The population of over 60s in Malta is rapidly increasing. According to the National Strategic Policy For Active Ageing (2023 – 2030) as at 31 December 2020, the Maltese population peaked at 516,100 persons. The percentages of the 60-plus, 65-plus and 80-plus were 24.9%, 18.9% and 4.3% respectively. This means that during the 1985 – 2020 period, the 65-plus age group increased from 9.9% to 18.9% of the total population.

This demographic shift has significant implications on the healthcare system and family dynamics. 

Children of elderly parents often find themselves in an incredibly challenging position.  They often find themselves juggling demanding careers, raising their own children, and striving to meet the multifaceted needs of their ageing parents. This delicate balancing act can be emotionally taxing, leaving them torn between their professional responsibilities, the joy and chaos of parenting, and the deep desire to provide the best care and support for their beloved parents. Balancing these responsibilities is no small feat, and employing a professional carer might be a beneficial solution to ensure that elderly parents receive the best care possible while maintaining personal balance.

This article aims to provide a comprehensive guide for individuals seeking to employ a carer for their elderly parents in Malta.

Key Considerations Before Deciding to Employ a Live-in Carer for Elderly Parents

There are three major aspects to consider before deciding to employ a carer.

Views of the Parents

  • Discussion and Comfort – Before making a decision, have an open discussion with your parent(s) about the need for a carer. Ensure they are comfortable with the idea and consider their feelings and preferences. Address any concerns they might have about privacy, independence, and the presence of a new person in their home.
  • Health and Personal Needs – Evaluate the specific health and personal care needs of your parent(s). Understand their medical conditions, daily routines, and personal preferences to ensure that any potential carer will be able to meet these needs effectively.
  • Adjustment Period – Recognise that there will be an adjustment period for both the parent(s) and the carer. Consider how this transition will be managed and what support might be needed to make it smoother.
  • Legal and Administrative Considerations – Be aware that hiring a carer from another country may involve a significant waiting period, typically between six months to a year. Consider this delay in  your planning and decision-making process. Ensure you are aware of all legal and administrative requirements, such as visas, work permits, employment contracts and payroll administration, and that they are clearly understood and planned for in advance.
  • Backup Plan – Consider having a contingency plan in case the selected carer is unable to start as planned. This could include temporary care solutions or backup candidates to avoid any disruption in care.

Views of the Children

  • Shared Responsibility – Children often drive the decision to hire a carer due to the increasing demands of their own lives, the deteriorating health of their parent(s), or the desire for peace of mind knowing their parent(s)’s care is in professional hands. Discuss and evaluate each offspring’s ability to contribute to the care process, either financially or through other means of support.
  • Role Distribution – Clearly define the roles and responsibilities of each family member in supporting the parent(s). This could include coordinating with the carer, managing financial aspects, healthcare, maintenance of living quarters, or providing emotional support to the parent(s).
  • Communication and Agreement – Ensure all family members are in agreement about the decision to employ a carer. Open communication is essential to address any concerns or differing opinions and to ensure a unified approach.

Financial Considerations

  • Cost Evaluation – Thoroughly assess the financial implications of hiring a carer. As of June 2024, the government subsidy for employing a carer amounts to €8,000 per annum, which covers approximately 60% of the total cost. Evaluate the family’s financial capacity to cover the remaining expenses. 
  • Budget Planning – Create a detailed budget that includes the carer’s salary, health insurance, accommodation, and any additional costs such as travel and visa fees. Planning ahead can help avoid financial strain and ensure that all necessary expenses are covered. A detailed breakdown of the costs can be found here.
  • Long-term Sustainability – Consider the long-term financial sustainability of employing a carer. This includes not only the immediate costs but also potential future increases in care needs and associated expenses. Ensure that the family can support the carer’s employment over the long term without compromising other financial commitments.
  • Agreeing to Split Costs – Have a transparent discussion with all family members about financial responsibilities. Evaluate each person’s financial capacity, including the parent’s ability to contribute, to determine fair contributions. 

A checklist to recruit a carer 

  1. Take a decision to employ carer

  2. Reach a decision with family on how to distribute the costs – Have a family meeting to discuss and agree on how the costs of hiring a carer will be shared. This can include setting up a family fund or agreeing on individual contributions. Transparency and fairness are crucial to avoid conflicts later on. A sample contract can be found here.

  3. Reach out on Facegroup groups – Use Facebook groups to find potential carers and gather recommendations. Relevant groups in Malta include:
    – RUBS (Are You Being Served?)RUBS Facebook Group
    Nepalese Expats in MaltaNepalese Expats Facebook Group
    Filipino Community in MaltaFilipino Expats Facebook Group

    Posting in these groups can help you find a suitable carer and get valuable feedback from others who have been through the process.

  4.  Contact a Licensed Agency – Reach out to licensed agencies that provide professional carers. Ensure the agency is reputable and compliant with Maltese regulations. Check online reviews and ask for recommendations, A list of licensed agencies can be found here.

  5. Interview Candidates – Interview as many candidates as possible to find the right fit for your parents’ needs. Prepare a list of questions that cover their experience, qualifications, availability, and approach to care. It’s also important to assess their personality and how well they might interact with your parents. A list of sample questions can be found here.

  6. Make a Shortlist – Involve other family members in the interviewing process to create a shortlist of potential candidates. Multiple perspectives can help ensure that you choose the best candidate for your parents.

  7. Make a Decision – Choose the best candidate based on qualifications, experience, and compatibility with your parents. Ensure that the decision is made collectively, with input from all relevant family members. The final say should be left to  the person who has the most active role in the care of the parents.

  8. Make a Job Offer – Extend a formal job offer to the selected candidate. Clearly outline the terms of employment, including salary, working hours, duties, and any benefits. A sample employment contract can be found here. This contract must be signed as part of the employment process. Additionally, the signed contract is required as part of the documentation needed to complete the work permit process if the carer is a third country national.

  9. Prepare Accommodation for the Carer – Ensure the carer is provided with a comfortable room equipped with a bed, a wardrobe, chest of drawers, a desk and  chair. This helps them feel valued and comfortable in your parent(s)’s home. Set up an internet connection and WiFi to ensure that the carer’s comfort and communication needs are met. It’s fair for the carer to hae equivalent amenities as the family members; if family members have an AC in their room, the carer’s room should also be equipped with an AC.

  10. Getting Organised
    – Provide recipes for the carer to prepare meals. Recognise that carers from different backgrounds may have unique cuisines and cooking methods. Be open to the possibility that the carer may have personal preferences, resulting in them preparing different dishes for themselves. Additionally, acknowledge that their food should be included in the household’s shopping list.
    – Prepare a cleaning checklist with instructions.
    – Give guidance on how to handle phone calls and people calling at the door.
    – Introduce the carer to the neighbours. 
  11. Get the paperwork organisedPayrollMalta can assist with this process.
    – Apply for Visa and Work Permit (if needed) – If the carer is not from  Malta, apply for a visa and work permit. Ensure you start this process early to avoid delays.
    – Apply for a PE Number which is necessary for processing the carer’s payments. This can be done here.
    – Get Health Insurance – Secure health insurance for the carer to cover medical expenses. This not only safeguards the carer but also ensures prompt resolution of any health issues to minimise downtime. Health insurance should include repatriation costs. 
  12. Chase and Wait – Follow up on the visa application process and wait for approval. Regularly check the status of the application and stay in close contact with Identita authorities to expedite the process if possible. 
  13. Organise Travel Arrangements – Once the visa is approved, book tickets for the carer to travel to Malta. Ensure you provide the appointed family member who will be picking up the carer from the airport with a clear travel itinerary and also inform the carer of who will be picking them up.

  14. Organise Payroll and Payment Options – Set up payroll and payment options for the carer. You can opt to compute the payroll, register for a PE Number, register with jobsplus, submit FSS registration, provide a payslip, submit FS3 and FS7 documents and make payments yourself. If this is too daunting PayrollMalta can deliver this service. We have considerable experience in this area and are well-versed in the necessary steps.
    – Ensure that payments are timely and transparent (ie you present a payslip) to maintain a positive employment relationship. 
  15. On arrival – Greeting the carer at the airport is a thoughtful gesture and ensures the carer feels welcomed and valued from the outset.

  16. Allow Rest Time – Allow the carer a minimum of one day (preferably two) to rest and adjust after travel. This ensures they begin their responsibilities feeling refreshed and prepared to deliver optimal care.

  17. Introduce to Family – Introduce the carer to your family and familiarise them with the household. Clear introductions help build rapport and ease the carer into their new environment.

  18. Set Up Essentials
    – Access to WiFi. This is essential to help them stay connected with their family abroad
    – 
    Local SIM card
    – Tal-Linja card for public transport
    – Exchange contact details and ensure a list of emergency numbers is provided and kept in an easily accessible and prominent place.
    – Set up a whatsapp group for ease of communication
    – Introduce to neighbours
    – Introduce to extended family members
    – House tour and house rules (this needs to be repeated more than once if necessary).
    – 
    Accompany & introduce carer to local shops, pharmacies, and any other outlets used by the family. 
  19. Organise Banking  – Assist the carer in opening a bank account or setting up a Revolut account for financial transactions. This ensures they have a secure and convenient way to manage their finances. 
  20. Apply for Government Subsidy – Ensure you apply for the Malta Government subsidy for employing a carer. Detailed information can be found here. Basic requirements include:
    Filled-out application form (application form)
    A Medical Report signed by the respective General Practitioner confirming the need for a carer
    – 
    A copy of the carer’s qualification (ensure they are MFHEA equivalence or ask the agency to assist if using one, or submit certificates to MFHEA directly)
    – 
    A copy of the employment agreement authenticated by a Notary Public
    – 
    An official document from Jobsplus or Identity Malta (for third country nationals) indicating that the carer is in regular employment with the applicant 
  21. Get NI Exemption – The employers of carers get an NI exemption. Information to secure this exemption can be found here. This needs to be applied for on a yearly basis. As part of the service PayrollMalta can take this burden off your mind.

  22. Conduct Health Tests – Accompany the carer to complete mandatory health tests as per Maltese regulations. Note that this is split into two visits, one to take blood work and another visit to certify those samples once they are processed.

  23. Set House Rules – Agree on and communicate house rules to ensure a harmonious living arrangement. Clear guidelines help set expectations and prevent misunderstandings. A list of house rules can be found here.

  24. Set Daily/Weekly Schedules
    – Create Structured Schedules – Develop daily and weekly schedules that outline the carer’s responsibilities.  After the carer has settled into the role, explain the administration of medications, meal preparation, personal care, and leisure activities for the parent(s).
    – Review and Adjust Regularly – Discuss with the parent/s to ensure the schedules set are working for them and regularly review and adjust them to ensure they meet their changing needs. Discuss any changes with the carer to ensure they understand and can implement the new plan effectively. 
  25. Organise Shopping & Paying for Expenses
    – Provide Financial Tools – Provide the carer with a debit or credit card to use for household expenses and shopping needs.
    – Receipt Management – Instruct the carer to save all receipts in a designated envelope. This will help keep track of expenses and facilitate accurate reconciliation.
    – Reconciliation Process – Establish a weekly or monthly process for reviewing and reconciling expenses. This ensures transparency and helps manage the household budget effectively. 
  26. Treat Like Family
    – 
    Involve in Family Activities – Invite the carer to join family meals, outings, and celebrations. This helps them feel included and appreciated, fostering a sense of belonging.
     
    Offer Assistance – Regularly ask the carer if they need help with anything, whether it’s related to their duties or personal needs. This shows you care about their well-being and are there to support them.
    – Provide Transportation – Offer to give the carer lifts to activities they wish to pursue within or outside of their duties especially in the beginning until they familiarise themselves with local transportation options. This gesture not only assists them but also builds trust and rapport. 
  27. You Are an Employer Now
     Patience and Understanding – Hanlon’s razor states. Never attribute to malice that which is adequately explained by stupidity”. In other words, rather than questioning people’s intentions, question their competence. Be patient in explaining tasks and procedures, recognizing that it may take multiple explanations for the carer to fully understand.
    – Invest in Training – Do not expect things to go smoothly without investing time in training and supporting the carer. Provide clear, consistent instructions and offer feedback regularly to help them improve.
    – Create a Supportive Environment – Encourage open communication where the carer feels comfortable asking questions and expressing concerns. This helps prevent misunderstandings and ensures they have the information they need to perform their duties effectively.

Conclusion

Employing a carer for elderly parents in Malta involves a multifaceted process that requires careful planning, open communication, and a compassionate approach. By following this step-by-step guide, you can ensure that all aspects of hiring and integrating a carer into your family are handled efficiently and thoughtfully.

From the initial discussions with your parents to the final steps of setting up daily routines and financial arrangements, each point in this guide aims to provide clarity and support. Remember, the key to a successful caregiving arrangement lies in treating the carer with respect and dignity, much like a family member, while also understanding your role as an employer. Patience, clear communication, and mutual respect will go a long way in fostering a positive and productive relationship.

By investing time and effort in finding the right carer, creating a welcoming environment, and setting clear expectations, you can ensure that your parents receive the highest quality of care. This not only enhances their well-being but also brings peace of mind to the entire family.

Should you have any specific questions or need further assistance, don’t hesitate to reach out to professional agencies or support groups within the community. The journey of caregiving is a collaborative effort, and with the right resources and support, it can be a rewarding experience for everyone involved.

For those looking to navigate the complexities of employing a carer in Malta, PayrollMalta offers solutions designed to meet the needs of household employers.

For further information and assistance with your payroll requirements, please reach out to info@payrollmalta.com or call 2258 8019.

 

Photo Source: https://www.thecareworkerscharity.org.uk/blog/carers/