Connie is a certified nursing aid who has worked for Mrs. L., a 95 year-old, 8 hours/day, 6 days a week, for the last 5 years. She does the daily routine for Mrs. L.: bath, exercise intermittently through-out the day, dress for the day, prepares breakfast, lunch and dinner, oversees medications, runs errands for groceries and to pick up supplies, cleans and does a load or two of laundry, and dresses for bed. She lives in the same housing complex as Mrs. L.. Mrs. L. called her after seeing an advertisement Connie had placed in their club-house. They agreed on a price of $10/hour 5 years ago. Although Connie knows she has earned a raise, she has never asked for one because she knows Mrs. L. is financially strapped. She also takes a lot of pride in her worked and knows Mrs. L. would not be able to stay home without her. She also arranged for a friend to come the one day of the week she's off.
Kesha, also a certified nursing aid, has worked for Mrs. O., a 61 year old home-bound patient, for the last 3 years, 6 days a week, 6-8 hours/day. A "friend of a friend" hooked them up. Kesha refers to Mrs. O. as "Mom." Her daily duties are very similar to those of Connie. They agreed on a price of $10/hour three years ago. Many others have tried to hire her to work for them, but Kesha would never think of leaving "Mom." She arranged for another woman to come in on the one day she isn't there, but only has her do the basics. Kesha is very particular about things like wound care dressings, etc., and only wants to do it herself.
Mrs. R. lives in a retirement community. She's 78 years old and has severe degenerative joint disease. She needs help but can't seem to find anyone she can afford. She has called multiple home health agencies but the lowest price she has been quoted for a nursing aid is $24/hour.
Connie and Kesha don't work for an agency.
The agencies pay their nursing aids about $10-12/hour. They tack on a 50% administrative fee.
That's the part that most folks have trouble paying.
Only a few are lucky enough to have found a Connie or a Kesha.