Tipping a Home Health Aide?

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Tipping a Home Health Aide?

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We absolutely love our Home Health Aide and want to tip her somehow during the holidays but I know these agencies usually don't allow the aides to accept gifts/money.

Has anyone found a way to express their gratitude for over the top care other than verbally?

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A caregiver is in a position of trust. That's the difference between them and waitresses, hairdressers and delivery drivers. I don't include cleaning ladies from your list because they too have something of a position of trust, operating for sustained periods in people's homes; but all the same it isn't the same relationship, nor the same balance of power, nor the same potential for abuse of trust.

You can't take tips, or gifts, or hospitality, and that's flat.

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Do you tip a waitress? Or a hairdresser? Or a cleaning lady? Or a delivery person? The only reason agencies get bent about it is because there's no way for them to guarantee their cut of it. I worked as a home/health CNA for years. If you want to kick her a few bucks for the holidays as a bonus then give her an envelope of cash and a card. There's no need to involve the agency she works for. There is also no need to involve the client if they have dementia because that could cause problems. The bonus is coming from you and from your family as a gift to the person who cares for your elderly loved one. You don't have dementia. You will not forget you gave it to her and then accuse her of stealing. So, I say do it and have not a single worry about it. Homecare agencies are super greedy and usually pay their field employees minimum wage or just above it. If they've got hundreds or thousands of field employees then the possibility of bonuses really adds up and they want their greedy cut of it. Just give her some cash. Trust me, there has never been an in-home caregiver who's EVER accepted a holiday bonus from a family and reported it to their agency. If you happen to have one that will go running back to the agency and tell them, then I would advise you to fire her at once. A caregiver like that can't be trusted in other ways. Like she'll discuss your family's business and what goes on in your house with her supervisors and agency and you don't want that because it will make problems with your caregiving plan. You will not have any problem with doing something nice for the caregiver you appreciate.

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The best way to tip a care giver from an agency is to make the agency's coordinator aware of your intentions so that they will have the aide accept whatever you are giving to them.(Aides don't accept gift because family members /client later accuses them of stealing especially those with dementia or some kind of memory issues)Good luck.

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It's different when you're accepting it from the client's grown kids or relatives. The getting accused of stealing, etc... is only when the caregiver is dealing with a dementia client. Then we know better than to accept a gift. If it's the client's family wanting to give the worker a holiday bonus or something like that, then you give it to them in cash.

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agency we are currently using says no gifts of any kind to staff. Presumably some CG know or see each other during shift change and maybe would let something slip about receiving a gift. My mother gave a CG an expensive door wreath no one in the family wanted or liked. instead of returning to the store mom gave to caregiver-i would have taken to goodwill or somewhere like that-but no. I told the manager mom had given a gift to CG. Mom was in the room during first day of care and went over all the rules including gifts as i knew mom would probably want to do gift giving anyway-no way to stop mom from letting things get out of hand on this topic.

Second agency we had for 2 weeks says yes you can give a gift but has to go thru the agency. They bill you $20 for the gift card then give to the intended staff- this way is on the up and up. Mom would more than likely forget and give to same person more than one time or open the door for other requests by staff for help-my car broke, my heat turned off etc. Only one lady of the current team/agency is above average and I feel pretty sure she would not accept a gift when the other lady did-which is an item of agreeing to work for the agency the staff sign and agree in writing to follow.

Maybe you could contribute to a food bank, shelter, community group in the name of this individual as an option????

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I never heard of this. Trust me when I say that having been in homecare myself near to 25 years now, no caregiver ever speaks a word to another employed by the same agency if a family gives them a cash bonus. A wreath or something is different. No one talks about the cash, ever. So if you're going to give the caregiver a real bonus and not something that you were planning on throwing away or donating to the Goodwill, give her an envelope with some cash.

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The prohibition against "tipping" is not just due to "greedy" employers. It is also because no patient should feel that they can get better care or more attention (or fear that some "other" patient is getting better care etc.) because of extra gratuities paid "under the table". And no genuinely caring nurse or aide really WANTS a patient to feel that way. Employers, "greedy" or not, can not afford to have a reputation that allows for that.

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I get what you are saying. Fair enough. It’s sad that caregivers make so little money for a challenging job.

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Unfortunately for you, it's considered "unethical" for health care workers for accept monetary gifts. Even a gift card would probably be somewhat suspect. But could you give her some special home made item, maybe something you have baked, designed or sewn? Does she have children? Is there something special you could give her children, for example tickets to some holiday program or activity. Or if you know her well enough, even child care so she and her husband could enjoy a night out. You may have to get really creative. Try and find out what would please her.

Of course, you might just let her know, in a handwritten note, how much her care means to you and your loved one. Though not of monetary value, it can be counted upon to lift one's spirits after many a long discouraging day! Take it from one who knows.

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Imho, praise this Aide in ways that don't involve money, e.g. baked goods, et al.

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My Dads CG mentioned once that she and her roommate kept their home pretty cold in the winter.. so Mom got her a lovely warm bathrobe for the holidays one year. She was thrilled,, and I am pretty sure she did not report it to her agency.. LOL Yes they are paid poorly, and our Gal was wonderful!

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If the care is private pay, and care givers are hired directly by patients or their families, then reward the care-giver any way you want! Even agencies do not have direct control (or supervision) over their employees and often pay very poorly. It's certainly true that most good care givers don't get paid nearly as much as they deserve. No one here is saying they do.

BUT if patients are being cared for in a facility, a nursing home or a hospital, tipping should not be allowed (and facilities prohibit it). That is because "tipping" gives the impression that QUALITY of care is commensurate to the amount paid. And no health care facility functions that way! If you or your loved one is hospitalized, or in a nursing home, they are entitled to receive the best possible care without worrying about having to pay "extra".

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Write to her agency (copy her in, too, just in case her agency isn't big on giving positive feedback). Give specific examples of excellent work. Make your letter business-like, rather than personal.

This will translate into a better resumé for her, which in turn will boost her earning potential, and meanwhile your praise will make her feel genuinely appreciated.

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Verbal thanks are lovely. Money is even better! How about gift cards to the grocery store, or big box store. A smart aide is not going to tell his/her employer. Do it often, don't wait for the holidays.

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I bet if everyone took a turn being a caregiver they would appreciate them more.

I had no clue how hard it would be to care for my mom with Parkinson’s disease.

Many caregivers are caring for patients that have debilitating diseases that rely on the caregiver for everything! It’s physically and emotionally exhausting to be a caregiver.

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I see all sides here. Agencies have a right to make a profit. They need to make money to stay in business.

Be honest, would you run a business without making a profit? No, you wouldn’t unless you ran a non profit and received grants and donations.

Aides have a very tough job and make very little money. Some clients don’t even have the decency to say thank you at the end of their shift.

Certain clients expect an aide to do chores outside of their job description and were unpleasant all around which s unfortunate.

I heard very sad stories from aides who took care of my mom.

I always said thank you to the aides and showed appreciation to them with money, gift cards, treats, meals and especially kindness.

It doesn’t cost one penny to be kind and show respect. It broke my heart to hear stories about them being taken for granted. Give a bonus on top of being kind.

I went above and beyond because I truly appreciated their help.

The suggestion of writing a letter is excellent! I was told that letters are placed in an employee’s file and raises or promotions are given to those who have received these letters.

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I don't see why everyone seems to think that ALL aides have a very tough job. My mom weight about 95 pounds and sleeps a lot. Her aid is going to school (remote) and does all her homework while she is on duty. Every situation is different. Yes, I am appreciative, and Yes, I make certain agency pays her, but I don't think her job is THAT hard.

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I feel if you find a good Aide, a little extra $$ won’t hurt anyone as long as she keeps it to herself. Any way you can get someone to stay so a parent who is, for example, combative doesn’t have a different Aide every day. My private pay Aide I got from an agency...who neglected to pay her for a long time. Even though I prepaid the agency a couple of thousand $$$ !!!
So she works for me for 3 + years. Good luck & hugs 🤗

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Same.

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My mother had an agency come in to her home. The gal who was coming in said the agency was always late giving them there paychecks. Sometimes taking 3 weeks to pay the help. Not good. I always tell people to not use that agency!! They really sucked.

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I worked for a large CG company. They charged the client over $25 an hour. I made $9 an hour. You do the math.

After a YEAR, I asked for a raise. I was turned down. The 'policy' was 'no raises, ever, you make what you make'.

I had to quit, since there was no hope of ever 'doing better'--and told my client's family so. They were devastated, as I was the first and only CG who could handle their mom, whom I had grown to love. I wasn't trying to shake them down, I had to give them a reason for my leaving for a $12 an hour job. (I was working both jobs and could go FT at the $12 an hour one).

I don't know how it happened, but the family (wealthy, to say the least) worked it out with my company to 'tip me out' so that my pay went to $14 an hour, after tax. 2 of the sons were lawyers and I am sure involved in this.

My 'boss' said she'd never seen this before--and I do not know how they worked it out, but I was happy to stay, and honestly, it is often only through being paid that you feel worthwhile. It's about the hardest job in the world!!

My client would also 'tip me' at Christmas and on my birthday. A crisp $100 bill, which was most appreciated. I did not tell my company, and I never felt bad about NOT telling them. Always a sweet note accompanied these gifts.

I stayed with this client until she had to be placed in independent living. Broke our hearts, both of us.

And I quit working for the 'big, cheap company'. Who by then were charging $30 an hour and STILL only paying $9 an hour. And couldn't figure out why their employees were leaving after only a few months.

CG is the hardest job out there, IMHO. A baked good and a card? I honestly would rather have nothing. I was making it possible for an elderly woman to spend 2 more years at home--a loaf of banana bread wouldn't make up for that.

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Midkid58, I am so glad it worked out for you. That’s just crazy to charge the client 25.00 an hour and you only got 9.00 an hour?? That is crazy!!!

I think the company that hired you should have paid you 14.00 an hour to begin with!!!

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I know this applies to the state where we run a care agency: tipping is discouraged because of how easily this can be misconstrued by clients, their family, or others as financial abuse of an elder. This is coupled with the fact that we are mandatory reporters. I have also had employees tell me that they do not want to be tipped because they want their clients to know that they would provide the same level of care with or without the tip. We request that gifts never exceed $25 dollars in value, and always emphasize verbal or non monetary gifts.

I would think a baked good or a really nice handwritten card/letter would suffice. :)

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A monetary thank you for under paid aides is only unacceptable to the agency, everyone else thinks it is completely acceptable.

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My mother takes call a bus to take her to the grocery store. They have a no tipping rule. On occasion my mother has tried to tip or give extra CASH to the driver and each driver has said to her “I can’t accept a tip or cash.,I WILL GET FIRED!!! This would have been confidential between my mother and the driver. The driver always said NO. I’m sure the agency has told them that if they accept tips or cash then they will be fired!

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Most of these are government employees and they are not making minimum wage.

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I brought this up with the agency I'm using. They said no money gifts as they have to turn it in to the management, who in turn has to complete some paperwork and it goes to the government, and taxes may have to be paid on the amount. I asked about gift cards, he said that would be okay, or send flowers to caregiver's home, or fruit basket, with a nice card.

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I encourage you to look closely at the knowledge of these agencies given here. Most people are aware these agencies are predatory and the real reason they try to enforce this rule has nothing to do with “taxes” or any such nonsense, the reason they put that in place is so if a family wants to give a monetary gift to the caregiver it’s supposed to be given to the agency so they can take a big bite out of it and leave crumbs for the caregiver ( which is unethical by the way and counterproductive to good caregivers and their clients)

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Tips and gifts are discouraged by agencies. They worry that home health care aides may "prey" on their clients, especially those with cognitive impairment. However, home health care aides usually make only minimum wage. So, make sure to have food and drinks the aide can eat/drink whenever they are there. If you do want to "gift," consider practical gifts like gift cards to Walmart and grocery stores. Gift cards to expensive restaurants will probably never get used.

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I don't provide food or drinks. It became obvious that none of it was touched. Many aides have food preferences due to diet, personal choices, or are foreigners who don't eat typical American fare (Sierra Leone, Nigeria most recently and there have been others) They also change frequently due to high turnover. One who had been a regular for several relocated recently and I gave her cash to apple to moving expenses.

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Most home healthy aides are not allowed to accept any gratitude but I sent her agency a recommendation of letter that how much I appreciated her help of my parents.

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Read the responses here, most of them advise family to show that gratitude regardless of what the agency says and keep it confidential between the family and caregiver. A letter of recommendation is not considered a “gift”, it’s generally expected as a matter of standard business practice for a job reference. I’m not sure how some conclude it’s a gift of some sort. I hope this helps clear some of these things up

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I gave my dad’s helper gift cards, and though he’s gone now, I still send her gift cards on occasion. A wonderful helper is a godsend

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Considering the fact anytime you employ a person to care for your loved one they’re providing the most important thing I join in with the recommendation of most here to go ahead and dismiss the agency’s rule not to give a gift to the cg, it’s a predatory unethical practice by the agency in the first place telling adults they can’t thank the caregiver!! so definitely I would gift them with either cash or a Visa gift card confidential between you and the caregiver

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I really think it has to do with tax declarations and to discourage uneven practices between care providers. Your care provider can't always choose their client and this is to keep the playing field equal.

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Be like the Military: Don't ask and don't tell !! I am sure the Aide wants the tip and as long as she keeps your generosity to herself, only the two of you will know this secret :-)

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It's only between the two of you as long as it stays between the two of you. And that's not always the case. There's a reason companies had to put this policy in place - to avoid conflict of interest with employee and client. Read your contract with the agency or call to ask about how to show appreciation at special times during the year. Don't do something that may get them fired.

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No one can tell you that you can't give a Christmas gift to a friend. :)

It sound to me like she has become more than a Home Health Aide to your family. You may have met her because of the agency, but she has now become a friend to your family.

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As others have said, tipping isn’t allowed unless it is through the agency.

I don’t think it’s bad to give gift cards though. I am sure your gesture will certainly be appreciated.

I always had food and beverages for the aide that helped mom through Council on Aging.

One aide was a single mom. I gave her money to order pizza for her little girl so she didn’t have to cook when she got home. Her kid loved pizza!

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Do you feel a pizza reflects the value of presumably the most important thing a person did for you?

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If there's any situation where the "don't ask/don't tell" theory applies, it's here.

Our home health aide was a true angel who always performed above and beyond, for a mere pittance - she didn't even make half of the hourly rate we paid the agency. With three children to support, she greatly appreciated the gift cards for the local chain supermarket that I gave her on holidays and her birthday.

The agency doesn't need to know diddly.

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Yep!!

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Most agencies do not permit caregivers to accept gifts, if they do the value is typically limited to $25.00.
A gift card is a good choice.
Often you can purchase gift cards at Sam's Club or Costco for less than the face value. (typically a $100 pack of 4 cards, $25.00 each will cost around $80.00) these are great for gifts. And you do not have to pay to activate them Some of the Visa and Mastercard cards you have to pay a fee to activate them.
One thing your caregiver would greatly appreciate would be a letter written to the agency and a copy to your caregiver telling how grateful you are for the help and care that this person is providing. You can give detailed information as to what they have done. This will go in the employee file and the copy you give to the employee might be able to be used if they wish to look for another job, or if they are asking for a raise.

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A letter of recommendation would be expected for a job well done-a reference or letter of recommendation is not considered a “gift” or even a thank you. it shouldn’t be in lieu of a financial reward. As some have already stated here before in regards to this issue, caregiver agencies are predatory and don’t allow the caregiver to receive a gift the family wishes to give them if the agency can’t get too! It’s disgusting how predatory these agencies are, I will echo what some have already said here, if you value your loved one and you have a caregiver for them by all means show your gratitude with a generous financial gift and keep it confidential between the caregiver and you. God knows they already have taken enough advantage of their caregivers the practice of not allowing an adult to gift a financial thank you to who they want is self serving on their part and ironically counterproductive to the clients they claim to care about so much!

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I would give them a card with a VISA that has whatever amount you think that you would like to give and not tell the agency. It's none of their business and they don't deserve any portion of the thank you that the caregiver receives. (You can get these VISA cards at any bank)

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I agree, the agencies are predatory so they don’t need to know, it’s an unethical practice to begin that undermines the whole caregiving experience and the quality of life for the people doing the most important thing of all! One caveat is giving a cash gift could also be given and kept confidential

Tipping a Home Health Aide?

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