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cscribe2180 Asked February 2015

When is it appropriate for a family member to be paid for caregiving?

My sister lives with my mother to "take care of her." My mother's needs have grown significantly in the last year. She needs help bathing, dressing, and needs someone to clean, take her to doctor's appointments and cook her meals. My sister does not work and makes no money. My mother fully supports her. She gives her her bank card to use and my sister routinely abuses the privilege, claiming she asks my mother and my mother says yes. My mom will always defend her. My sister seems to think she she should be paid for basic household duties like cooking, cleaning and doing laundry. I just think that's ludicrous, especially given the fact that she contributes absolutely nothing financially and routinely spends my mother's money with no accounting for my mother's financial needs. Am I being too harsh? Is it wrong of me to think a family member should perform the household basics because a) they live in the same house, and b) it's their mother?

anonymous292156 May 2015
I agree with ThirdCoastGirl. (except $ 10/ hr. is low and 40 hrs./ wk is understating it, so I would greatly increase one of those numbers)

ThirdCoastGirl May 2015
Yes, you should pay your sister. It sounds like she's doing a lot with your mother if she "needs help bathing, dressing, and needs someone to clean, take her to doctor's appointments and cook her meals." Then you said she is getting worse with the possibility of falling more often. Sounds to me like your sister may be getting burned out. It is a lot for one person to take care of someone 24/7 who is getting worse. You had a good week long experience and that's great. But you also had your husband and kids to help with as something as little as "Please get X a beverage." That may not sound like a lot but if you have three other people helping with such little things it adds up quick. Your sister does everything all day long.

From your comment about your mom always defending her it seems like you may be a little put off by that. It could be possible that your mother would have helped pay off your sister's debts even if she wasn't living with her. It sounds like that's a big part of the problem and you don't like it. If you had helpers come in, would it be possible for her to give money to them? If so, then she needs to be in a NH and not in control of her finances. If it's your sister then it could have beeb her choice to help her and there's nothing you can do about it whether you agree or not.

Yes, your sister deserves to be compensated. If you mother died tomorrow, she'd be out of luck. The job market is absolutely awful. Who knows how long it would take to find a job? And how old is she? Advanced age doesn't help when looking for a job. It kinda sounds like you feel like your sister has had it too easy and you're not going to take it any more. Sorry if I'm over stepping.

You guys definitely need to talk about it. Sooner rather than later especially if you feel your mom is getting worse with her mobility. Here are a couple of options.
1) You could rotate taking care of her. You get her six months and your sister gets her six months. That way your mom can keep her house, your sister has to get a job to maintain it (and it gives her respite - yes working would be respite).
2) Or you could ask your sister if she would be open to a part time job. Then you could pay for the helpers that come in. Your sister would still be taking care of your mom the majority of the time but she would have job experience and income all her own.
3) Keep things the way they are but pay you sister (by that I mean your mom). Pay her maybe $10/hr for 40 hours a week.

Whatever you choose you need to realize your sister is doing a huge job and doesn't need someone criticizing everything that goes on. You two need to set up boundaries/ground rules and follow them without running commentary on how things need to be done.

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anonymous292156 May 2015
When your sister moved in did she give up a job and a home and a life to do it? I think most of us are having a harsh reaction to your question, but that's my reaction because that is what I've done. So far, most of us answering seem to think you are not giving your sister enough credit. (but I've asked a question on here and had some answer with a lambast about their own experiences with details that had nothing to do with my own situation- still, you do get a feel for opinions and maybe something you hadn't considered). good luck with all

susan26 Feb 2015
It is not unsual for elderly parents to "be on their best behaviour" when they are looked after for a week by the "out of town sibling". Yes, she was helpful and loved it, and sunny and light, and happy and all of that. We have that same situation with my FIL where he is wonderfully perky for anyone else and puts enormous effort into staying perky for the week or for however long is required. Then they leave, confident in the knowledge that he doesn't need much support or help or assistance, and any body can do what I do. Its not rocket science after all, and gosh, its not even that hard.

But of course, FIL crashes for weeks afterwards from the strain of trying to keep it together for so long, and we have to put up with the moods, the tension, the exhaustion .... only now, we have family members who wonder why the hell we think it is so hard, or what on earth we need help with, or why we should we paid.

Pay your sister. She deserves to be valued. She is doing a huge job, and it is soul destroying on so many levels. trust us here .... we do it everyday and most of us have family members who undervalue or belitte what we do in every way, yet the fact remains: we do what others talk about doing. We carry the load 24/7 and manage to put it down for a week's leave - maybe.

it is not comparable to looking after her for a week and only seeing the very best of what your mom is because she is on best behaviour.

jeannegibbs Feb 2015
thezookeeper, I think maybe your answer is to a different post ... ??

thezookeeper Feb 2015
Yes, there should be compensation. That should include all the incidentals you've mentioned that are clearly not "mom's" expenses, so even Pam's suggestion of $240 per hr (that's over $80k per year, and add rent to that, too) is a bit high and probably includes food, too! I assume mom is not competent and that your POA has "sprung" and you are in control now. Since sis will need a lawyer to snatch POA from you or file in court for guardianship, you need a lawyer right now, too. No emails, no updates, no phone calls to sis. Mom can say whatever she likes to her. All siblings are entitled to know what your mom wants them to know, and if she cannot express those wishes now, hopefully she gave instructions in advance about how she wanted that handled by the POA. If there is a trust involved, and sis is either a trustee, co-trustee, successor or beneficiary, she has certain rights to know about the finances, including the sale of property. But medical info is completely at the discretion of the POA. Only way around that is if mom already gave the doctors permission to discuss mom's care with sis. Then she can call the doctors directly and not involve you at all. I know this from very nasty, very ugly personal experience.

cscribe2180 Feb 2015
My mom stayed with us for a week while my sister was on vacation. She was happier than I've seen her in months. She was mentally stimulated and so enjoyed spending time with my children. Of course it was a lot, on top of child-rearing and full-time jobs, but my husband and I were truly happy to do it. I'm only sorry I couldn't replicate it all the time, because I work full time and couldn't work from home like I did for that week so I could keep an eye on her. Honestly, after that week, I didn't have any sort of eye-opening moment where I thought "wow, my sister deserves every penny and more because this is so hard." I managed to successfully fulfill my mothers needs along with those of my children, my full-time career and my household. We had no problem making her part of our routine. To me, we did nothing particularly special for her, we just took care of her. The sad part? My mother said we "spoiled her." That said to me she's not getting a basic standard at her home.

She doesn't have dementia. She's cloudy at times, but it's not like dementia or alzheimer's. She has an incurable neurological disorder that causes her to lose her balance. She walks with a walker or uses a wheelchair. She falls frequently, and that is very stressful, because you're always afraid she will fall without warning. And she's getting worse.

I don't take offense to the sibling drama comment. That's exactly what it is. My mother has always babied her, and I've just come to accept it. But she's sick now. She needs real care. I offered numerous times to have her move in with us, starting some two years ago, but that would require her to sell her house and she's not willing to do that, which I fully respect. She agreed to this arrangement because it means she can stay in her house. In my opinion, my sister agreed to it because it means she doesn't have to take responsibility for her actions, keep her promises or act like an adult, and can live off my mom's income without any consequences. So there you go. It has to stop. It's been a bear trying to stop it. But I want to set my grievances aside and do what's fair for my mother and sister, regardless of what I may think personally, hence the payment question.

pamstegma Feb 2015
About the only fair way is for you to move in with mom for a week while your sister is away. Yes move in, because living in with an elder is no picnic.
$20 an hour? She is getting $480 per day? Seems a bit high, a nursing home would be cheaper. Cut her back to $240 per day.

BarbBrooklyn Feb 2015
You are so conflicted about this arrangement, it seems.

If this was a live in domestic, would you expect her to keep the house clean because she rented space there? or would that be part of her paid duties?

These arrangments don't work, usually, in my experience, because there is sibling drama lurking in the background. Please understand, I'm not saying that you're at fault here, but this is the nature of the beast. If you haven't seen Still Alice yet, go see it. you can see that the sibling who willing gives up career opportunities to stay home with demented Mom is eventually going to be told by dad and siblings that she's only doing this because she doesn't really have a career.

If mom is on edge, that's not good. Would she be better served in Independent or Assisted Living? The answer is probably yes. Go on some tours. Give your sister enough notice to get her act together.

cscribe2180 Feb 2015
ABSOLUTELY, she is my mother too, and I do all I can and more to help her—to help them BOTH. Trust me, my sister does NOT do all the work, she is NOT alone in this at all. My issue here is with the fact that promises were made and systematically broken.

My mom agreed for her to move into the house on the premise that she'd be paying rent and contributing to the utilities, in addition to helping with basic housework. Neither has happened. On the contrary, my mother has assumed responsibility for all of her bills in addition to her own expenses, which I now manage for her. She also renovated her basement to my sister's specifications to the tune of $14,000. She allows my sister to buy whatever she wants and as a result her financial situation has become very serious, especially given the level of care she now needs.

Trust me, I have indeed looked into what live-in caregiving costs in my area, and by my financial analysis, considering all the essentials like food, rent, utilities and phone are provided, my sister has been making about $20 an hour, seven days a week. That doesn't include extra expenditures for clothing, vacations, paying off debts, and other items my mother has paid out of pocket for.

I wouldn't have an issue at ALL if the household basics were getting done, but they are not, at least not consistently. My mother is constantly on edge because she doesn't want to "bother" my sister to help her. It breaks my heart. At the same time, I know the stresses of caregiving to a degree, I'm a mom to two small children and I know it can be hard, especially when it's an adult and it's your mother. My mother has only recently reached a point where she needs help bathing, dressing, and help going to the bathroom. I do NOT expect my sister to do things like this without compensation. In fact I'd MUCH prefer these duties be given to a professional, but that is up to my mother and sister.

And YES, I absolutely agree this should be a business arrangement for which my sister files taxes on income. At this point, it is not, and that's where a lot of my red flags go up. But we are in the process of finally formalizing the arrangement to make sure it is fair to my mother.

To that end, my sister expects to be paid for keeping the house that she lives in clean, for cooking meals she eats with my mother, and for doing laundry she'd already have to do anyway because she has to wash her own clothes. Sorry, but to me, it's a bit much to expect payment for keeping your own living space...well, livable. But if I'm off base there, then say so. That's why I asked the question in the first place.

BarbBrooklyn Feb 2015
Please listen to what Jeanne says. Find out what CNAs cost in your area. You wouldn't be charging a live in aide rent. You would be lucky to find one.

Get to an elder care attorney and set up a caregiving agreement.

jeannegibbs Feb 2015
Yes, you are wrong to assume that one family member should do all the work with no compensation because it is their mother. Isn't she your mother, too?

In my mind, it is ALWAYS appropriate for a family member to be paid for caregiving, to the extent that isn't a financial hardship for the parent. In some cases room and board may be sufficient compensation, but not when round-the-clock caregiving is involved.

What would it cost your mother if your sister moves out and she needs to hire someone to help her bathe, dress, cook, drive her to appointments, clean the house, do the laundry? These are all things that can be hired out, so you should be able to determine the local costs. Can mother be left alone? Or does she need someone to be with her through the night? If so, what would that cost?

Your profile doesn't indicate what your mother's impairments are -- does she have mobility issues? The beginnings of dementia?

Mom defends your sister. She must be happy with the arrangement. Why is it bothering you?

Absolutely Sis should be compensated ...

BUT

The arrangement should be put on a business-like basis. There should be personal services contract that spells out what services are provided and what compensation is offered. Compensation could include room, board, and $x per month. The use of Mother's funds should be totally stopped. That would be considered "gifts" (which is OK, mothers are allowed to give gifts but it would complicate matters a lot if/when Mom must apply for Medicaid.) Much better to have this on a business basis. Sis does X, Mom pays Y. Sis should report and pay taxes on her income.

It is absurd to expect your sister to exist on no income just because the person she is caring for is her mother.

Look into what live-in caregiving costs in your area. That would be a big eye-opener, I would think.

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