Live-in care. Any advice on compensation?

Lakegirl1: Imho, you will require two caregivers since the four 12 hour shifts alone is a LOT of hours on the clock. Also, you may want to inquire about placement in a managed care facility as your mother has moderate dementia.

Dementia never takes a second off. Requires 24 hours of care 365 days per year. If caregiving gets to be toooo much in the home, I would suggest facility placement with memory care.

Sorry for multiple posts.

Agencies in my area charge $29 per hour (rural Maryland). Before Covid for direct pay I started at $18 per hour. Now for direct pay I start at $25 per hour. I have two caregivers making $31 per hour but they have been with us about 10 years.

I found in this line of work you want to pay well. People will quit to get an extra $1 per hour.

Have good cable tv and internet in your house. I don't watch tv but the caregivers enjoy it.

I forgot to mention that I also have accounts with 3 agencies as backup.

I have one shift covered by an agency worker. She has been with us about 3 years.

I find it better to have more people working fewer hours. If you are short caregivers, they get burned out.

Almost all of my caregivers are working other jobs and some work two other jobs.

We also give a large Christmas/holiday bonus.

I have 24 hour care but not live in....

We start at $25 per hour. This is in a rural part of Maryland.
We pay legal--as W2 employees.
We have workers comp/social security.
We pay 1.5 (time and a half on about 6 holidays.)
Caregivers accrue paid vacation time they can use the next year. This is a formula based upon hours they work.
We also provide some free food....snacks etc.

Are the arrangements for care being described assuming that these are employees of the primary (family member) caregiver? I checked with home care agencies and found that they required a minimum number of hours plus costs of agency oversight? I ask because home care costs thru an agency ends up being as expensive AL in MN.
Much advice thru this forum warns against caregivers being employers. But my research into this makes home care agency costs out of reach. I am writing because I am 82 and healthy but am trying to plan for my care when it’s needed.

are you only going to have one caregiver for her? No relief staff? I had multiple caregivers, 3shifts, and I was the live in manager for the couple. Three shifts were approximately eight hours each and I worked with the staff on what shifts they wanted to work. Periodically I’d say about every three four months they would want of mix it up for a change of pace. I also encouraged them if they were gonna be off shift to ask one of their other teammates if they wanted to cover and swap shifts, that way they kept their money and could keep their appointments as well and didn’t over burden me because I had my shifts too and also as someone else said. The buck stops with you. You cover everybody who doesn’t show up. It was very very helpful I rarely had to go to the agency for help because like someone else mentioned I’m also very picky.

another thing I did was offer time and a half for four major holidays so that I could get a break and have some time with my family.

I believe it was Christmas Eve, Christmas Day, New Year’s Eve, Thanksgiving eve, Thanksgiving day, Fourth of July day & evening. I offered four pay rates increasing incrementally rather quickly. Now granted this was years ago, but $10 an hour for the first day for the first four hours - I considered it training to see their skills in listening performing and getting along with me & the couple. Then immediately it went to $13 an hour for two weeks, $14 an hour for the next month and then $15 an hour there after and it stayed. All these were for the sake of trying to save money and make sure I had a caregiver that was a good fit.

100% agree with others here -one person being responsible for all those hours - they’re gonna get burnt out after a few months. Think about back up because sickness and things happen.

Also you must get nanny cams. And check them periodically especially when they’re new to see what their attitude and care level is and make them keep logs of everything that they do. I saved all my forms if you’re interested.

I would like to second what others have said. This is simply too much for one caregiver to handle for an extended period of time. Plus, if you rely on just one person, what happens if they get sick, have their own family demands, get burnt out, etc. And, it is quite possible your Mom may require greater attention as time goes by. My sister slept through the night the first three years she was with us; the last year she was up and wandering all night long. So for the first 3 years, I took the chance and used a baby monitor at night rather than paying for care. This gave me more $$$s for care during the day. I was able to rely on only one caregiver - with backup working on weekends - when they were working an 8am-6 pm day.

Yes, It is more difficult to manage a team of caregivers; there is greater chance for a "failure" to occur related to shift changes which creates a good deal of anxiety. I was able to find a placement agency that added only 10% to the wages of the caregivers. Being in the Midwest, this meant a total hourly wage of about $24/hour. IF someone didn't show up, I usually - but not 100% - could get coverage through the agency. The problem with this, however, was that my sister might not have known the substitute and vice-versa...and the subs weren't trained "my way."

I think that when you opt for home care, you have to realize that, just as with kids, the buck ultimately stops with you. It was stressful at times, but I was willing to assume this role and have absolutely no regrets. My sister passed away just a year ago from seizures associated with her Alzheimers.

Wishing you peace of mind as you begin this journey.

I have had aides and other household help. I pay what home health dept at local hospital pays. Currently a CNA is $18.00 per hour. I give sick time and vacation pay after 6 months. I provide health insurance after one year. I do not "buy back" this time. It's "use it or lose it" during the year it is awarded. I have WC and also pay with SS and taxes withheld. It's all expensive, but I believe in being fair or don't hire someone.

I am afraid the compensation will be paid according to "what the traffic can bear" for your area. It also may depend upon whether you have to use an agency or whether or not you can hire trusted and vetted people without paying both your aide and his or her agency. Agencies are charging in my bay area of SF upward from 42.00 and hour I just found out via a friend who has returned home on Hospice care and 24/7 needs. The cost is enormous. She was lucky enough to be able to hire two people trusted who have worked for her before for two 12 hour shifts daily at 20.00 and hour. They are being spelled by friends and family. But wow, the expense of home care is almost prohibitive unless there is some wealth involved or the care needs are very time limited. I sure wish I could tell you more and I surely do wish you the very best of luck.

Seven 12-hour shifts at night and four 12-hour shifts every week except one. That’s 132 hours a week. It doesn’t matter is your mom is asleep or not, the caregiver is required to be there. Hourly caregiver pay is $15/hour and up. That’s $2244 a week. Room and board subtract $200/week. So you’ll need to pay her around $8,000/ month.
That being said 132 hours a week is 3 times as many hours as most people work. And burn-out will come soon IF you can find someone to do it.
I suggest you look for a team, as someone else suggested. No one person can do what your expecting and if your mom has mild dementia it will get worse, usually pretty fast. So having 2 people, maybe even 3 would be best.
I think 1099 is the best and easiest way to do this. It gives scheduling flexibility and saves you tons of red tape and paperwork. And usually caregivers prefer this way. They can write off mileage when she needs to travel [around town] and scrubs and keeping vaccines up to date.
Most of the people on thi forum, including me, have been caregivers 24/7 and know how hard it is do spend that many hours without relief. Good luck. I know you’ll do what’s best for everyone.

When my grandmother was growing very elderly, we found a nursing student that could live in the house with Gram rent free in exchange for a little companionship (and welfare checks).

When grandmother needed more help - with ADLs, and eventually 24/7, my dad hired three care providers and named the one with the best qualifications the manager. She was to create a schedule, create a grocery list and meal plan, do the shopping and report back with any problems. The manager earned a higher wage per hour. Each generally worked an average of 8 hours per 24-hour period. When one needed time off, she was responsible for swapping shifts or covering hours with one of the others. The care providers liked the freedom and flexibility, the pay and preferred the one-on-one in-home care over working in a care facility. After grandma passed away, they all maintained close friendships.

This worked beautifully. My parents were elderly with their own health problems and this set up enabled them to have quality time with Grandma and keep her in her home. There may have been a personnel change or two over the years.

The rate was established by contacting agencies in their market about rates and then negotiating to pay more than half based on skills (many care providers would earn half what the agency charges).

Background checks and personal references were conducted for all and they were paid through payroll. Insurance companies were contacted to ensure coverage in case of injury on the property/on the job.

No vacation pay or health insurance benefits were provided, but covering time off was cooperative among the three. Free food was provided during a shift (home cooked— and grandma would have companionship during meals).

I would hire 2 caregivers - one during the week and the other one weekends .

I have used a team of caregivers for both parents and an aunt. They set their own schedules and work together covering call outs or needed days off. So much easier and less stress on the family. One family member still supervised the schedules.

Since all elders slept well during the night cameras were installed to monitor. Alerts would notify of action in the homes. Of course if wandering began or someone did not feel well a caregiver was found to spent the night.

I would be hesitant to employee one live in caregiver.

You will need a back up plan for no shows and callouts

Check with the state labor board to verify. As I've read from your forum, caregiver employees from private or agencies, are people like us and require their own personal time off for their own family, if any, medical appts., errands and annual vacation off. I think working 12 daily hours for only one employee, live in included, is just too long to work without rest. Is any commuting involved? How about hiring 3 caregivers for round-the-clock care? And do not forget about the 2 days off requirements.

So you are trying to fifure out a fair wage for 132 hour weeks, 3 weeks a month and 108 hours for 1 week a month?

I think you should definitely offer vacation and sick pay. I would not let a caregiver that is working that many hours NOT take the vacation time off. I would even allow them to use sick days for breaks.

This type of schedule can burn the hardiest person to a nub in no time. I would consider finding someone to work 3 full days, around the clock every week, have this person for 4 full days and nobody lives in, they just stay there while on duty.

That is just my opinion because I think counting on one person for too much is not a wise move. Especially, a paid employee.

Lakegirl1, be sure to check with your State Labor office to see how many hours a caregiver can work a week. Four 12 hours shifts back to back is exhausting. Plus would the live-in caregiver be on-call during the night?

Could you explain "She will have every Fri-Sun days off and one full weekend off (including nights) a month". Sorry, I can't figure this out :(

If you haven't already, have an Employment Contract drawn up staying the number of hours each week, the duties required, and the hourly rate.

As for pay, sounds like you are hiring private instead of going through an Agency. Be sure to vet the person carefully, and make sure she has her flu and covid shots. Pay would be whatever is common where your live. If you live in a large metro area, the hourly rate would be much higher. Usually the pay is whatever the caregiver and you agree upon.

Hope you find someone that both you and especially your Mother enjoy having around the house.

Oh, I just remembered, check with your Mom's household insurance carrier regarding "workman's comp" policy which is used in case the caregiver should get injured on the job.