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We have been getting home support in 3x a week. They come in the morning on mom's dialysis days to help her with personal care and meals, and back in the evening to help with meals and make sure mom is comfortable. They do quite a lot in a small amount of time, including some housework like dishes or bedmaking, and it's a huge help to me - I can now sleep in a bit on dialysis days (my morning personality is not suited to helping someone shower or clean their bottom!!), and I can plan evening activities knowing someone is there to make sure mom is safe and looked after.

We're in Canada. This is organized through the public health system, but the home support is operated by a private company that holds the contract with the government. How much you pay is based on your income - low income people would get a full subsidy for home support, for example. Mom has enough income that we are not subsidized, but honestly, I feel what we pay is pretty nominal ($40 per day), and consider us lucky to live where we do. For that, we get about an hour and a quarter's worth of home care per day - 45 minutes in the morning and a half hour in the evening. We could get up to 4 hours per day if we were assessed for needing that much. The down side of using "public" home support instead of going to a private company is that there is a rotating group of workers, and who we get when can be a little unpredictable.

I know these women - they are almost all women - don't make much money in comparison to the work they do. Minimum wage in my province is $11.35, and I'd be surprised if they make much more than that. I'd guess $12-15 at most. Lots of them seem to be single moms. We don't always get the same workers, but there are 2 regular ladies that mom and I both really like, and these 2 almost always do the morning the shifts (which are the longest and most physically intimate). The rest are workers we see occasionally, but we're getting to know them too.

So my question is - is it appropriate to tip home support workers during the holidays? And how much do you think would be appropriate? Would you differentiate between the workers who provide regular care and the ones who are there occasionally? Would it be more appropriate to give gifts? (I don't do holiday baking or crafts, so it would end up being store bought gifts.) I would greatly appreciate your thoughts on this!

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Again - if the aide works through an agency please check what the policy is. You may be putting the aide's employment in danger if you are gifting. I work for an agency that contracts with Providers to service consumers in their home. If the aides are receiving gifts it is against policy and the aide must be reported to the Department of Public Health and the Provider could be in jeopardy of loosing their contract. That's an awful lot of trouble you may be causing because you insist on gifting the aide.

Make a donation in her name to a non=profit of her choice. Make her a goodie plate or something small (a scarf or pair of gloves) but stay away from cash or gift cards. The aide needs to reports all gifts received to the agency they work for.
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I think as an unpaid caregiver a suitable cristmass tip would be around the $ 200- $ 250 mark if the siblings or children all go to gather. A paid caregiver $ 50 both with some little gift.
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If we had a good one we would tip in the form of a gift card, but right now our aide is deplorable. Been on the payroll of an agency for over a month, had 2 days where she actually showed up on time, today was the 3rd no call no show.
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I am here in the US, and I work for a home care agency. Their policy is that we can accept a small gift from a client or their family, but it absolutely must be reported to the agency. This is simply to help protect everyone involved.
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I gave our primary daytime worker (through an agency) a gift card of $50, she was a wonderful lady, and I give her a couple of gift cards a year to this day. She was my rock and went with me to put mom in the nh, and she is not doing well herself. To the day I die I will keep sending her gift cards....I did give any fly-by-nights the agency sent on weekends or on holidays a small token, to Starbucks I think. One of them drove over from another county on Thanksgiving.....My brother told me when mom was in the nh that the help would remember, appreciate anything the family sent to the workers, so I would buy a big basket of candy and cookies and leave it at the nurses station on my mother's floor, with a card saying it was from  'Lassie's mother'.   After mom passed on, I took up another big basket of goodies in appreciation.
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Dorianne - it applies to family - I think reasoning is that gifts might 'buy' extra attention so those with limited means would be disadvantaged
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I am a nurse living in U.S. All of my employers (hospital, Dr office, dialysis unit, home health agency) strictly forbid us accepting ANY gift from a patient or their family. I'm assumed that rule was for all employees. It would be best if you asked their employer before giving a gift because you put the employee in an awkward position if they are not to accept gifts. They may take it to not hurt your feelings however, that could cause them to be fired.
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@Teri4077 - oh that kind of makes sense. Hmm.
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Dorianne, my brother is severely disabled and lives in a group home as well as working in a sheltered workshop. No one in the family has ever been allowed to give any of his wonderful staff members gifts of any kind. We've always been told that the rationale is based on potential bias in the care of individuals whose family members give gifts -- they may be treated better than those whose families don't give gifts.
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@moecam - this interests me: "....no person working with vulnerable people can accept significant gifts or they can be charged with elder abuse...."

What if the gift comes from a family member of the vulnerable person though?
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ABSOLUTELY, I HAVE TWO ANGELS CARING FOR MY MOM. I WILL GIVE THEM EACH $40!
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I am Canadian & very thankful to be on right side of border when it comes to health care - due to the variable personal that come I'd get a gift certificate to Tim Hortons for the 2 who come regularly -

My mom is in NH so we can't do gifts to anyone over a few dollars however they usually have a Xmas party so I donate a nice bottle of wine for the draw they have at the party so it is not to any 1 person but to the group - these parties are generally in early Dec. so do it soon - this way the maintenance man / cook / directer all have equal chance to get the gift & they do as much behind the scenes as the front line people

There are laws here in Ontario that no person working with vulnerable people can accept significant gifts or they can be charged with elder abuse so by going to a group not a person then that means no body is singled out - hope this helps
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I appreciate the input from everyone! I will definitely check in with the agency about Christmas gifts.

We are in BC, Canada. Home support is provided by a private agency under contract to the regional (public) health care body. We pay the agency directly, but the fee scale (even if you don't get subsidized, which we don't) really seems nominal compared to what people are paying in the US, considering we could get up to 4 hours a day for $40 if we needed it (less than minimum wage). I guess technically we pay the rest through our tax dollars. But having been an office temp at one point in my life, I know how much usually goes to the agency and how little goes to the worker!
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It's best to check with their employers. It could or could not be against company policy. This is a bit off topic, but when I was employed at the company I worked for (not a caregiver), accepting gifts of any kind was illegal and could mean termination of employment.
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Since paying for my mom's home health care has basically left me broke the last 7 years, I just give each of the girls a $25 gift card to Target. They can use it for groceries or something for their own family. I pay her aides cash off the books, so they don't pay taxes. Their pay from me is a lot better than they were making working at the agencies, and I feed them on their shifts with my mom, too. Not that i don't appeciate them a lot, they know I do, but they also know I am struggling to make ends meet at my mom's house and at my own house.
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I always give a bonus or gift at the holidays, gift cards to a department store or a restaurant are always appreciated- whatever you can afford. I usually give 100 each but they work for me so no restrictions.
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Robinr says, "We have encouraged people that they can show their appreciation by making a contribution to our non-profit agency, or to an employee appreciation fund we established, which is rarely done."
The problem with this policy is that an exceptional caregiver doesn't directly receive the gift of appreciation she deserves! I suspected that the agency of our mom's reliable caregiver had such a policy, so we slipped cash into a Christmas card. She was very grateful.
I volunteer in a literacy program and a student gave me a thank-you note with a cash gift. I was touched by her gesture but embarrassed; I didn't need the cash, and she had dug deeply into her pocket to give it.
My program director said I could suggest she donate the money to the program instead. The program receives an abundance of donations and grants, so I found that idea offensive. I wrote her a warm thank you card returning the cash, explaining I'm not allowed to accept it, and would be happy to go for coffee one day together after class instead.
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Dorianne, I am also in the same position as you. We live in BC Canada & get homecare every night & Monday mornings are shower days. I live with my mother (in childhood home) we use to have both AM & PM Care, but knowing how short they were on workers in the summer I dropped mornings except for Monday’s. We have different ladies that come in as they always rotate their shifts, but we do get the regular ones that mom & I like also.
We have a Head Nurse/Worker that arranges the Home care & anything else we need my suggestion would to be call your person/Worker & ask her what is acceptable. I am going to do that myself. We are totally subsidized as my mothers income is low. I do bake so I might make just make cookies. As a 24/7 caregiver it does get tough. I do appreciate whatever help I get with our homecare & right now they don’t do as much as Your mom’s people but in all I still appreciate them very much. I have also noticed some are single mothers.
Hope I was of some help. If you ever need to chat message me please anytime.
Cheers GailMarie
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I think it is very important to acknowledge the important work these women are doing for you. I give gift certificates, money or something else I think they might like and a card to tell them how much they are appreciated.
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I think that would be up to you. You would also want to call the agency the person works for and ask about their rules on gifting
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I would agree that you should check with the agency first to see what is allowed. The reasons they are usually forbidden to accept gifts is because in some memory care cases, people forget about the gifts and caregivers may get in trouble.
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Thanks for asking this question. Appreciate hearing both from those who employ caregivers and the caregivers themselves. We live in the US in the Midwest. I pay our caregiver directly more than her agency. Also give her Christmas and birthday presents. Last year I think it was $100 cash, but I have also done Target gift cards. Helps to know where they shop. Not all people do online shopping, which is the danger of giving Amazon. I also give a small gift of something I know they can use. They may be diabetic, allergic to nuts, or glucose intolerant but like wine. Of course, she has been with us for awhile, so I know these things. I like the idea of taking them out to a special lunch/dinner.
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I think there is a huge difference between what is appropriate for someone privately contracted or full time vs someone who is employed by an agency, and in Canada agency caregivers, while not at the top of the pay scale, are usually compensated a little bit better than many in the USA seem to be. In my experience agencies and facilities have a very strict zero tipping/gifts policy, some administrators take it to the extreme (sister's boss made her throw away a cookie a resident gave her 🙄), but most accept that some gifting goes on and they will turn a blind eye as long as it is moderate and discrete.
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I live in the U.S. When we had aides coming to take care of my dad, we gave each aide who worked 35 hrs a week $200. Note: we had the same aides for more than a year. Not allowed by agency , but they took such good care of my dad, we felt their kindness and hard work should be recognized. Now my mother is in a memory unit which costs $9,000 per month. I slip $20 to her morning and evening aides periodically. My mom is difficult so those two ladies will discreetly receive $ in a holiday card. I learned the hard way last year that you aren't allowed to give money directly. We are also giving $300 to admin to distribute to staff (I know her 2 main aides will get some of that but trust me they are worth it!) They all take such good care of my mom.
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Two thoughts on this.

When I was a single mother caring for other people's children the best gift was cash. Although gift cards are nice, they limit you to one store (unless you buy a 'Mall' card), the item purchased is often a bit more or less than the gift card value, so I would have to top up, or not get the full value. Boxes of chocolates are immediately regifted, I do not want them.

Cash can be used to pay an utility bill or be tucked away for a rainy day.

Another nice thing was being taken out to lunch or dinner (nothing fancy) by the family. Or having a lunch left for me (I prepared lunch for the children and dinner for the family).

How to allocate the money between workers? I love math, I would add up the hours for each care giver over the next month. The top two would get something over and above, the others, as you may not see them on gift day, I would do a total cash gift and ask the agency to distribute it.

If you disregard that the shifts are different lengths, and just assign $10.00 per shift for the next 4 weeks, you would be dividing $240.00 between the workers based on # shifts worked. Of course you can use any $ amount per shift. You can give the regulars something extra to recognize their additional contributions.

Depending on where you live you could give tickets for the care giver to take her family to a special Christmas event. In Victoria, Butchart Garden's Christmas lights are beautiful, but make sure you give extra to cover the cost of hot chocolate and a treat. Vancouver has the new Christmas Lights, and I believe Grouse Mountain has a Christmas event too now. I am sure in your community there are similar events.
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Hi, Dorianne!

Thank you for posting your question. I am also from Canada and I did not know what to do at Xmas with the nurse that takes care of my husband's problem and the man that showers him. I had not thought about gift cards but that's an excellent idea. I'll give each of them an Amazon gift card so they can use it to buy whatever they may like. I don't like to give cash as it seems so ...diminishing.

Best wishes to you and your mother and may your holyday season be peaceful and serene. That's all I ask and hope also for mine.
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I'm on the other side of the coin - pardon the pun. My main client is well-heeled (I manage her life overall) and have been a dedicated care manager for almost three years. One Christmas/holiday time, I wanted to 'thank her' for providing me stable work-income and (1) invited her to a symphony, a little dinner before, an autographed book (mystery I knew she'd love), and a beautiful card of a stained glass image which she kept on her window for months after the holidays. What did I get? Not even a "Merry Christmas" Nada Nothing. I think I even gave her (and her visiting sister) a bottle of sparking apple juice. She resides in a retirement development with a 'no tipping rule' except at the end of the year (they pool all tips for cooks, aids, housekeeping, etc. (of course, not me as an ind contractor). Lesson here to me: expect the unexpected or (try to maintain a 'no expectation' consciousness - more of the time than not.
WHAT I'D DO IF IN YOUR SHOES: (1) if tipping not allowed, buy a gift or gift card for their child(ren) somewhere. Target, toy store, book store; (2) if tipping allowed, let your heart lead the way. Honest, caring carers are gems of gold. Commitment, hard work, and compassion are invaluable. Thank them anyway you feel is appropriate; (3) we know that rules are rules and folded green thank yous are often provided regardless. I cannot give the maintenance crew any thank yous at the end of the year where I live (ind senior living). I wanted to give one of the two a bottle of Tequila and he said he could not take it. I said "okay, I'll just leave it here by the door and walk away." I never saw it again. Cheers.
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We've had the same person come three hours three times a week. The agency is paid $22.00 per hour, she receives
$11+. We give her $100. at Christmas. I do give her a gift
on her birthday and other smaller things on occasion.
She's a single mother and does appreciate being thought of.
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skyfall, is your mom in the US? My mom is in AL ($5500 a month!) and I have been under the impression that monetary gifts are not allowed. Shall I check with the admin? thanks!
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I worked Elder Care, and yes, the wages were kind of a joke....minimum wage and no raises----hence a HUGE turnover in employees. My client's family found out how little I made and tipped me out MONTHLY. They worked it out privately with my company--but they almost doubled my "take home" pay. My client gave me a $100 bill and a sweet note on Christmas and my birthday.

Honestly, for me? A little "trinket" would have been pointless and useless to me. I appreciated the cards the family gave me, and the many, many thanks better than a tree ornament or some such thing.

DO check with the company--I know mine was "opposed" to tips, but turned a blind eye if you got one.
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