The Role of the Home Health Aide/Personal Care Aide in Family Spending & Budgeting

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. 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 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.

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.

Debt & 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, Home Health Aides/Personal Care Aides 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.

Daily Expense Tracker

One way to determine where money is going in the household and to properly set up a budget is 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 with headings indicating the date, type of expense, and amount spent.

Here is a sample of a daily expense tracker:

Daily Expense Tracker Worksheet

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!

Here is a Sample Daily Expense Tracker Worksheet that Home Health Aides/Personal Care Aides can print and use with their patients, or even themselves!

Planning a Budget

A budget involves planning for expenses within the limits of the amount of income (money coming in). People often find it helpful to set up categories of expenses when planning their budget. The first step is to determine all the household expenses. The second step is to determine all sources of income. Then, once all the data has been collected, a person will be able to determine if the monthly income meets, exceeds, or is less than the monthly household expenses. We will take a look at how to determine expenses and income next.

Determining Expenses

The next step in effectively managing money is to determine what the actual expenses of the household are. Actual expenses are expenses the patient and family has. These include rent or mortgage payments, car payments, car or health insurance payments, groceries, gas and electric bills, water bills, tuition for school, prescription medication costs, gas for the car, and clothing.

Depending on the patient and their family’s unique needs, types of expenses will vary. Home Health Aides/Personal Care Aides should discuss with their patient the expenses they have in order to best help them develop a budget. Remember, never be judgmental in how a patient spends their money. People choose to spend their money in very different ways. Home Health Aides/Personal Care Aides may not agree with the way their patient spends their money, just like the patient may not agree with how a HHA/PCA spends their own money. Remember, it is the patient’s money, just like a paycheck is the HHA/PCA’s money. The Home Health Aides/Personal Care Aides’ job is to assist the patients with being able to plan effectively so as to reduce their stress about money, and to live independently and according to their income restrictions and preferences.

Home Health Aides/Personal Care Aides can determine expenditures (expenses) by writing down the cost of all the family’s living expenses. They could do this in a spreadsheet, a word document, or on a piece of paper with categories. Once they have figured out all the categories of expenses and how much each costs the family on a monthly basis, they should then add up the total expenses.

Here is an Expenditure Worksheet that can be downloaded and printed.

Determining Income

Once Home Health Aides/Personal Care Aides have figured out the expenses, they need to determine the amount of income the household has. This done by writing down all the sources of income and the amount of income from each source. An example of what this might look like is this:

Monthly Income Worksheet

Now that they have figured out expenses and amount of income for the month, they need to figure out the balance left after expenses. To do this, subtract the Total Monthly Expenses from Total Monthly Income. This is the amount leftover. They may find that the Total Monthly Expenses exceeds (is more than) the Total Monthly Income. In this case, they will need to assist the family to determine where expenses can be eliminated.

Here is an example:

Total Monthly Income: $5,300

(-) Total Monthly Expenses: $4, 750

________________________________________

Amount leftover: $550

In this case, there is $550 leftover after accounting for all the monthly expenses. Families can decide to put this money into savings in order to build up retirement savings, pay for future college expenses, save for a more expensive item, or to save for an unexpected cost.

Here is an example of a situation where expenses exceeds (is greater than) monthly income:

Total Monthly Income: $6,250

(-) Total Monthly Expenses: $7,500

__________________________________________

Amount leftover: -$1250

In this case, the family is spending $1250 more than what their income is. They will need to make adjustments to their spending in order to live within their means.

Here is a Monthly Income Worksheet that you can download and print

Introduction

In addition to helping the family plan and work within a budget, Home Health Aides/Personal Care Aides can also help the family cut or reduce their costs. Costs can be reduced in many ways. We often do not even realize all the little things we can do to cut our costs. Saving a little bit here and there and cutting back even just a little adds up in the long run to big savings! Here are some ways Home Health Aides/Personal Care Aides can help their patient and their family cut costs and things they can think about doing to help the family save money!