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I'm a long-distance caregiver for an elderly cousin in a memory unit. During covid, most of the longtime nursing staff left, and a rotating cast of agency nurses took over. I was worried (with good reason) about the care she was getting, so I hired a professional geriatric care manager -- a state-licensed, trained, highly skilled professional -- to go into the memory unit and look in on her once a week. It's the best decision I've ever made; the care manager has been a true godsend, identifying and fixing multiple problems and advocating tirelessly on my cousin's behalf. She has really improved her quality of life, and given me great peace of mind. Best of all, I can see in my video chats with the two of them that there's a real bond between them. I'd like to do something for her for the holidays, but am not sure what's appropriate. Giving her a tip feels weird and not quite right. Flowers? Gift certificate? If anyone who's worked with a professional care manager has any suggestions, I'd appreciate it! Thank you!

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I think a gift is perfectly respectable, and I’m sure would be appreciated. But perhaps, sign it from your elderly cousin and yourself.

I will assume since you’re a long-distance caregiver that this will have to be delivered and not hand-given?

I think gift recommendations will depend upon your budget somewhat. You had mentioned flowers, which can be quite expensive. How much are you looking to spend?

Regardless of the gift, I think the nicest thing you can do is when you write the card, you tell her what you told us - of the bond between them, and of how much of a godsend she has been to you both. That will mean more to her than anything. The gift is just the icing on the cake.
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A gift would be very thoughtful of you. A delivery of some nice fruit or candies along with a gift card to a commonly used store would be well received I’d think. And good for you being such a good long distance caregiver
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I see no problem in a gift. It shows you appreciate what she does. I worked for a small retail store. Our boss gave us a weeks wages and a gift.
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I'd send a card with a handwritten letter and $200-$500 in it, depending on what you can afford. $200 is only a bit more than the fruit baskets and cheese things, and it's money she can use to pay rent, get her own kids something, and so on. Money is usually tight in that industry, even among management.
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Often employees of a health care agency, such as a memory care unit, are not allowed to receive gifts or tips. But since you hired the care manager yourself, and she has been especially helpful, feel free to reward her somehow.

If you know what some of her interests are, perhaps tickets to a concert, play or sports event would be appreciated. Just a little casual conversation will sometimes reveal what a person and/or her family really enjoy. If you know of a store that she likes, you might buy her a gift certificate or the same from an on-line merchant she has mentioned using. Cash is always appreciated, but taking the time to listen to her leisure time interests, or favorite activities show that you appreciate her as an individual.
You might hear of a special activity or performance of interest to her children. And there is always Disney! A day at a nearby theme park, such as Disney World, is very expensive for a family...but exciting for kids of all ages (if you can afford it). Do your research and take into consideration any extra expenses, that might be involved in whatever you choose.
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