Companion Care Costs

[smilingartichoke]

I'm trying to set up some regular 'companion care' for my elderly DF who lives alone, rurally and who is no longer driving on medical grounds (dementia).

The kind of service I'm looking at is one where a regular carer with a car will visit my DF once or twice a week and get him out of the house for some 'wellbeing' activities, trips to a local beach, walking in local beauty spots etc

I'm just wondering what the norm is in terms of incidental expenses incurred during such outings? I know my DF would be expected to cover the costs of the carers time and mileage. But what about cups of tea, ice-cream or other refreshments?

I'd expect DH to cover his own costs obvs but what about the carer's costs?

Googling leads me to think that a carer might reasonably expect to be bought a cup of tea or light refreshment by their client. Anyone have any experiences to share?

So as not to drip feed - my DF did go on an outing with a local companion service as a trial last week and has complained to me that they'd called in a local (cheap) cafe for a cup of tea (DF paid) and the carer was 'trying to get a free meal' out of the situation. DF has always been a very suspicious and paranoid person though and the dementia has made this worse, so this may be an incorrect reading of the situation.

I will clarify arrangements with the carer, but before broaching, wanted to get a feel for how this kind of arrangement usually works. Wishing I'd asked up front.. but hey-ho.

I would expect the client to cover the costs if they have a meal/coffee/snack together. And if they are together around a meal time, I would expect them both to eat. I would also expect there to be an agreement of max costs for this. Eg an agreement that a lunch time meal would be max £20 so that finances can budgeted appropriately and there is no possibility that the older person can feel taken advantage of.

Although the companion is expected to be friendly and sociable, and with time a geniune relationship might develop between them, the companion isn't the client's friend, and it's not a social occasion. The companion is being paid for their time and care even at a meal time. It's not a break for the companion

My mother had companion care and covered all (reasonable) costs. So if they are going for tea and cake the client pays for both of them.

As you say he has dementia and is inclined to be paranoid, and his version of events will not be reliable. She might simply have said the food looked nice and he interpreted that as 'trying to rinse me for a meal'.

Get the carer to keep receipts so you can reimburse them when they invoice.

I don't think the carer would expect to pay expenses on a trip suggested by the person cared for. But they should not be expecting to be bought meals. That's quite cheeky. Coffee fair enough.

I’d expect the person to cover the costs of the carer’s expenses if they’re out. If they’re both going for coffee or they’re at a hospital appointment that ends up over lunchtime (eg 12-2pm).

At work, if I have control over what and when I eat I take a packed lunch. If I have to travel for work, I don’t have control and incur additional costs then work pays (but a set rate - lunch is no more than £10 for instance). So you or he needs to set expectations and he needs to bear it in mind when planning trips. The carer is working and doesn’t have the choice about where to go or where they stop to eat or drink.

(this can be a difficult one and a bit of a culture clash sometimes!)

Companion would be bought coffee and cake if out at a cafe. I think it’s a good idea to set ground rules. For example coffee and cake no more than £10 per visit. Could ask them to pay for own and then reimburse weekly with a receipt.

I wouldn’t personally choose to spend £7.50 on a coffee and a scone ( it’s about an hours wage once tax etc deducted) I’d spend £3.60 on a Tesco meal deal with its Costa coffee from a machine. but when my work pays I do. Unless you are happy to tell companion to sit watching him drink / eat which doesn’t seem very companionable. Maybe a flask and some biscuits on a bench at a beauty spot? Also I’d expect to pay mileage 45p a mile so may want to define how far day trip is to be.

And watch out for the elderly person deluding themselves that this is a fun day out for the companion and expecting them to be grateful for it. It’s a job, they probably wouldn’t choose to spend their time doing whatever it is with this person and nor should they be expected to pay for it.

But a lot depends on timings. If
they’re out 9.30 - 12 for a walk at a local nature reserve then coffee whilst out is perfectly reasonable.
If it’s more like 10am - 4pm and a visit to the beach then paying for a sandwich or fish and chips for lunch is reasonable.

Receipts should always be provided. And we have clear guidelines at work re max amounts per meal and no alcohol to be purchased.

Most cafes would expect both individuals to purchase something.

It would not be fair for an employee to be forced to buy something when they are at work, did not choose the venue or the price point.

Therefore some element of paying for refreshments would be necessary. This might need to be agreed in advance and limited, receipts would be needed.

You may have to be very clear with your DF that this is the case, as he is likely to view it as their responsibility to pay for what they eat and drink, even if he almost certainly chosen where to go.

They can’t take him to a cafe and then the carer whips out a packed lunch. So if you want him to go out for lunch then you need to pay for them both.

I’d set a weekly budget, like a nanny.

When we had a similar arrangement for my DH so I had some respite. We paid for the companion’s coffee and cake when they went out. Always an afternoon event so lunch wasn’t required but again if it had been over lunch would have expected to pay. If the companion takes them out in the car would expect to pay mileage ( amount per mile was set by the agency) . Likewise if they stayed in provided refreshments for the companion say coffee / tea and biscuits or cake to have with DH. Unreasonable to expect companion to pay for refreshments or mileage but a good idea to have a maximum budget, particularly if lunch is required.

Yes, you'd have to pay the carers costs if going to a cafe was something the client wanted to do, but that doesn't have to be the activity! You can specify free activities or that the carer eg takes for a haircut, etc which shouldn't incur costs. You can even suggest they make a picnic together before going if it's a longer trip (but you'd have to buy the food)

That's really helpful. Thanks all. I think in this instance it was the companion's suggestion that they stop at the cafe. I think the best approach might be to move to an earlier slot that avoids lunchtime and therefore naturally limits the kind of costs that might reasonably be incurred.

Absolutely make clear to the companion up front what if any budget is available to cover costs for outings. I can easily see that the person being cared for can misunderstand the relationship and think they are ‘friends’ rather than at work.

obviously an employer would be responsible for costs wholly incurred while at work.

I know it’s not the same, but if I’m out at work over lunchtime I get a £5 allowance. It’s up to me what I spend it on and I supply the receipt and get reimbursed at the end of the month with my wages.

Perhaps that type of position could be adopted if being out at mealtimes cannot be avoided or your dad chooses to go out for lunch so the companion has to accompany him.

The companion would get one cup of basic tea coffee paid (they need to be a customer to remain in the place so that’s fair) and if they want anything else they can get a fiver to spend. Up to them if they choose to get a meal deal on the way home or buy a sandwich at £7in the pub when your dads getting fish and chips knowing they will only get a fiver back.

Well, you could indeed limit the maximum costs to be incurred by the companion in the way @RentalWoesNotFun describes.

it will entirely depend on how you want to treat the paid companion. In my experience, good ‘carers’ are like gold dust so that if you have found someone who you trust, who does a really good job I would want to make their time ‘at work’ as pleasant as possible in acknowledgment of how much you value their contribution. I think it’s a really tough job, one I don’t think I could do.

guess it depends in what line you want to walk.

My sister did this service for 3 different clients at a time usually. She took them all out. One lady liked her shopping trips and my sister pushed her in her wheelchair and her husband went too but didn't like looking in the shops so he often sat in a cafe waiting while my sister helped his wife try clothes on. She took this couple out for years then the man died and she continued to take the lady out. Another gentleman liked walking and my sister said he had long legs and she had to almost take 2 steps to keep up with him. We'd giggle at the thought of my sister having to struggl to keep up with him as he was in his late 70's. He'd had a stroke and couldn't talk but was very fit. The final lady just liked my sister especially driving her for a cream tea at a local garden centre, a small walk in the park and get a coffee or similar. My sister paid for any food and drinks and billed clients directly with retained receipts because in all cases the elderly peoples DC had engaged her to go out with their parents because they were either too busy to take them themselves or did not live close enough. She took them out 2 or 3 times a week and also visited them in their home once or twice a week too. Sometimes she'd cook a meal for the gentleman and he'd have it for 2 days and she'd make a jigsaw with one lady or do a crossword and make drinks and sit in garden chatting to the other lady. She had a gardener come each week and my sister said it was a pleasure to sit in her lovely garden and drink coffee. Each visit was about 2 - 2 1/2 hours if they went out or sometimes just 1 - 1/2 hour in their own home. Just to see a friendly face 2 or 3 times a week made a big difference to them. She charged them £30 per hour plus fuel milage which the families seemed happy to pay. All of her clients had their faculties about them though. She had one client for almost 12 years before she died and she often popped in and picked her up her prescription or a cake to take for her. I know my sister used to worry about her when she was on holiday and she'd ask my other sister to drop in on her with a cake and have a coffee with her so she wasn't on her own for a fortnight. After she died her daughter gave me sister £1k for making her Mum's later life happier. She lived in London and could only travel to see her Mum about every 3 weeks. She told my sister her Mum was very fond of her. My sister was embarrassed because she said she was just doing her job although she liked this lady a lot.

You need to cover the carer’s expenses, but it is probably easier in this situation to reimburse them directly, rather than via your father. Alternatively, agree a weekly budget for the carer, to cover all the costs of every outing.