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I do so much for my patients and even send a daily report, in details to keep them posted. However, I don't feel appreciated, I hardly receive a thank you reply and the pay is the lowest for this job. I have been with the family for over a year and didn't even receive a Christmas card with a thank you note. I feel like I am working for the wrong family but I just keep going because I bonded with my patient. However, I don't feel appreciated. I even do extra hours that are not counted with pay. Please advise. Thanks

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I feel the same way, although I am not the first caregiver. Their first one lasted for 3 months and the second one for 6 months.
Both of the previous caregivers told me that the family counted every penny as they do the grocery shopping and they didn't get paid for some extra hours but the payment gets deducted when they have to come late and the family suspect them or accuse them of eating the food in the house which they don't. So I give them an accounting of all the expenses with Excel spreadsheets, photo of each purchase and receipt. I use my own vehicle to shop with no mileage or gasoline reimbursement, and I do it after or before working hours. I also try to fit to get everything the patient needs within a very small budget that included her personal stuff and not just the grocery by picking items from different stores, wherever they are cheaper. Last year, I was able to put a Christmas tree and all its decor for the patient's house to cheer my patient's up, out of the money I saved. I am also a great cook as I love cooking and give the patient a well-balanced diet. I don't believe in a shortcut with food flavouring as I believe that elderly needs healthier cooking so I used natural ingredients and spices. I take photos of each meal I serve so they see each portion and what their loved one eats. I include that in my detailed report. The house is a big 2 story and I clean it, including all the windows. I have a reliever whom I always coach because she often gives our patient ramen and she brings canned food instead. The patient also does not listen to her and she hardly can get her to take a bath, but she always does for me.

I am also very organized and have organized everything in the house that made working and finding stuff very easily.

I detailed everything that is done at home on each report.

I do it because that's just how I am. I wanted to keep my house cleaned and organized and I would love to receive a detail report from my caregiver if I have one so I do what I would want others to do to me.

Well, you're not alone, I believe there are many of us. I did not get a Christmas card either, with at least a thank you note.  I am sorry for sharing much and hope that this can somehow give you a little comfort knowing that you are not alone. 
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As a caregiver, you should always think highly of yourself and value. You bring a lot to the table such as education,experience and compassion. In the healthcare field, you have to speak up and be vocal about being appreciated and fair pay wages. If, not then individuals will walk all over you. A family that appreciate you caring for their love ones will show you with bonuses and a pay increase or raise. You should rethink and reevaluate your situation of the pros and cons. Wish you well !! From a Homecare agency owner in Michigan.
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Anyone who has to care for a LO doing it all, showering and toileting, should be very thankful when someone else is doing it. I always thanked the CHAs and told them they were not paid enough for what they did. These Jerks probably have no idea what you do. You may want to request a raise. I think it would have been nice to give you a gift card or a days pay.
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I'm kind of like Bookluvr was, when people do a job for me it often just doesn't occur to me to thank them for it, it's what they are paid to do, plus you spend less time with the family so they haven't bonded with you. If you are their first caregiver they might not even realize the extras you do and how lucky they are to have you.

And when it comes to doing more than expected, I've observed that in almost every workplace there are people who do all the little extras, from shovelling snow off the walk to stocking the break room to logging unpaid overtime, and the longer they do it the more it just becomes expected of them. Unless you are prepared to suck it up indefinitely or move on I agree that it is time to have a sit down with the family to revisit your contract.
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Some people are rude jerks. Not even bothering to give their loved one's main caregiver a Christmas card, with maybe a little gift as a token of appreciation, would be a clue that this includes the family you're working for. But as you recognise, the person you're actually working for is your patient - and you do feel appreciated by him or her, yes?

Stop doing unpaid hours: rudeness stops being something you should rise above as soon as it costs you money. If you really can't leave on time, because it would leave your caree at risk in some way, then at least log your hours accurately for, say, up to a month and then bring it to the family's attention: "there is a consistent overrun of seven or eight hours each week, and we need to revisit the contract."
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"It's a job they're paying you to do it. If you don't like it, then you shouldn't be working there." ... That's an attitude I see a lot towards - not just with the nurses (at the hospitals), but cashiers, bank tellers and even the janitor. I've seen how people treat these workers like - nothing. No greeting. No thank you. Nothing. I make it a point smile, make small conversations and even thank them. So, when I'm next in line, they usually enthusiastically greet me by name even before I reach their counter.

When I used to have a paid caregiver cover for me on Saturdays, she always greets me first with an enthusiastic good morning and a big smile. I just automatically respond back to her. If she didn't do this, I would have treated her with solemnness. I learned to say 'thank you' after the home nurses and other caregivers were done with bedridden mom - from my dad. I don't think I would have thanked them because - that's their job. So, I followed Dad's example and started thanking people - even if it's their job to do so.

If you feel it's important to feel appreciated and you don't think you would lose your job, you can very, very tactfully mention that usually in this job, you're only required to give them the bare essential updates. That because you have bonded with your client, you're willing to work for a lower pay than your usual fees... That you don't even charge them for the extra hours you worked for them. It would be nice to be shown appreciation once in a while... I don't know. I don't think I have the Oooomph to do this!
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