife ( Medical Asst Training) $100 a day each. She is also paying my niece (Physical Therapist Assistant student) $50 a day. My nephew’s wife feels that they are being paid far less than the value that they are bringing to the quality of life and care for my mother. My niece-in-law went out to local “for-profit” home care providers to find out the rate they charge for home care. The rate she came up with was $20,000. A month. This is what she is asking to be compensated to care. She is requesting to be compensated at $5000 a month now and $15,000 a month from my mother’s estate when she passes. They are also asking $1000 a month to cover food costs.
Currently my mother is paying $250 a day and has 3 people caring for her ($200 day for nephew and wife). On average this works out to $7500 month, ($6000 month for nephew and wife). My mother is not a rich woman. But thanks to my late father’s investments has enough money to live comfortably. Her monthly income including social security, retirement funds, and dividends from investments totals to $5570 a month. We have had to supplement this amount by an additional $4000 a month from the stocks to cover her currently monthly expenses including the amount she pays for personal health care.
Being the Financial POA for my mother they presented this proposal to me. My mother does not want to upset anyone and is feeling caught in the middle. My brother and I both feel that the current rate of compensation is a generous amount. My sister (mother of nephew) feels for all that they are doing that they should be paid more than $100 a day each but does not know what the new rate should be. Everyone but my nephew’s wife agrees that $20,000 a month is an extraordinary amount to be compensated.
We cannot agree or move forward without a Personal Care Agreement that would include a fair rate of pay for personal health care, food compensation, and location where the care should take place.
What I need help with is:
-What a fair and reasonable rate of compensation for my nephew and his wife to take care of my mother full time.
-A reasonable rate to be recompensed for food cost.
-If she should pay for any additional outside services such as house cleaning, lawn maintenance, snow removal etc. Or should it be covered for what is paid for health care?
-If my mother is paying for personal health care, should she have the right to say where that care should take place.
Thanks for your help.
The $15,000 from the estate looks dodgy. The caregivers should be paid as they go and not try to dodge payroll and income tax. The recipient may be able to deduct some medical related payments if she itemizes.
Using the for profit's $20,000 as a benchmark should also require matching their other assumptions:
- payroll processing
- payroll tax matching
- insurance (liability and workers comp)
- substitute caregiver pool
- no guests/pets in client's home; personal property allowed in bedroom if overnight
- meal prep may include eating with client depending on shift length
- light housekeeping, including client's personal laundry
I assume that you will take out taxes, pay SS, etc? Your mother becomes an employer and is responsible for maintaining Worker's Comp insurance and an adequate umbrella policy in case of injury.
You are, in essence, asking nephew and his wife to give up their lives and privacy. Are you sure they want to do this? Maybe they are asking this amount so that the answer will be no?
Find out what level of care mom needs from the local Area Agency on Aging (called a "needs assessment"). Is she at the point that she needs skilled nusing ($11k per month where I live) or Assisted Living with some add on services? Find out the cost for that. She would have better socialization in those settings.
What your nephews wife wants (she’s driving this notion, isn’t she) is beyond egregious. $20k PLUS free room & board, right?
+ $1000 for food. Just u wait Lil Missy is gonna be asking for a car...
Lil Missy is not professionally degreed in anything, is she? FFS 10k a mo is what a MsRN makes. She either a blatant opportunist or is really dumb as a sm box of rocks. I’d suggest that your brother gets a private investigator to run a bkgrd on her to find out which one it is.
On the “for profit bills 20k a mo”.... well the for profit agency actually pays their workers maybe 40-55% of the 20large. The company does full FICA, workmans comp, retirement, health insurance and Covid compliance. They likely also do some type of training, like w Red Cross to have their staffing certified. For 20K, the agency is able to cover all shifts should a scheduled worker have their own emergency, like that morning they a running a temp of 100 so cannot work safely due to Covid concerns. Nephew & his wife provide NONE of this.
Again 20k a mo + free R&B + food $ is beyond egregious.
None of the trio are professionals or have licenses, they are baseline workers. In the private sector, I bet they would get paid $10 -$14 hr with benefits taken out from the $, $20-25k a yr. Its a low wage job. Home health companies are always looking for workers, you can probably easily go onto your states Dept of Employment Security and look at jobs posts as what hourly wage places like this are paying. Caregiving is basically viewed as low skill scut work w/low wages, unless your degreed or licensed. Right now at $100 day every day, they are both making 36k a year, that’s a decent income in the US especially as they have no rent to worry about.
Question for you..... for last year when Lil Missy & your nephew & the niece worked to care for your mom, did you - as your moms DPOA - report all in moms 2020 taxes? And did you as DPOA have all 3 do W-9 & maybe I-9s? Did mom pay FICA on the wages?
If not, you might, might be able to get past this for 2020 taxes, but for 2021 you as moms dPOA must do all the reporting and FICA quarterly payments as per IRS regulations. IRS rules on household workers as being employees and NOT as contract labor is pretty clear. Its not just an IRS issue but if your mom should find herself actually outliving her money (it happens) and mom needs to apply to Medicaid to pay for her room & board at a facility, cause shes now 96 and her needs are beyond staying at her home is feasible for, then all that $$$ paid to lil Missy, your nephew & niece will be viewed by Medicaid as “gifting” by mom and make her ineligible for Medicaid for a long penalty period. Mom has to have a legit caregiver agreement and proper payment with FICA & IRS reporting to get beyond this. Medicaid has a 5 year lookback.
- They are performing a job and should be getting paid for hours worked with benefits and full reporting to tax authorities in the quarter or year of work. That’s how employment works in the US.
- Your mom can in her will put in a bequest to them (or whomever she wants to) but there is no guarantee that mom will die with assets or with enough assets to do a distribution as per the terms of the will.
- Getting old in America is very $$$$ expensive. At 93, she’s outlived the actuarial tables, so she could live to 94 or 104. If, imho, she gets close to 100 she could outlive her money between the costs of care and costs to upkeep her home & other assets unless she has for sure 1M+ liquid. Otherwise there’s risk might not be $ left in the estate.
Compensation:
Start with the basics. How many hours do they work and how much are they paid per hour?
Someone needs to be there 24/7. Most likely she doesn't have to pay for the caregiver's sleep hours unless they can't get at least 5 hours sleep straight.
What is the minimum wage? Given that she probably won't expect them to "work" during all work hours, starting your negotiation at minimum wage isn't unreasonable. You can consider what other perks she may be willing to offer.
An example: She needs 20 hours a day of paid coverage per day and the minimum wage in IL is $11.00 an hour. Live in caregivers cover 8 hours a day each. The other niece averages 4 hours a day over the week.
So:
Caregivers 1 & 2: 40 hours a week straight pay plus 16 hours overtime: $704 a week each. Payroll will have Mom pay her share of SS, Medicare, etc., so she is out of pocket something like $758 per week each or $8K a month for all three caregivers.
They will also deduct the caregiver's share and federal/state/local income tax withholding. I'm not going to try the tax withholding, but just taking out SS and Medicare give them a net of about $650.
Caregiver 3: 28 hours a week straight pay: $308 a week, with a net less than $285. Note that she works half the hours, but gets paid less than half as much because the other two get overtime for hours worked in excess of 40 per week.
The payroll service may be willing to run a few examples at various pay rates, or someone can pick up a payroll tax book at the library and build a spreadsheet.
Food costs
Would she prefer to set a weekly budget amount or review receipts? Give them access to a household account or use delivery/curbside from a store with a credit card on file? Is Mom on a special diet? Will she pay for beer or whatever pricey convenience foods she won't consume herself?
Outside services
These are negotiable. If she pays more or offers other perks, she should be able to expect more. For example, if they are able to work or study from home, they should be willing to visibly work for Mom too. If Mom is picky about how the work is done, she may prefer to keep her current providers. The caregivers need to be flexible about 10 minute tasks like changing a light bulb or picking fresh tomatoes from the yard, but may balk at a two hour project too many days in a row.
A few thoughts
Carrying her in her wheelchair downstairs doesn't sound safe to me. Is a ramp or assistive device feasible?
Spell out expectations. Will there be a probationary period to see if it works before they give up their current housing? How much personal property can they bring and what can they put outside of their room(s)? Can they have friends over? Do they have a pet or does Mom and will they agree on petcare rules? When/where can they drink/smoke/watch football?
Have an exit strategy. How will they know it isn't working anymore? How much notice does either side need to give? If they are "terminated for cause" do they have to get out right away, but if Mom passes or goes into care can they stay 90 days but have to pay for utilities and food?
Note: the wife may be extra cranky because she doesn't think her husband will do his half of their hours. So in my example she'd end up with all 32 overtime hours and he'd just do 40 hours a week.
If it makes Mom happy and she can afford it, I'd say build in opportunities for pay increases and respite care for time off. Keeping her in her home with 24 hour care may just cost more than institutional care.
Same in this case, mom can ask to have nephew and his wife to care for her, but if they are not willing to take the job for what you offer in pay then they are NOT available. Tell mom they won't take the job, they are not available.
Take mom to tour a few AL places so she can see what they offer. Mom will have friends her age to socialize with.
If you offer less than what the nephew and wife ask, and they reluctantly accept, they will NOT be happy with less money and it will reflect in their care of your mom.
It is very common for employees who think they are underpaid to underwork, underperform and resort to stealing to get what they think they deserve.
I would not keep the nephew and wife as caregivers.
I do think that $20,000 which comes out to $240,000 a year is a lot, that's $120,000/per caregiver a year. But what you're paying is $36,000/yr per caregiver is low. Check the rates in your area to find out what caregivers make plus over-time and see what the reasonable amount should be.
It's best to find outsiders, and have formal employment contracts with them. If they don't perform the job satisfactorily, they can be let go. With relatives, if you fire them, you ruin the relationship as well.
Increase offer to $350 per day total. (for nephew and wife)
Hire weekly maid visit (Like a merry maid) to handle some deep cleaning, laundry help.
Offer a food budget that everyone agrees on. Help with meal planning and shopping, and include extra for occasional take out.
Have your mom try a month at an Assisted Living (I say this because my grandfather who we thought really wanted the taken care of at home option LOVED his AL once he settled in and didn't want to come home, it allowed him to thrive in with supported independence that he treasured)
Handle the doctors appointments and managing that care yourself. Let them tell you when refills are needed and you prefill med boxes yourself (do 2 weeks at a time) decreasing the med management to giving pills at proper times
Get a ramp or moving chair on stairs.
Contact your local Elder Services and pay them for whatever services they will offer (Usually $25/hr for bathing visits)
Work out a coverage plan so that 1 weekend a month your or someone else comes in to give the niece and nephew respite time off paid.
$72K per year with no benefits or time off to work or be available 18 to 24 hrs a day for a couple is just too much to ask of them. If they were a service and you had 2 people working 12 hour shifts then maybe $36K each would still be low but acceptable. I think you need to really readjust what you are asking them to do. If you can not, it might be best for family relations not to offer the positions to family members. but $100 is really only 4 hours of basic manual labor.
From your list it looks like they are expected to provide 24/7 care. Who is relieving them for days off?
At 720 hours a month (24x30days) at $15 per hour is $10,800 per month, for the two of them. This is barely minimum wage where I live.
They should be paid their full wage each month. No waiting for the estate to reimburse them.
Yes, they would clean the house, no they should not be responsible for the exterior.
The bigger issue is what happens when she dies? How long will the kids have to move out, so the house can be sold?
I feel you are being extremely fair with your current compensation package. Rate plus room and board. It’s hard being a care giver but also an honor.
Also would POA need to get extra insurances?
They did everything you wrote except shop and pay for groceries, set up doctors appointments (but they did drive her), or handle med refills. She did not require lifting or a wheelchair (didn’t have stairs) but did require a walker. They did take her on outings such as going to the park. They did not handle any outside maintenance.
MIL also had a nurse and a pt who came out once a week to handle medical end of things which was covered through Medicare. The caregiver did not take vitals and such.
This is in GA where the cost of living may differ from where you live.
Edited to add: in our case this wasn’t a two person job, so I would think you would pay for the total care not per person. (The agency we used, assigned two caregivers who switched off weeks). It seems to be that one of them could still hold a job outside the home.
This is in Maryland, which is important because I think costs vary by state
1) My FIL is paying $24/hour to an agency who is providing 24x7 home health care. The average caregiver pay in Maryland is variously reported from $13/hr to $17/hr. Let's say the average is $15/hour.
** No way should agency overhead costs be paid to family caregivers, as it seems like the niece-in-law is requesting **
OTOH, $250 a day is reasonable for 3 people as will be seen next.
2) There is only 1 of them on duty at any one time. So, I think the total pay in Maryland, if I were paying, would be $15*24*(30.4) (avg days in month) = $10,944 a month, or $360 a day.
3) $1,000 a month would not be unreasonable for a family of 3, since that's about what I'm paying. We buy organic dairy and vegetables. Let's say the grocery bill is 1/3 more because of that. That means a non-organic bill would be $769.
*** Why not let them buy their own food? Keeping food costs separate would be the norm anyway. ***
4) Rent needs to be subtracted from the total compensation.
Hope this helps.
CEB60714, please do a breakdown for your nephew showing the rate of pay x actual hours worked (I'm pretty sure all 3 aren't necessary at the same time, 24/7!) then deduct rent, utilities, etc. and show them the actual cost. If they still balk at not receiving $20k a month, find other care. There are responsible, loving caregivers out there. (And heck, if you're going to pay $20k/mo., let me know--I'll do it, lol!!!)
I’ve been here as the caregiver before, and I’ve been on the side of overseeing everything.
First, that is a large amount, but I’m thinking she got her number from having 2 people 24/7 at home with your mom.
Do they have their own home or will your mom’s be the primary residence? In our situation, we left our home to care for my in-laws, so we did have a home and they weren’t housing us because we needed a place to stay- the bills at home kept coming (as well as maintenance and everything that goes with home ownership).
They are getting a place to stay, and needs met. In return they are caring for your mom. I believe the current rate is fair if they’re not having to pay they’re own bills at home. Also, caregiving is an around the clock job (as I’m sure you know), so there’s a lot of sacrifice because they are tied down to her and her needs.
I also think there needs to be a contractual agreement on expectations so that it’s clear cut and if anything happens, all parties are protected. I’ve seen this go bad so many times with family- sometimes it’s easier to hire out.
Good luck!
Many here ran into trouble with live in caregiver arrangements that weren’t spelled out. Especially since it’s in a pandemic still, rules for guests and visitors must be established. If the kids go out during the day, do they wear masks? If not, they must wear them while working with your mom. What happens when your mom passes or moves to NH etc? How long do they get to stay in the house, and what will the rent be when they aren’t working? This all has to be in a contract. Paying for their food is also compensation and is taxed for SS purposes.
At some point your mom may be incontinent and need to be bathed and have diapers changed. Make sure they are on board with this. You don’t want a caregiver crises down the road.
If the answer is yes, it is different. I assume the answer is no. Without any education they should be getting minimum wage, that is what these agencies are paying to there workers. Everything else that you are asking them to do (medical appointments, driving mom, grocery shopping) is there compensation for living rent free. $1000 a month for food is really high, unless they consider a lot of take outs and restaurant food.
I believe what you are paying them now is very fare. The niece in law is a very greedy person. Tell her to go look for outside job and find out how much she will earn. With current unemployment rate, she will be lucky to get a job. Also, I am surprised your sister is quite about there requests. She should tell them that there compensation is more than fare already.
I was an unpaid caregiver for both my parents. I could have easily earned a high wage elsewhere - but chose to care for them myself at great personal cost. I would do it all again in a heartbeat. I believe that no amount of money is too much to pay someone who is caring for an elderly person. The job requirements range (sometimes switching suddenly) from grief counselor, cook, laundress, janitor, medical liaison, CNA, teacher, secretary, security guard, lawyer, accountant ... you get the picture. Having a loving family member in that position is priceless as long as that person is emotionally (and not solely financially) motivated.
That being said, because of the 24/7 aspect of care, and my other life needs (raising my own young children), I had to bring in help also. I hired several wonderful people through the years who are now (that my parents are gone) closer to me than some of my own siblings. They were much nicer to my parents than many family members. They both worked for a modest wage, not the lowest in the market, but certainly well below the highest. They truly loved my parents and my parents loved them. I found them through a help wanted website.
If the need would have arisen, I have no doubt that one of them (who was single) would have moved in with Mom to help at the end of her life when she required lots of care. I also know that she wouldn’t have charged much more than she was already earning.
When my grandmother required 24-hour care, my parents were not physically strong enough to personally care for her. They hired 3 workers to each take 8 hours per day to keep Grandma in her home. My parents selected one to work as the “manager.” She scheduled the others, figured out duties, budgeted expenses, etc. There were a couple personnel changes over the years, but this worked out very well. The pay was very modest.
If you do not feel comfortable paying these amounts trust your instincts. You have options.
If you meet these demands now, what will happen when the job gets harder, as it inevitably will?
Shop around and consider other arrangements.
You could even call an agency and ask what they charge. Keep in mind that an agency will have "administrative fees" and the caregiver only gets a portion. So if an agency is charging 20,000 a month the caregiver is probably getting less than half that. Also, is the amount of work enough that the agency would charge you for a Nurse? That would cost far more than a caregiver. Or are they charging what they would charge for a CNA? Again more than what they would charge for a caregiver.
Also the amount would be based on the hours.
4 1/2 years ago when I was caring for my Husband I paid the caregivers a base of $20.00 per hour (contract and taxes taken out) They worked 7 Hours. Relaxed atmosphere and they had time to study. (they were in college awaiting the new term to begin)
Have a contract as to what is expected. I would review the Contract every 6 months. Things change and what someone is doing this month may change drastically and the work may require more compensation.
Other than "light housekeeping" if you want the house cleaned I would hire a cleaning company or contract the cleaning separate from the caregiving.
Same with yard work.
One of the reasons this might be important is to keep mom's personal care separate so that you have proof that "X" dollars were spent for her care in case there is a time when you have to apply for Medicaid.
As far as where the care should take place...The simple answer is Mom should be cared for where she is the safest. If mom's home is set up where she is safe being cared for there AND your nephew and his wife are safe caring for her there then there should not be a problem. HOWEVER if this is a split level house or a walk-up apartment or other home with barriers long term care for her there might not be possible. Now totally different story if we are in a Ranch House or a house with a first floor main bedroom with wide halls, no carpet......you get the idea.
Food cost would come from a "household budget" that would include food, cable, gas, electric, insurance.
If this were a different situation where mom had moved in with the nephew and wife I would say to split all the bills 3 ways to come up with the amount each should cover. In this case I would thing they should pay a portion of the household expenses as well.
"Room and Board" should not be considered "pay".
I went on line to look for Caregivers and everyone wanted $10 - $25 an hr.
I found out that tge Companies would charge $25 an hr and actually pay $10 to the Caregivers.
So, I started calling individual Caregivers myself and interviewed a couple and
I hired a lady that has her own Company and she accepted $9 hr for 24 7 Care.
She provides other Caregivers to help her so they do 12 hr shifts 7 days a week.
The cost is $1512 a week which is a little over $6,000 a month.
I order my Dad's groceries and have them delivered.
The Caregivers bring their own food.
Even at $6,000 a month, his savings is dwindling fast.
I'm now considering hiring a Live In.
The Least Expensive Live In I was $3,000 a month Plus Free Room and Board and one 24 hr period off per month tho some wanted one 24 hr off per week which means you would have to pay additional $250 for a person to spend that 24 hr time or get family members to take a shift.
It sounds to me that the Grandkids are trying to take advantage of Grandma and your mom.
They shouldn't be looking at what a Company charges per hr, they should be looking at what you can get a nice Live in will accept.
And they should even give Grandma a discount.
I would tell them to accept $3,000 a month or you'll hire a Live In yourself and they'll have to wait for their inheritance not gouge Mom and Grandma.
Theaven already got a pretty sweet deal and they're being Greedy!
Prayers