I need help in determining a rate of pay for my nephew and his wife to take care of my elderly mother. My mother is 93 years old and in sound mind. She uses a walker to get around. She is on oxygen and has recently developed other major medical problems. She may need to be put on palliative care soon. She needs assistance with:
-Toiletry and bathing.
-Shopping and meal preparation
-Laundry and maintaining a clean house.
-Medication administered and health needs monitored.
-Communicating with doctors and tracking her medical needs.
-Communicating electronically for online doctor appointments
-Transportation to medical appointments.
-Carried downstairs out of the house in a wheelchair for appointments.
-At night she may need to wake up someone to help her with bathroom needs or need for additional pain or sleeping medication. This may occur 0-5 times a night depending upon her difficulties (Average is about once a night).
-Always have someone in the house in case of emergencies or care needs.

My mother wants my nephew and his wife to care for her at her house and they want to provide that care. The proposal would be that they would be living with my mother at her house rent free with a stipend paid to my nephew and his wife for personal health care and a budget to cover her food.

My mother is currently paying my nephew and his wife ( Medical Asst Training) $100 a day each. She is also paying my niece (Physical Therapist Assistant student) $50 a day. My nephew’s wife feels that they are being paid far less than the value that they are bringing to the quality of life and care for my mother. My niece-in-law went out to local “for-profit” home care providers to find out the rate they charge for home care. The rate she came up with was $20,000. A month. This is what she is asking to be compensated to care. She is requesting to be compensated at $5000 a month now and $15,000 a month from my mother’s estate when she passes. They are also asking $1000 a month to cover food costs.
Currently my mother is paying $250 a day and has 3 people caring for her ($200 day for nephew and wife). On average this works out to $7500 month, ($6000 month for nephew and wife). My mother is not a rich woman. But thanks to my late father’s investments has enough money to live comfortably. Her monthly income including social security, retirement funds, and dividends from investments totals to $5570 a month. We have had to supplement this amount by an additional $4000 a month from the stocks to cover her currently monthly expenses including the amount she pays for personal health care.
Being the Financial POA for my mother they presented this proposal to me. My mother does not want to upset anyone and is feeling caught in the middle. My brother and I both feel that the current rate of compensation is a generous amount. My sister (mother of nephew) feels for all that they are doing that they should be paid more than $100 a day each but does not know what the new rate should be. Everyone but my nephew’s wife agrees that $20,000 a month is an extraordinary amount to be compensated.
We cannot agree or move forward without a Personal Care Agreement that would include a fair rate of pay for personal health care, food compensation, and location where the care should take place.
What I need help with is:
-What a fair and reasonable rate of compensation for my nephew and his wife to take care of my mother full time.
-A reasonable rate to be recompensed for food cost.
-If she should pay for any additional outside services such as house cleaning, lawn maintenance, snow removal etc. Or should it be covered for what is paid for health care?
-If my mother is paying for personal health care, should she have the right to say where that care should take place.

Thanks for your help.

Find Care & Housing
Why don’t you interview some caregivers.

I was an unpaid caregiver for both my parents. I could have easily earned a high wage elsewhere - but chose to care for them myself at great personal cost. I would do it all again in a heartbeat. I believe that no amount of money is too much to pay someone who is caring for an elderly person. The job requirements range (sometimes switching suddenly) from grief counselor, cook, laundress, janitor, medical liaison, CNA, teacher, secretary, security guard, lawyer, accountant ... you get the picture. Having a loving family member in that position is priceless as long as that person is emotionally (and not solely financially) motivated.

That being said, because of the 24/7 aspect of care, and my other life needs (raising my own young children), I had to bring in help also. I hired several wonderful people through the years who are now (that my parents are gone) closer to me than some of my own siblings. They were much nicer to my parents than many family members. They both worked for a modest wage, not the lowest in the market, but certainly well below the highest. They truly loved my parents and my parents loved them. I found them through a help wanted website.

If the need would have arisen, I have no doubt that one of them (who was single) would have moved in with Mom to help at the end of her life when she required lots of care. I also know that she wouldn’t have charged much more than she was already earning.

When my grandmother required 24-hour care, my parents were not physically strong enough to personally care for her. They hired 3 workers to each take 8 hours per day to keep Grandma in her home. My parents selected one to work as the “manager.” She scheduled the others, figured out duties, budgeted expenses, etc. There were a couple personnel changes over the years, but this worked out very well. The pay was very modest.

If you do not feel comfortable paying these amounts trust your instincts. You have options.

If you meet these demands now, what will happen when the job gets harder, as it inevitably will?

Shop around and consider other arrangements.
Helpful Answer (11)
Reply to ACaringDaughter
JoyfulOne Mar 5, 2021
This is an excellent answer!
I think $20K a month is ridiculous. I also think $1K a month for food for 3 people is insane. Plus they don't have to pay rent/mtg payment like they would if they were out in the working world earning a living. And, by the way, would these two even have the capability of earning $10K per person if they were employed in the workforce? Did they earn anywhere close to that prior to helping g'ma? Just guessing, but I bet the answer is no.

I'm just gonna say this: How would your niece/nephew even have an inkling of an idea that g'ma would have enough money in estate to cover $15K PER MO after death? Unless you have discussed the details of her finances with them, this would indicate your sister did. Someone had to tell them there is a substantial amount of money that will probably outlive her medical expenses and personal needs for the rest of her life. Who discussed that with them? I mean at $15K per month to be paid later, let's say she lives another 5 years. You would have paid them $5K per month = 60K per year or 300K in 5 years and the estate would owe them another $900K when she passes. I doubt seriously these two would have ever made that kind of money in 5 years working outside this proposed arrangement (unless they have given up some very lucrative jobs to help grandma. . . and I find that hard to believe). As well, who is to say there would be that much left at the end of her life? Are they willing to walk away with only the $5K they made each month if the extra $900 is gone? An estate is really only the remainder of what you had.

How much is grandma's house worth? Maybe make a deal with that. Upon death, house transfers to them. Still a gamble. G'ma lives one more year they get the house, g'ma lives 10 more years they get the house (as long as they continued to be there to help). Then balance of assets distributed as indicated in will.

Now the food. Two of them plus g'ma in the house. Why wouldn't there be meals cooked that everyone eats? Think about your own budget for food. Do you spend $1K a month? Does that even sound reasonable to you?

If you have two adult relatives living in a rent free/tax free/insurance free house, I can see upping the care amount a little, but not anything near to what they are asking. No matter where these two yokels live and work, they should be paying housing expense, cleaning their own house, cooking food, washing clothes, upkeep of the yard. Agencies have expenses that private caregivers do not have. The office management and overhead push their prices up.

$20K per month works out to 2309.47 per week for each one of them. And that amt would be 13.74 per hour ASSUMING both are working 24 hrs a day, 7 days a week and that is not happening AT ALL. Both are not tending to her needs at the same time during the day or night. My guess is the niece is helping with toileting and anything to do with personal issues. In fact, with the mindset of some men, niece might be doing all the housework, laundry, and getting up as needed during the night. Very possible that nephew is hanging out all day, but not really lifting a finger - maybe he mows the yard weekly or biweekly during cold seasons? Maybe he does most of the driving errands like groceries? He's probably handy to stay in house IF niece has to run a personal errand. These two are not working 24 hrs a day - and you can bet one is working much more than the other. So at 200 per day, it comes out to $8.33/hr for 24 hrs (plus shelter and food/other living expenses for free). Tell them to keep track of their hours and they can figure out who earned how many hours per day. Maybe one of them can get a job outside the home/work from home since neither of them is actually on their feet working an entire 12 or 24 hr day.

Bottom line is these two get $700 per week each (100x7days), so total of $1400 per week. (1400x4.33 wks per month = a little over $6K per month) With no other expenses, they could even be saving.
Helpful Answer (11)
Reply to my2cents
Smithbarbl Mar 5, 2021
You are a very wise and helpful person. NO caregiver should demand such an outrageous amount from a relative.
$20k a mo, well that is above costs of 24/7 private pay at a NH in most areas. AND ADDITIONALLY a NH will have a whole range of staff from dietary to activities to therapists & full time nursing care staff & a MD medical director. Plus on site medication management, transportation and religious outreach. For that amount of $$$, your mom should totally have the expectation of that level of professional care and amenities.

What your nephews wife wants (she’s driving this notion, isn’t she) is beyond egregious. $20k PLUS free room & board, right?
+ $1000 for food. Just u wait Lil Missy is gonna be asking for a car...

Lil Missy is not professionally degreed in anything, is she? FFS 10k a mo is what a MsRN makes. She either a blatant opportunist or is really dumb as a sm box of rocks. I’d suggest that your brother gets a private investigator to run a bkgrd on her to find out which one it is.

On the “for profit bills 20k a mo”.... well the for profit agency actually pays their workers maybe 40-55% of the 20large. The company does full FICA, workmans comp, retirement, health insurance and Covid compliance. They likely also do some type of training, like w Red Cross to have their staffing certified. For 20K, the agency is able to cover all shifts should a scheduled worker have their own emergency, like that morning they a running a temp of 100 so cannot work safely due to Covid concerns. Nephew & his wife provide NONE of this.

Again 20k a mo + free R&B + food $ is beyond egregious.
None of the trio are professionals or have licenses, they are baseline workers. In the private sector, I bet they would get paid $10 -$14 hr with benefits taken out from the $, $20-25k a yr. Its a low wage job. Home health companies are always looking for workers, you can probably easily go onto your states Dept of Employment Security and look at jobs posts as what hourly wage places like this are paying. Caregiving is basically viewed as low skill scut work w/low wages, unless your degreed or licensed. Right now at $100 day every day, they are both making 36k a year, that’s a decent income in the US especially as they have no rent to worry about.

Question for you..... for last year when Lil Missy & your nephew & the niece worked to care for your mom, did you - as your moms DPOA - report all in moms 2020 taxes? And did you as DPOA have all 3 do W-9 & maybe I-9s? Did mom pay FICA on the wages?

If not, you might, might be able to get past this for 2020 taxes, but for 2021 you as moms dPOA must do all the reporting and FICA quarterly payments as per IRS regulations. IRS rules on household workers as being employees and NOT as contract labor is pretty clear. Its not just an IRS issue but if your mom should find herself actually outliving her money (it happens) and mom needs to apply to Medicaid to pay for her room & board at a facility, cause shes now 96 and her needs are beyond staying at her home is feasible for, then all that $$$ paid to lil Missy, your nephew & niece will be viewed by Medicaid as “gifting” by mom and make her ineligible for Medicaid for a long penalty period. Mom has to have a legit caregiver agreement and proper payment with FICA & IRS reporting to get beyond this. Medicaid has a 5 year lookback.
Helpful Answer (10)
Reply to igloo572

Haven't yet read every reply, but looks like most feel 20k a month is a bit steep. $240k / year. Plus another 12k / year for food?!! LOL wth they eating, Wagyu beef? And... they get to live there rent free? Utility free? House maintenance free? And, how about those income taxes? Who's going to take responsibility for that? Yes, a for profit facility or business is going to be expensive. That's because they have this thing called "overhead" -- business expenses. I think maybe you should get some legal advice since you are financial POA.
I took Mother in mid 2017. I went a whole year before I told her I needed to be paid, and I really felt icky at the time having to ask, but I gave up a job with paid medical insurance, profit sharing and a 52k year salary. Doh!
I drew up a contract and had it notorized. She pays me $350 a week, and buys me a tank of gas each month. When I take her back home for visits she pays the travel expenses -- car rental, fuel, food, lodging. At tax time, I file as self employed, covering those taxes and taking deductions for mileage, utilities, food.
Honestly, I don't even know if how I'm doing this is how it should be done. And yes, taking care of elderly people is hard work, but I'm not going to be ridiculous about what I think I should be paid.
Helpful Answer (10)
Reply to MumsHelper
innerchild5 Mar 15, 2021
Is your mom still responsible for home taxes, maintenance, utilities, besides what you paid to take care of her? My sibling has lived with mom for about 14 yrs. thought it would only be to heal fo divorce, but never left. I had empathy for healing, but it has turned nightmare since. He started working within yr and half and drive her vehicle. She continued to pay the car insurance, HIS life insurance policies on his family, etc. too desired, but he feels living there for past 14 yrs, with her keeping up cleaning pretty much like a boarding house. He does car repair, if need be, but he is one driving the car, she hasn't driven! He picks up groceries when up to it. She pays for most. He does what he wants in more ways the one. I have been there daily through the yrs, do one grocery shopping, helping with paperwork, which drove me to insanity as she throws out needed documents. I brought my mom to get a trust after my dad died to help keep things in order, but she never gave me co-trustee to actually manage things. It was trying drive with my hands and feet tied. She never had ANY idea of paper work, as my deceased father always did it all. I took her to all dr appts. and with her for aftercare. It!s been a HUGE MESS, NOW burned out from the golden CB gleaning 14 yrs of saving his $ and has the financial ACE/control and threatened if my other br and I try to do anything. He finagled a new attorney and my mother does not know what she agrees to. She got scripted to talk on phone. Long story short, most of family do not know how controlling and narc he is. I'm the ostracized one now and hurt badly. My faith keeps me getting through each day. I am 70 yrs old, mom 98, and though good for her age, she really wasn't competent to understand the web LB has spun. He has whole family believing I am crazy. I went to counseling to keep sane from the lifetime of dysfunction. I m tired, and needed to vent. I resigned letting the more one has, more they think trey deserve. Pray for peace he'll have to face Judgment day. I don't know if any of this makes any sense, Very depressed , can't sleep. 😥
You need to see a lawyer. If your mother runs out of money, she may not qualify for medicaid from paying out all of that money to a relative. Then you could be stuck financially for her care. Each state is different so you really need to see a lawyer. I personally think that those rates are outrageous for caring for a grandmother. Furthermore, free room and board with food on top of a hefty wage is outrageous. I think grandma is being taken advantage of.
Helpful Answer (9)
Reply to Sandy321
Doug4321 Mar 5, 2021
Good point about Medicaid. If you document this well, would payment for caregiving not be considered a gift?
When she applies for Medicaid and a reviewer sees checks larger than $600, then a red flag goes up....gifting!
Consult an elder attorney not only for advice here but to make a contract between mom and nephew. Anyone who gets paid will need to file taxes as income. As POA you can pay the lawyer with her money. Usually it is the person with the contract who gives them a w2 or 1099 each year. Also do you know that Assisted living and memory care payments can partially be claimed as a tax deduction which is not the case here.
FYI 220k/ per year would be an average if you hired 5 full time caregivers wages, insurance and management expenses. Yet your mom does not need any caregivers to assist with ADLs currently. Ignore the wife and seek legal help. Otherwise this will blow up when she needs a SNF and nephew and wife walk away scott free
Helpful Answer (8)
Reply to MACinCT

Ceb - your are NOT obligated to fulfill mom's every wish and whim. She can ask to go to the moon but it's not possible.

Same in this case, mom can ask to have nephew and his wife to care for her, but if they are not willing to take the job for what you offer in pay then they are NOT available. Tell mom they won't take the job, they are not available.

Take mom to tour a few AL places so she can see what they offer. Mom will have friends her age to socialize with.

If you offer less than what the nephew and wife ask, and they reluctantly accept, they will NOT be happy with less money and it will reflect in their care of your mom.

It is very common for employees who think they are underpaid to underwork, underperform and resort to stealing to get what they think they deserve.

I would not keep the nephew and wife as caregivers.

I do think that $20,000 which comes out to $240,000 a year is a lot, that's $120,000/per caregiver a year. But what you're paying is $36,000/yr per caregiver is low. Check the rates in your area to find out what caregivers make plus over-time and see what the reasonable amount should be.

It's best to find outsiders, and have formal employment contracts with them. If they don't perform the job satisfactorily, they can be let go. With relatives, if you fire them, you ruin the relationship as well.
Helpful Answer (8)
Reply to polarbear

Sounds like grandma is getting ripped off....get professional help and information from an Elder lawyer.
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Reply to DiamondAngel14

The kind of person who would charge as much as the niece wants, is not the kind of person who needs to be taking care of your mother. I found a woman who had gone through nursing school, except for the final tests, to take care of my mother for $500.00 a week. We supplied her food and she lived with Mom. We would let her use our car and we visited daily and helped. She would go out while we were there sometimes. I'm so sorry you are going through this but it would make things even worse to let your mother be robbed blind by a greedy person.
Helpful Answer (7)
Reply to missingjim

My opinion is this level of care should not be done by family members. Hire trained, experienced, caregivers, with credentials.
Helpful Answer (7)
Reply to amoeba
Countrymouse Mar 6, 2021
The nephew's wife does have training, though I'm not quite sure what a Medical Asst is.
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