Caregiver Costs

It's nice when  day can turn around completely, from the disaster of morning home care to a terrific evening with friends. That was yesterday. It started with a real run-in with my home care workers, and ended with David and Anne helping me figure out the live-in worker numbers. Along the way, David and I took the first steps in solving my transportation dilemma. David bought a wheelchair van for my use. Once we finalize the paperwork on it next week, we will immediately start the process of selling my pickup truck.

Both the live-in care worker and the transition from truck to van are pretty good indicators of how my life has changed over the last 6 months. From being able to get into the truck and drive it, albeit with a bit of help in the getting in part, down to not only being unable to drive, but unable to make the transfer from wheelchair to passenger seat. All of this is due to the dramatic loss of upper body strength.

Then there is the live-in caregiver part. I really only need about 4 or so hours per day of dedicated care. Some days it is even less than that. For example, on Monday I need an hour of personal care that includes helping me with toileting, showering, catheterization, dressing, and so on. I also need about an hour for Range of Motion Exercises. However I only do the exercises on Monday, Wednesday, and Friday. Then I occasionally need a half hour to an hour in the afternoon, dealing once again with toileting and a potential catheter adjustment, as well as a reminder to take my medications. Finally, I need about an hour of personal care once again as I go to bed in the evening.

In addition to that personal care, there are meals and such which I need help with, but which the caregiver will also be making for his or her self. I'm not sure if that should be added in or not, so in an abundance of caution, I am adding a half hour for lunch preparation and a half hour for cleaning afterwards. I am also adding an hour for major apartment cleaning every Monday. All totalled, it is about 28 hours over a 7 day week of dedicated work.

However the live-in is entitled to at least one day a week of unpaid time off. Let's say that's Monday, one of the heaviest days. I will have to hire a separate person to take over that time. The time allocation for Monday is 5 hours. This means the live-in will have dedicated work time of 23 hours over a 6 day work week, or about 4 hours per day on average. On the other hand, I will expect the live-in to share in the tidying, laundry, and other normal household chores, along with being "on call" for most afternoons. Evenings are optional.

That takes care of the working engagement and some of the living engagement. As a home, the caregiver will share this apartment with me, although he or she will have a bedroom with a TV and Roku. I am uncertain how we will work it out, but I don't have a lot of choice in the matter. I need someone around during some of the day, and all of the night. The caregiver will have to truly live here.

The Province of Alberta through the Alberta Health Care Self-Managed Care program will fund $2,987.39 for care. Their estimate is that I need 35.6 hours per week of care. The differential is in things like laundry, additional personal care, and additional incidental care. The AHS "pay rate" for this care is about $20/hour. I would like to stay close to that number, but there are expenses imputed into that pay rate, things like CPP, EI, taxes, WCB and such. So I need to set aside about 15% of that funding for employment costs, along with about $100 for accounting and tax filing costs.

In the end, it looks like I can offer $2,400 or so as pay for the live-in, and about $100/day for backfill of roughly five days a month. This does not include room and board, which I will peg at $450 a month, with room for negotiation. It means the live-in will have almost $2,000 a month clear, after he living expenses. That's a whole lot more pocket money that I have. It seems like a good deal to me.