What is a fair rate to compensate family members to care for their grandmother?

They have it made. Take what they are now getting or find another place to live and other jobs.

Other posters have written very smart answers.

Just so you have a basis for comparison. We are in NYC and pay $16,505 per month for my mom's residence in a skilled nursing facility. Her medical needs are very similar to your mother's. She is able to socialize and is happy there.

I frequently get this question. I am sure the rates vary from state to state. However, in southern Ohio I have seen, Agencies charge 19 to 25 per hour and
the people assigned to do the work get $15 to 18 of that for Assisted Living services as described. I have told family members that Medicaid likely would
allow $9.50 per hour for routine assisted living services as long as everything was
well documented and likely up to 12 hours a day in home. My own mother needed
assistence in her condo and had help during the day only. Then moved into
a private care home with 15 residents for $5500. per month everything included except her medications and personal products. She was 94 at the time
and had good days and not good days. My mother in law ( age 93) had 3 people
15 hours of the day and I think they were paid $15 an hour. They were not licensed but had N.H experience. So $225 a 15 hour day 3 years ago. Last client I had in a skilled nursing home was charged $7000 per month plus separate bill for rehab and personal expenses for routine living matters. She had no major problems except mild dementia and needed structured guidence. As previously suggested -call professional agencies for a quote and ask other people in similar situations. Family members do not have to work for free, But they can't get wealthy doing it either especially if she would have to justify the expensive to Medicaid if entering a nursing h ome.

Wow, I can’t even believe this! My 92 year old mother lives with my husband and I , now just over two years. My sister is the financial poa. My mom has dementia and does absolutely nothing but sleep all day and night. She is ambulatory and can do her own toileting but needs help showering, brushing teeth, grooming and needs to be told when she needs to change diapers, clothes, socks, comb her hair. I do her mani-pedicures, change her sheets, wash clothes, cook and prepare meals. But all of this is really not difficult work. The main thing is the restrictions on our life as she has now taken up our guest room and we can’t go overnight away from home. She is quiet and not demanding. So for two years we were paid $500/month and this year I asked fir a raise to $600. My husband snd I are retired and our income is $3000 mo by. I donor understand how people like your nephew and wife can in all good books conscience think they deserve to be those astronomical fees for their grandmother and get rent free, food, snd barely have to really work. What the he’ll are they doing that they can’t do ALL the housework? After all isn’t it then that are making the messes? And some yard work too! It’s not like they are actively busy caring for grandma 24/7. Are they just lazy greedy young people ripping grandma off? Institutions are bad enough charging people so, so much for a barely decent existence. My poor MIL after living with us fir three years ended up in a nursing home after breaking her hip that cost $6000/mth and it was horrific. No need fir details. So who needs to be making $20,000 a month!? My and wife are both doctors and they don’t make that much! Aaarrrgggghh. Sorry for the rant but I can’t believe there’s even a question about this.

An agency or full time in home caregiver here is about $300/24 hour period which would be $9000/9300/month. $20,000 sounds inflated. Perhaps your niece was able to find that level of cost at some very upscale facilitu, but it is not the norm. I don't know of any caregivers getting $20,000/month! If that were the going rate, maybe a lot more people would be caretakers.

Get an elder care lawyer and a contract drawn.

What is a fair rate for rent? What is a fair rate for food? Those amounts need to be figured in as well. Be sure to have a contract drawn up that is very specific as to their duties and responsibilities. Cleaning sounds a no-brainer. They live there, so why aren't they cleaning? Would they not do that in their own apartment or house? Are they spending their time solely with her, or are they doing other things and "working her in?" Also, make sure a 1099 tax form reporting their income (which includes rent and food) is in the plan. I don't think a comparison with "going rates" is valid. It's like comparing apples to oranges. Your niece-in-law sounds like a gold-digger. $20,000 a month is an inexcusable demand.

I have recently been researching 24 hour care. In general, most agencies charge $9-12 an hour plus free room and board. That includes light house keeping, meal prep, laundry, driving to appointments, shopping, medication, personal hygiene, etc. At $12 an hour, it comes to roughly $8600 a month. PLUS FREE room and board!

Non live-in care thru an agency for the same services ranges from $18-25 an hour. Also keep in mind hat the agency takes a fee off the top so the care gives are not earning the full amount. At the top fee of $25 an hour, that comes to $18,000 a month. However, you need to consider that your nephew and his wife have FREE housing and a food stipend! Compared to the live-in rate with free room and board, I wouldn’t pay more than maybe $12,000 a month if they are living in your mom’s house.

As for getting a monthly fee after she passes?! Absolutely not!!

It is very kind of your nephew to care for your mom. But you have a lot to consider with payment. I wish you luck in figuring it out. I know how difficult a decision it is. You may want to pay a professional senior care consultant to figure out what is best for your mom. They charge a fee but in his case, I think it would be well worth it!

If resources alloiw, you might set a "salary" of $10,000/month for a live in care giver. If your niece and nephew won't do it for that rate, hire someone who will.
A food allowance would be a nice bonus, but is not necessary. People generally buy their own food and personal items with the money they earn from their jobs.
There should be no ties to "per month" money after your mother's death. You are paying for her care. That job ends when your mother dies. Pay what you can to ensure wonderful care for your mother, but don't let niece and nephew guilt or manipulate you into satisfying their overly ambitious wishful thinking.
Care giving is not a wrealth-building

When my mom lived with me I took care of all her needs 24/7. She was mobile but still required assistance with showering, washing hair, etc. I could not leave her alone so unless she went with me I was house bound too. I had no issues with that. I’d take her to doctor appointments, get her hair done and sometimes we just walked around in a store for the exercise. We never asked her to pay for anything. The last 6 months that she lived with us before she moved into a Memory Care Facility I drew up a contract and she paid me $800 a month for her care. I also had to quit my job when she first moved in so I no longer had income or medical insurance until I was able to get on Medicare. Her cost to live in the memory care facility is $195 a day and $100 for incontinence care (they furnish the depends, wipes, etc) in that fee. Your niece and nephew sound money hungry. $20,000 is ridiculous and money after her death is even more ridiculous. I visited 7-8 communities before moving mom into the one she’s in. It’s a lovely place and is getting great care. She’s met new friends her age and seems happy. Good luck.

I suggest you yourself interview both agencies and some independent providers where your mother lives and to get their fees, which you will then have for a range of what is appropriate pay in her area. We are currently legally paying my daughter to care for her grandparents through a national payroll company that handles "granny nanny" payroll. In their state it is required that any hours worked over 44 must be paid at time and a half. If someone needs to be on duty for your mother 24 hours, then your nephew and his wife would each be working 12 hours/day. I myself worked for an agency as a caregiver after my divorce and it was the policy of the agency that I be provided my meals when I was with my client, whether we were eating in her home or if I was taking her out to dinner to get her out of the house, so I think it is reasonable that your nephew and wife's food could be paid for by your mother if they are eating with her, as my daughter's meals are. I strongly recommend that you meet with an elder law attorney ASAP before coming to any agreement with your nephew and his wife. As your mother's financial POA, it is your responsibility to manage your mother's money wisely for her and for her estate, and the attorney can help you to determine what is reasonable and ethical, and to write up the care agreement contact for all to agree upon and sign. (The attorney may also have suggestions as to how to help your mother's income last longer.) This will bring you and your mother peace of mind and help ensure that family relations do not become strained or severed. Most elder care attorneys will give a free consultation to give you an idea of what they'd recommend based on your situation and their fees.

The kind of person who would charge as much as the niece wants, is not the kind of person who needs to be taking care of your mother. I found a woman who had gone through nursing school, except for the final tests, to take care of my mother for $500.00 a week. We supplied her food and she lived with Mom. We would let her use our car and we visited daily and helped. She would go out while we were there sometimes. I'm so sorry you are going through this but it would make things even worse to let your mother be robbed blind by a greedy person.

I had a live-in caregiver for two parents and paid her $1,000/month, PLUS she received FREE room and board, free utilities, etc. It seemed like a win/win for everyone. Your nieces financial request is way out of line. She is getting a free place to live. This is not the lottery.

If your mother needs a skilled level of care, the just compensation would top out at the daily rate of the nearest nursing home. For example $415/day x 30 = $12,450/month. This includes everything, including a bond, taxes and expenses to keep proper paperwork and be supervised by someone who manages eldercare (a geriatric care manager).

We went through a Caregiving agency and mom paid $24.00 an hour. The agency took out whatever fees were necessary. It would have been $240.00 a day for 24 hour care. She didn’t want them sleeping there. Since most of her activity was at night, this didn’t work. We really tried to keep mom home, but when it became a danger, we moved her to a full Memory Care facility. She did not go willingly! When she call 911 for her weekly rides to ER, we had her return to the facility and not back home.
Mom has diagnosed Vascular Dementia and Alzheimer’s. It took a few months to get settled but this was the best way to go! She has her own room with bathroom, meals and snacks, activities, med tech to give her medicine, and one on one care. We pay $8300. a month for full care. Plus.....peace of mind!
Hopefully this will help!

I have been an unpaid caregiver for my dear, now departed, wife. of 61 years...I was proud and happy to do it but it is rough in the long run, that is for sure...this is one fact that many non-caregivers are oblivious to. My thinking is that mom either be put into assisted living or skilled nursing facility, although that is a matter for family, for mom, and for doctors to decide..

While I realize the young people caring for her could spell one another and thus get some respite time on a regular basis, I believe if mom stays in her own home, then I believe it would be appropriate to have paid caregivers come in one day a week, or better, two days a week. Reason: caregiving, even for the closest of loved ones, is EXHAUSTIING and then some..

The $100 a day now being paid to each of the two caregivers is just $4 and change an hour. That amount would buy just four hours of help from an agency...

Assisted living in my area costs from $4000 a month and more. Skilled nursing in my area is north of $10,000 a month each person for two-to-a-room accommodations. Despite good intentions, extremely few homes are staffed to give anything close to immediate response to patient's needs as would be the case in dedicated caregiving from loved ones...

I say, forget the room and board as part of compensation...then get the average cost of skilled nursing home care in your area, and divide it by two, paying each grandchild one half. Also, allow them to alternate on a reasonable basis, so each can take off every other night from six PM until 6AM or a little later the following morning.

I reiterate: Caregiving full time is extremely hard on one's entire being, despite the love of doing it..

Grace + Peace,

Old
Bob

PS hiring one paid helper through an agency at $25 an hour would cost $18,000 per month.

I think $20K a month is ridiculous. I also think $1K a month for food for 3 people is insane. Plus they don't have to pay rent/mtg payment like they would if they were out in the working world earning a living. And, by the way, would these two even have the capability of earning $10K per person if they were employed in the workforce? Did they earn anywhere close to that prior to helping g'ma? Just guessing, but I bet the answer is no.

I'm just gonna say this: How would your niece/nephew even have an inkling of an idea that g'ma would have enough money in estate to cover $15K PER MO after death? Unless you have discussed the details of her finances with them, this would indicate your sister did. Someone had to tell them there is a substantial amount of money that will probably outlive her medical expenses and personal needs for the rest of her life. Who discussed that with them? I mean at $15K per month to be paid later, let's say she lives another 5 years. You would have paid them $5K per month = 60K per year or 300K in 5 years and the estate would owe them another $900K when she passes. I doubt seriously these two would have ever made that kind of money in 5 years working outside this proposed arrangement (unless they have given up some very lucrative jobs to help grandma. . . and I find that hard to believe). As well, who is to say there would be that much left at the end of her life? Are they willing to walk away with only the $5K they made each month if the extra $900 is gone? An estate is really only the remainder of what you had.

How much is grandma's house worth? Maybe make a deal with that. Upon death, house transfers to them. Still a gamble. G'ma lives one more year they get the house, g'ma lives 10 more years they get the house (as long as they continued to be there to help). Then balance of assets distributed as indicated in will.

Now the food. Two of them plus g'ma in the house. Why wouldn't there be meals cooked that everyone eats? Think about your own budget for food. Do you spend $1K a month? Does that even sound reasonable to you?

If you have two adult relatives living in a rent free/tax free/insurance free house, I can see upping the care amount a little, but not anything near to what they are asking. No matter where these two yokels live and work, they should be paying housing expense, cleaning their own house, cooking food, washing clothes, upkeep of the yard. Agencies have expenses that private caregivers do not have. The office management and overhead push their prices up.

$20K per month works out to 2309.47 per week for each one of them. And that amt would be 13.74 per hour ASSUMING both are working 24 hrs a day, 7 days a week and that is not happening AT ALL. Both are not tending to her needs at the same time during the day or night. My guess is the niece is helping with toileting and anything to do with personal issues. In fact, with the mindset of some men, niece might be doing all the housework, laundry, and getting up as needed during the night. Very possible that nephew is hanging out all day, but not really lifting a finger - maybe he mows the yard weekly or biweekly during cold seasons? Maybe he does most of the driving errands like groceries? He's probably handy to stay in house IF niece has to run a personal errand. These two are not working 24 hrs a day - and you can bet one is working much more than the other. So at 200 per day, it comes out to $8.33/hr for 24 hrs (plus shelter and food/other living expenses for free). Tell them to keep track of their hours and they can figure out who earned how many hours per day. Maybe one of them can get a job outside the home/work from home since neither of them is actually on their feet working an entire 12 or 24 hr day.

Bottom line is these two get $700 per week each (100x7days), so total of $1400 per week. (1400x4.33 wks per month = a little over $6K per month) With no other expenses, they could even be saving.

One possible way of looking at it:
Home health care in my area is $17/hour. Multiply that x 24 hours a day. That would cost you $408 per day for outside the family care in your mother’s home. Multiply that 30 days a month. That’s $12,240 per month. Then subtract the cost of rent, etc...
Personally, I would expect a family member to not charge that extreme rate since they will be living there.
I do think, for the future of your entire family, everyone comes to an agreement that each feels comfortable with. Otherwise, someone in the family will hold a grudge forever.

First, 20k is outrageous for a family member to be paid. Usually $15 to $20 per hour. The high amount is probably a quote for 24/7 in-home skilled nursing care. A home care agency is licensed (which costs thousands of dollars) has several laws to follow, has an administrator and a director of nursing, allied staff, pays payroll taxes, education and many has other administrative costs. Your nephew is not licensed and probably does not even know the Home Care Bill of Rights, so they are being greedy. A medical assistant course is not what is needed here. He needs to be certified as a nursing assistant along with training in medication administrating. Medical assistants are trained to work in a clinic. Totally different and not trained in elder care. You are correct in your assumption. Educate the nephews wife about people like me who spend 200k for college and have spent thousands to open a home care agency. Licensed nursing home administrators don't even get paid 20k a month. $100 a day is sufficient.

The more I think about this....wow.
-Toiletry and bathing --- toileting throughout a day and possibly a little help at night. I would call this a regular daily task, toileting alone. If she has Medicare, ask doctor to order home health which could include a bath couple times a week.
-Shopping and meal preparation ---- Niece and nephew have to do this no matter where they live. In g'mas house, they are getting meals/shopping free
-Laundry and maintaining a clean house. --- Niece and neph have to do this no matter where they live.
-Medication administered and health needs monitored. --- Medication is minimal time. Fill a daily pill box or dispense from bottles. This is no major task
-Communicating with doctors and tracking her medical needs. --- Minimal time spent unless they are talking to a doctor several times a day. Again, Medicare can send a visiting nurse, at least weekly, and communicate her health issues, ask for meds, order blood lab work, urine tests, etc.
-Communicating electronically for online doctor appointments --- Doubt this takes much time on daily basis.
-Transportation to medical appointments. -- How often is she leaving the house for a medical appt. Maybe a couple times a month? Might be able to online video visits??
-Carried downstairs out of the house in a wheelchair for appointments. ---- Are you saying her room is on an upper floor or there are stairs from front door to car area? Move her bedroom to any room downstairs to avoid falls. Have a ramp built to get from front door to car. Safety.
-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). ---- This task is probably going to be ongoing unless she is strong enough to get out of bed, sit on bedside toilet, and return to bed (no walking to a bathroom alone).
-Always have someone in the house in case of emergencies or care needs. --- I would venture to say, for the most part, you have two relatives who are hanging out in the house 'just in case' and I understand the need for that. The rest of the chores you have on your list are just off and on during the day. . . not up and at it all day long. Bet you could find a live in person, not related, who would be quite willing to make $700 a week plus free house/food/paid expenses, Most of what you listed can be completed from the house. Even groceries can be ordered and delivered. Most medical things (rx, supplies, etc) can be ordered and delivered.

I do all all those chores on my own for free. It would be pure heaven if I had another able bodied person in the house to help out with some cleaning or outside chores so someone is inside with parent all the time. Just to be able to get out for a few hours and know someone was sitting on the couch watching tv and available if parent hollered would be nice. I order groceries about 2x a month, pay all the bills and inventory pills/medical supplies to order those at first of ea month, make dr appts/call dr, take to appts. I speak from experience that most of the time, I'm sitting. Minor amts of time, I'm getting up/down to do something parent needs. Yes it interrupts my day, all day long. Another person here at same time....would be great.

My caregiver's agency charges me $22 / hr. They pay my caregiver $11 / hr. When I've had an emergency, she comes and I pay her $15/ hr (off the clock). Sometimes her older son will come stay with my hubby and I pay him the same $15/hr.

What is their motive to helping? What are there qualifications and lifestyle if they were working and not caretaking?

Excuse me if this comes off rude, are they free loading? I praise them for wanting to take care of some of the needs of your mother, but demanding 5k a month seems slightly high.

Imho, the wage that the niece is asking for seems exorbitant. I received zero wages to care for my late mother out of state. As well, your mother may require care from medical professionals.

It seems like those NOT doing the work are fussing about the cost but unwilling to work. Do you want to skimp on Grandma so there is more for you?
It seems like those doing the work understand what a commitment this care is and want to be compensated for it. Especially if they have put their own career advancement on hold in order to care for Grandma. It's not a particular thrill to live in an old ladies house. It's never your own.
If everyone would just love on grandma and get her the best care, you might be abe to fall asleep without moral regret.

You didn't mention insurance paying partial of full compensation. Since the nephew and wife are either taking classes to become licensed or are already licensed. Then insurance should be filed. This will help then continue paying at the rate she is paying now. Nephew and wife should consider the rent that they are not paying but. Consider as part of their payment.
I worked in a factory and at the time. I quit in late 1980 I was getting $15 ann hour.that comes to 110$ a day. I say she is paying enough, she is taking care of room and board.besides $100 a day.
I personally think the grandmother needs to be in a home and that price is around $5000 a month remember insurance pays that. Or most and you know she gets fed, dressed, help in bathroom med given. Everyday. I don't think it is safe to be carried up and down stairs everyday.and it isn't healthy for nephew and wife to be doing it either.

Ceb, can you request a daily log to justify their request for such a large sum of pay?

They can not require the same pay as an agency that is based on 3 shifts and not live in. They also need to realize that part of that rate includes licensing, bonding, insurance and taxes matched. It covers administration and oversight to ensure that the caregivers are qualified and that all of the laws are being satisfied.

If they want agency pay then they need to provide the exact same services, with the same licensing, insurance, bonding and oversight.

That means that they are shift workers and not live in caregivers. So they will lose their residence and all of those added benefits.

I would require a daily log, provided daily for a month before any contract negotiations so that you all have a true picture of what they are going to be doing. I would also include any increase in care needs, because the greed will come out when they are actually having to do hands on care.

I would get some needs assessments and care price quotes from several agencies and private hire live ins.

You would have no problem finding caregivers for the 6k, room and board that you are paying.

Unfortunately mom may not be able to afford what she wants and her needs will have to be priority if these loving family members insist on this unreasonable wage.

Haven't yet read every reply, but looks like most feel 20k a month is a bit steep. $240k / year. Plus another 12k / year for food?!! LOL wth they eating, Wagyu beef? And... they get to live there rent free? Utility free? House maintenance free? And, how about those income taxes? Who's going to take responsibility for that? Yes, a for profit facility or business is going to be expensive. That's because they have this thing called "overhead" -- business expenses. I think maybe you should get some legal advice since you are financial POA.
I took Mother in mid 2017. I went a whole year before I told her I needed to be paid, and I really felt icky at the time having to ask, but I gave up a job with paid medical insurance, profit sharing and a 52k year salary. Doh!
I drew up a contract and had it notorized. She pays me $350 a week, and buys me a tank of gas each month. When I take her back home for visits she pays the travel expenses -- car rental, fuel, food, lodging. At tax time, I file as self employed, covering those taxes and taking deductions for mileage, utilities, food.
Honestly, I don't even know if how I'm doing this is how it should be done. And yes, taking care of elderly people is hard work, but I'm not going to be ridiculous about what I think I should be paid.

There isn’t enough money in the world for grandchildren to be paid to be caregivers for grandparents.

In the end it will most likely destroy the relationship.

Someone other than a relative should do the job, ideally in a facility where there is a full staff. It’s too big of a job for one or two people.

My opinion is this level of care should not be done by family members. Hire trained, experienced, caregivers, with credentials.

"Carried downstairs out of the house in a wheelchair for appointments"

That is a deal-breaker on upstairs living.

A bedroom & bathroom must be provided on the ground floor or a stair lift installed.