Solution 5: Share an In-Home Care Provider With Another Elder or Adult With Disabilities
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Elders and adults with disabilities may need many different types of care. Some may need only occasional assistance with chores and errands, or even just a daily visit or call to check in and make sure everything's okay. Others may need more extensive daily help with walking, hygiene, meal preparation, or skilled nursing care. At every point on this spectrum, sharing provides a number of solutions.
This section covers sharing an in-home care provider. Below, we also cover sharing care with another family (Solution 6).
Getting Light Assistance
An in-home assistant can provide occasional or light help, with tasks such as:
- preparing meals
- shopping for groceries and other necessities
- caring for pets
- doing housework
- keeping track of medication
- managing finances, and
Adults (or their families) can pool their resources to employ someone who will come regularly to help, possibly spending an hour or two at each person's house per day. The assistant could also save time (and the care receiver's money) by running errands for several people at once. For example, several seniors could hire an assistant to make a weekly trip to the grocery store and pharmacy, picking up food and medicine for everyone, based on shopping lists they prepare, at the same time.
Getting Help for More Extensive Needs
For adults who need more help, such as with walking, eating, and other fundamental needs, more than occasional assistance is needed.
If two people (or their families) want to share an in-home caregiver, one option is to have the caregiver split time between households. Alternatively, an elder or other person who needs care and has sufficient mobility could travel to another's home— usually a friend's or family member's—during the day, to share the help of the caregiver. Even if you don't have another family member or friend in mind, you could use the Internet to find another family seeking adult care in your area. In addition to the cost savings, this type of care sharing provides an opportunity to socialize.
If you're going to make an arrangement with a friend, family member, or neighbor to share a caregiver, make sure you decide on these important issues (and put them in a written agreement):
- how to find and choose the caregiver
- where care will be provided—you can choose one home, agree to alternate homes, or have the caregiver split time between homes
- expectations about timing, activities, and food
- issues relating to medication schedules and other special needs
- financial issues, including how much to pay the caregiver; whether to enter into a formal employment relationship; how to divide payments if you're not using the same number of hours or the caregiver lives at one home; whether families have to pay for time they don't use (if one of the elders stays home one day, for example); and what to do if the level of care each person needs is different, and
- how to resolve conflicts if they arise.
Sample Caregiver Sharing Agreement
Fran Sampson, Josh Laurence, and Betty Serpa (Fran's mom) agree with Joan and Mark Morgan and Alice Phillips (Mark's mom) to share an in-home caregiver. The caregiver will be providing care for Betty and Alice. Betty lives with Fran and Josh in their home on Roberts Avenue, and Alice lives on her own at the Piedmont Garden apartments on Pleasant Valley Road. The parties all agree as follows:
- The caregiver will work at Fran and Josh's home on Roberts Avenue on the following schedule: Monday through Friday, 8 a.m. to 5 p.m.
- The caregiver will assist Betty in the following activities as needed: bathing, dressing, grooming, transferring from chair to walker, doing exercises, managing medications, driving to medical appointments, and preparing food and snacks.
- On Mondays, Wednesdays, and Fridays, Mark will bring Alice to the house at 8:30 a.m. and pick her up at 4:30 p.m.
- On the days that Alice is present, the caregiver will assist Alice in the following activities as needed: managing medications, preparing food and snacks, doing exercises.
- Fran, Josh, and Betty will be the caregiver's employers, and they agree to pay the caregiver $15 per hour. It's up to them to work out a contract with the caregiver stating when and how the caregiver will be paid, and arranging all the other terms of employment. Fran, Josh, and Betty agree that they'll deduct taxes and Social Security and pay their share of taxes, as well as pay for workers' compensation insurance. Mark won't pay any share of the taxes or workers' compensation insurance.
- Mark will reimburse Fran and Josh for the care that Alice receives at an hourly rate of $10. The parties agree that it's fair for Mark to pay more than half of the hourly rate, to account for Fran, Josh, and Betty's added expense in paying taxes and insurance expenses.
- Mark will reimburse Fran and Josh monthly for Alice's care, based on the hours that Alice actually used the caregiver's services that month. Mark is free to notify Fran, Josh, and Betty that Alice won't be coming to their home on any given day, but he will pay for at least two days of care per week even if Alice uses less care.
- Any party may end this agreement by giving one week's notice.
- If disagreements arise between us that we can't work out ourselves, we'll try mediation (at our local community mediation center) before terminating this agreement.
- Fran and Josh agree that they will maintain liability insurance on their home.
- Fran, Josh, and Betty can seek Medicare reimbursement for the care expenses for Betty, and so can Mark. Fran, Josh, and Betty will provide documentation of Mark's payments, and will deduct his contributions from the amounts they claim.
__________________ Fran Sampson ________ Date
__________________ Josh Laurence ________ Date
__________________ Betty Serpa _________ Date
__________________ Mark Morgan ________ Date
__________________ Alice Phillips ________ Date