Are there rules for fairly compensating home health workers?

1 answer | Last updated: Sep 14, 2017
Helplessinchicago asked...

Hello, I have been a caregiver for about five years. I usually have consecutive 24 hour shifts and some clients talk all night and/or have frequent attended bathroom breaks throughout the night. I also have had assignments with multiple clients to care for - at the same rate. This often means that I spend a 72 or 96 hour period with very little sleep. My agency just offers to cut my hours, but, I need to work to pay my bills, and I have seen that my clients with dementia have a very hard time adapting to frequent caregiver changes. Is it legal to pay us 8 hours for a 24 hour shift - especially with an active client or multiple clients? I recently had an assignment of two elderly dementia clients - which was extremely difficult since there were no accommodations in the home - the doors were not safety locked so I was afraid to sleep - and one had Parkinson's and was unable to ambulate. But, this was made even more abusive when their son came home from the hospital after quadruple heart bypass - and suddenly I had three difficult clients but I WAS ONLY PAID FOR ONE.

Is there a part of evaluating client needs that takes into account the needs of ALL the clients being cared for?

Shouldn't we be paid for each client we are RESPONSIBLE for?

Shouldn't we be paid above the 8 hour level for hours of sleep lost taking care of the clients in the home?

Shouldn't we be paid for more than 8 hours when we are racing about 20+ hours per day?

This is extremely unfair.

Expert Answers

Merrily Orsini, MSSW, was a pioneer in the business of providing geriatric care managed in-home care. She currently serves on the board of the National Association for Home Care and Hospice and is Chair of the Private Duty Homecare Association. She holds a master's degree in social work and is a nationally known writer and speaker on aging, elder issues, and in-home care.

There are laws governing fair compensation for home healthcare workers. The agency where you work should have policies in place that detail what a job entails and how much you are paid for your work. The job description should specify the rate for one client or more, and should also always be in compliance with state and federal laws governing wage and hour regulations. The agency should also do a plan of care prior to starting service that details for the client as well, what the caregiver will and will not do and what the charge is for the service. In homecare there is a "Companion Exemption" rule that is applicable in some states that allows for a caregiver to an elderly or disabled person to stay in the home for more hours than other types of work. However, even in these exemptions the caregiver is not expected to actually be working the amount you indicate in your question. The Department of Labor has details about wage and hour and also provides a Toll-Free Help Line at 1-866-4-USA-DOL. Here is a link to the local offices in each state as well: