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My mom receives hospice care in my home. Until today, I was able to give mom full showers; however, her condition no longer can tolerate.


I myself am in the throes of a Fibro Flare.... I had a CNA come to help me give my mom a bed bath. Is it customary to tip?

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No, in fact it would be considered unethical if the CNA were to accept it.
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Not customary, no, and if the CNA is from an agency the agency will probably have rules about it.

Appreciation and warm thanks go a long way, though :)
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Hi Countrymouse and CWillie....
Yes, she's from a hospice agency and I didn't tip because I know from my own experience as a CNA, we couldn't (and wouldn't) accept a tip. I just didn't know if home healthcare was different, or if things had changed along with so much else!
I haven't worked in direct care since the early 80's. Gosh, I feel so old.
I didn't want to insult her one way or the other.
Thank you very much for your help.
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She is getting paid. She does not require a TIP.
All Hospice (or if not all of them they should) prohibit gifts to the Nurses, CNA's and other staff greater than $25.00.
Times that it might be appropriate to give a gift...
If you happen to know the persons birthday
Christmas

The best thing you can do is send a note to the CNA's supervisor and tell them that this person has done an outstanding job, is kind, is...whatever else you wish to say. This will go into the persons file. I would also give a copy to the CNA as well. This recognition of good work would be appreciated just as much as a gift.

If you do give a gift do so as a Gift Card. Starbucks, Panera, Dunkin Donuts or other place that she might like.

The CNA that came to help me always came in the morning and since I was getting breakfast ready for my Husband I would ask her if she wanted Oatmeal or sometimes I would have Greek Yogurt and granola or fruit. I always made a pot of coffee the mornings that the Nurse and the CNA came so they would leave with a cup of coffee.
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Even the wonderful CNA that took care of my mother when she was in SNF would not accept a Christmas gift...& she said it was enough that she was appreciated! My mother’s is home now since March 2017, not from lack of care...but due to financial concerns & she just begged to come home...J have a private pay Aide ...that I share hours with.
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No, she is an employee of the hospice agency. Should not even except a tip.

You can have an aid as long as Mom is on Hospice. Its part of the service. Take advantage of it.
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No. It’s not expected.
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I respectfully disagree with most other responders here. I don't know why it's unethical. We (often) tip letter carriers, sanitation workers, barbers/stylists, the person who loads your car with groceries or nowadays, the person who drives them to your house, the pest control guy, house cleaners, servers, bartenders, etc. All these people receive paychecks (though in the case of servers, I know they generally work for tips - paychecks just barely offset taxes and insurance, if they're lucky enough to have it) but we tip or bonus them anyway. That's the "royal we"; not everyone does this, I get that.

In Florida, according to Zip Recruiter, CNAs working for hospice organizations make less than $15 an hour. CNAs in other care institutions often make less than that - I recently saw an add paying $10.25/hr for CNAs. To me, that's not a living wage, and not to get political, but I am not a proponent of the $15 minimum wage bills being considered in this country. But I think people who provide such personal care for our loved ones SHOULD definitely be paid more than they are. Burger flipping and changing adult diapers are very different things. Since that's the employer side of the equation, though, I say you can - if you wish - tip a person who comes into your (or her) home to provide personal services.

It might not be a bad idea to contact the hospice you are working with to ask about their policies and, as another said, write a nice letter of appreciation for the CNA you're working with, but this is a very low paying industry, shamefully. And we in the Silver Tsunami (aging baby boomers) are just about to bombard the industry in numbers never seen before. I want the person who takes care of me to be well compensated for what has got to be very difficult, backbreaking work. Often thankless.

Our mother - who is an extraordinarily difficult person - has been in a memory care home (small biz that operates 5 care homes around our area with 5 residents each) since January. Despite their sales pitch that they have low CNA turnover, two good ones have left since January. My brother, sister, and I hoped to encourage two good ones left to stay, so we gave the older one who has been there 6 years $100, and the younger one $50. Appreciation and expressing gratitude is nice, but money speaks very loudly! We did not check first with the ownership/management and nothing was mentioned about tipping or gifting in our initial talks. But we are so grateful that they even deal with our mother, we felt very strongly about expressing our gratitude with cash.

It may not be expected, but it is always appreciated, and I frankly don't see anything unethical about it.
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Grandma1954 Jul 2019
You do not TIP the letter carrier or the person that delivers the newspaper. You may give them a gift at the Holidays. But you do not TIP every time you get the mail.
There are Boundaries that Hospice establishes and one of the Boundaries is the employees are not permitted to accept a TIP. Most will also limit gifts to $25.00 any greater the gift is usually turned in to the management and it will most likely given to a family in need or used in the facility for staff or for families.
The problem arises when one family can afford to TIP or give a large gift and another family can not. If the staff begins to show preferential treatment to one family over another there could be trouble. Even if there is not special treatment it is the perception of favoritism
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What's unethical about it? - it's not so much that it need be unethical in itself, as that the vulnerability of the service user group in general creates too much potential for abuse or error. It's simplest to say "no tips," and then workers know to say no, or to make sure that any cash that is pressed on them (my great aunt was a forceful presser, I know it can be hard to refuse without giving offence) is returned to safe hands.

I agree that care workers are grotesquely underpaid, but tipping is not the answer.
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No. Honestly it is not something you would begin to be able to afford in future. As a nurse we were taught NEVER to take money. I found one exception when working in a predominantly Greek immigrant community and I was told at that time certain things unique to the culture, one being that tipping the nurse who sends them home with the baby meant luck to the baby to them. As a nurse we could accept say a coffeemaker given us when the person who had a relative realized ours was on last legs, but not the CASH for a coffee maker. It was a hard and fast rule. Care workers, once the rate is divvied up between agency and themselves, are poorly paid. This is true. But I agree with the always wise Countrymouse, that tipping isn't the answer.
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NO! It is the CNA's job. Not at all professional to take a tip from patients or family.
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TIPS: To Insure Proper Service

Since it no longer guarantees that you will get proper service I think it is a personal decision.

Giving a gift that has a hand written note with enough cash to buy lunch is fine, having to fork over a 50.00 everytime not so much.

I was raised where a large percentage of the population lives on tips, so I am a tipper, because you can see that the jobs are hard, the pay is poor and they work hard usually on their feet all day, so a little thank you by giving a generous tip can change someone's entire day.

I don't think it is a question of ethics.
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