9.1.1: The Home Health Aide/Personal Care Aide’s Role in Family Spending and Budgeting
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Home Health Aides/Personal Care Aides may be asked, as directed in the Care Plan, to assist their patient and their family with developing and sticking to a budget. They may also be asked to assist the patient with paying bills and running errands, such as grocery shopping or banking for their patient. It is important to remember that assisting someone with their money is a task in which accurate record keeping is paramount (very important). Home Health Aides/Personal Care Aides must always carefully and immediately document how much of the patient’s money they spent and what they spent it on.
Home Health Aides/Personal Care Aides should only provide assistance with managing and handling a patient’s money and budget as directed by the Care Plan. Their employer will tell them the policies and procedures for the agency they work regarding whether or not they will help with handling a patient’s money and what the rules are for doing so. If Home Health Aides/Personal Care Aides are not allowed to handle money, they must NEVER agree to do so, as they could get into a lot of trouble and potentially lose their job. If a patient or family member ever asks a HHA/PCA to handle their money and they are not allowed to do so or do not feel comfortable doing so, they should discuss this with a supervisor and seek their guidance.
Even if part of their job is to handle a patient’s money, Home Health Aides/Personal Care Aides should NEVER use the patient’s money for their own needs, even if they are planning to pay them back (Leahy, Fuzy & Grafe, 2013). This is considered to be stealing. They could lose their job, get their agency into a lot of trouble, and face legal and criminal action, such as getting arrested. Document all use of the patient’s money as directed by the Care Plan and the agency’s policies and procedures. Use checks instead of cash whenever possible. This is the easiest way to accurately keep track of how money was spent. It is much more difficult to keep track of cash. The patient must sign the checks, which demonstrates that they intended the money to be used for the purpose they assigned.
1. It is okay to buy yourself something at the store with your patient’s money. True or False? ___________
2. It is okay to borrow money from your patient, as long as you promise to pay it back. True or False? ___________
3. Using a patient’s money in any way other than that directed in the Care Plan or for which they have specifically instructed you to do so is considered stealing and could result in losing your job or going to jail. True or False? ___________
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1. False
2. False
3. True
FEEDBACK:
1. It is never okay to use a patient’s money for any purpose other than that directed within the Care Plan and by the patient.
2. It is never okay to borrow money from a patient or their family, even if you intend to pay it back.
3. Using a patient’s money in any way than that directed in the Care Plan could be considered stealing and is punishable by loss of job, fines, and/or jail time. The agency for which the HHA/PCA works can also face serious penalty.
Income
Many people, including patients and their families may live on a fixed income. A fixed income means that a person lives on a set income and must plan their expenses in order to fit into the amount of money that they have coming in. People may have income from a variety of sources. Income is the amount of money that enters a household. Some people get a paycheck once a week or biweekly. Biweekly paychecks are usually paychecks that come in twice per month, or every other week. Others receive a pension from a retirement plan. Some people may receive financial assistance from state or government sources.
If Home Health Aides/Personal Care Aides will be helping their patient plan a budget, they must first know the amount of money that is coming in to the household in order to help make a plan. The patient may be sensitive about the amount of money they make. Never be judgmental about the amount of money or the source of a patient’s income. Allow a patient to manage their budget independently if they prefer, but offer assistance when needed. Some patients may require complete assistance with planning for their budget. The Care Plan will direct the HHA/PCA as to how much assistance they will provide their patient and their family with managing expenses.
1. Income is the amount of money coming in to a household, regardless of source. True or False? _________
2. A fixed income means a person can spend as much as they want regardless of how much money they make. True or False? _________
- Answer
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1. True
2. False
FEEDBACK:
1. The amount of money entering a household is known as income. Income can be from a variety of sources such as pension plans, employment, and financial assistance from a government.
2. When people are on fixed incomes, meaning they have a set amount of money coming in to the household, they must be watchful of how much they spend. They should not spend more than the amount of money earned from income.
Debt and Stress
Money can be a real source of stress for many people. If we are unable to buy things we need or want, it can cause great frustration, anger, or depression. When people spend more than the amount of money they have, they can incur debt. Debt is any money that is owed. Some people incur debt by spending more money than their income (money they earn). They may borrow money from family, friends, or lending agencies, such as banks. They may also use credit cards to purchase items they cannot afford. If a person does not pay their credit card bills on time or in the full amount due, over a relatively short period of time, a higher amount of money than what the person borrowed becomes due. This is because credit card and lending agencies charge what is called interest. Interest is the amount of money a person pays on top of what they borrowed. When we borrow money from lending agencies or credit card companies, we are charged interest. This is the cost of allowing us to borrow money that we do not currently have.
If a patient has a high amount of debt and is having difficulty paying their bills or loans, and would like assistance with this aspect of their life, Home Health Aides/Personal Care Aides could speak with their supervisor about what options their patient has. Many communities may have credit counseling services available to help patients and families manage their debts and plan for living expenses appropriately. If Home Health Aides/Personal Care Aides think their patient could benefit from this type of service, they should discuss their concerns with their supervisor. The home care team may be able to provide budgeting assistance and referrals to community agencies to help families with this type of need. The best way to reduce stress about money is to budget and plan for expenses.
To help your patient and family determine their debt to income ratio, a Debt to Income Ratio Calculator Worksheet can be downloaded and copied from American Consumer Credit Counseling at: http://www.consumercredit.com/media/11405/debt–to–income–ratio.pdf
1. Which of the following best describes debt?
a). The amount of money coming in to the household.
b). The expenses that a family has.
c). The amount of money in a person’s savings account.
d). The amount of money a person owes after borrowing.
- Answer
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1. D
FEEDBACK:
Debt is the amount of money that a person owes after borrowing. Income is the amount of money coming in to a household.
Daily Expense Tracker
One way to determine where money is going in the household and to properly set up a budget is to use a daily expense tracker which helps to keep track of daily expenses for a period of time. This can give a patient and their HHA/PCA useful information where money needs to be allocated (distributed or assigned to a particular category) and where spending cuts can be made. When doing this, it is important to keep track of every item that is purchased, even if it seems small or insignificant. Oftentimes, people may not even realize the amount of money they spend on unnecessary items. These can be helpful places to cut back on expenses without too much hardship.
You can make a daily expense tracker in a software program such as Excel or using a word document. You can even keep track on a piece of paper with headings indicating the date, type of expense, and amount spent. Alternatively, a Daily Expense Tracker Worksheet can be downloaded from American Consumer Credit Counseling at: http://www.consumercredit.com/media/11395/daily–expense–tracker.pdf
A Daily Expense Tracker Worksheet Home Health Aides/Personal Care Aides might look like the following example.
Daily Expense Tracker Worksheet
| Date | Type of Expense (What and where was the money spent on) | Amount Spent |
Let’s look at a sample daily expense tracker that has been filled out:
Daily Expense Tracker Worksheet
| Date | Type of Expense (What and where was the money spent on) | Amount Spent |
| 01/15/15 | Gas for car-gas station | $20.00 |
| 01/16/15 | Groceries-supermarket | $27.21 |
| 01/16/15 | Lunch-Fast food restaurant | $5.99 |
| 01/16/15 | Gum & soda-gas station | $4.51 |
| 01/17/15 | Cleaning products-grocery store | $15.61 |
As you can see from the previous example, expenses were tracked for 3 days. Money was spent on gas, groceries, lunch, gum & soda, and cleaning products. Using a daily expense tracker such as this may be a helpful way for a person to recognize that they are spending some money on unnecessary items such as eating out or purchasing gum or soda. If they find their expenses exceed their income, eliminating unnecessary items is one way to help income meet their expenses.
1. Which of the items from the sample daily expense tracker worksheet are probably unnecessary? Select all that apply.
a). Gas for car
b). Groceries
c). Fast food
d). Gum and soda
- Answer
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1. C and D
FEEDBACK:
While some of these items are necessary, such as gas for the car, or groceries, other items such as gum and a lunch from a fast food restaurant are not necessary. These types of items can add up in the long run and are often items we forget about spending money on when we try to figure out where our money has gone!