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.
Have your nephew and his wife ever done anything like this before? Do they have any experience of providing 24/7 care, and living in their workplace? This isn't an ironical question - for all I know, they may both have had residential placements in hospital or nursing home settings.
But unless there are substantial reasons to believe they do both know what they're letting themselves in for, I can't see this plan working as is. Perhaps an alternative option to consider would be their living with their grandmother as her primary caregivers, assisting her at night time and supporting her as their family member, but with hands-on care provided by paid services so that they are then free to continue their usual employment.
What do you and what does your mother and what do other informed parties think of the quality of care the grandchildren are providing at the moment?
Maybe if they want to be a part of your mom's life, they can play the role of nice niece and nice nephew ( visit, assist "sometimes') and you and get ( for less money from what I read in the comments) good services that you will have better control over and use the extra money for even more services maybe. Way harder to reprimand family for things that would go wrong than changing paid employees...Just think about how it would be if , down the road , you decide to not let them keep on living there ...
It must be hard to navigate between family relationship and business boundaries. I am sure you do not need that extra burden right now. Mixing family and business ( money) is a a well known very very delicate thing.
I recently called a local agency and obtained rates for 24/7 care attendant for my 90 yo dad. The payment goes to agency who pays the employee their ‘rate of pay’. Annual cost for 1 person 24/7 was $88K. I’m in western KY. Your local agency rates may be different.
I have to ask... will these ‘caregiver family members’ be receiving a $ inheritance from mom? Is it already arranged? Non the less a family care giver who changes and gives their time and attendance may feel it just to be compensated something fair to market -all living costs considered and monetarily balanced including housing, food, utilities, transportation costs, etc.
Difficult care conditions including Loss of or interrupted sleep is part of the daily rate of the job for agency workers. If you find an agency fees are different for shifts during nights and weekends then consider adding the difference just to those hours.
Tough spot... I pray they will have utmost respect and concern for mom and appreciate not just the money being offered but the opportunity to give her what only loving family member(s) brings to quality of her late life stage.
Most will give a free initial consult.
Just for comparison:
We live in Spain, which is a reasonably wealthy country with a reasonably good level of care.
My widowed 87 years old mother, with mild dementia and mobility impairment after Covid is looked after at home 24/24 by 3 professional carers working in shifts.
What we pay to the carers, plus Social Security tax to them all, plus the employment agency fee, plus 10 hours a week of cooking and cleaning by another lady (included her Social Security tax), plus 2 hrs per week of physiotherapy at home is less than 4000 dollars. And they all work at the legal fee per hour.
I myself look after my mum between 3 to 4 days a week without pay (company, cooking, cleaning, night shifts, doctor and pharmacist appointments). I'm also renting an appartment from the family at about 1200 dollars. Lately I asked for a cut in my rent of about 200 $ a month to compensate for my work (and pay for therapy, both psychological and physical, to heal from the stress), and my siblings refused.
Well, a very different story....
20k a month seems totally far fetched to me!