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I am in New York state and I have my brothers' daughter working with me 3 days a week during the evening. My mom qualify for medicaid. The person has to sign up with an agency. You have to pick an elderly care insurance that will interview you and your love one. Then they decide on the hours you need. Your choice of the person to help you may work the hours, You may have one or more persons if you want to divide the hour up.
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I am a paid live-in caregiver for my mom. We live together in Washington state and I dont know about how other states work. But my mom is receiving retirement (SSA) social security benefits. It's about 1400.00 a month. She qualified for medicaid and therefore was eligible for the COPES program. COPES, for short, is a Washington State Medicaid (Apple Health) waiver program designed to enable individuals who require nursing home level care, to receive that care in their home or alternative care environment, such as an assisted living residence.
My moms case worker determines how many hours per month a caregiver can work and be paid to assist her (me). I can work up to 140 hours per month at 15.50 per hour. This is paid by medicaid thru a 3rd party payroll website. I have health and life insurance available and also have taxes taken out of my checks just like any other job. I am also a union member.
Things have been going ok for the last 2 years but now my mom is to the point where she can't be left alone. She has respitory issues and can go into respitory failure very quickly due to carbon dioxide buildup. I have 2 adult sons who both work and live with us, so thankfully there's always someone home if I need to go shopping or run errands. But this is getting too hard for the 3 of us to manage. Tensions are high and stress is always present. I think it's time to look at putting my mom in an assisted living home. I've done the best I could but it's so much harder than I would have ever imagined. I will never be a caregiver again unless it's for one of my children. It's that hard. I'm not sure if you're thinking about becoming a caregiver yourself or if you're asking because you're thinking about hiring a family member as a caregiver. But this is my story.
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I was thinking of making a contract with my siblings to outline what I would be doing. And the payment take the form of a “gift”. I have healthcare but just need assistance with my current mortgage (that I will not be living at during this time). What problems do you all see with this plan?
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disgustedtoo Jan 2020
If the person ever needs Medicaid, "gifting" is a big no-no. Contract or not, you don't want to be calling it any kind of gift. Medicaid will look at all financials from up to 5 years back (in general) and payments/withdrawals would have to be accounted for.

As to your comment about not "living at during", assumption is this is your home, but you will be staying with someone else. Will that house be vacant? If so, you will have to explore alternative insurance, as most homeowner's insurance won't cover an unoccupied home. If no one is living there, the MTG company could possibly give you crap too.

Might be better to go find a part-time job somewhere instead...
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Contact your local Area Aging on Agency and ask about Consumer Directed Care. In this program the client is responsible to find and hire their own caregiver and the caregiver is paid through a Third Party agency who is responsible for the background check and to withhold taxes. The rate is set by the Federal Government and the agency collects a small fee for processing on top of the rate.
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I cared for my mother for 5-1/2 years before she went to a care home. I moved in with her and received no compensation whatsoever. However, we paid my sister $15.00 per hour when I needed a break. (go to the movies, out with friends, etc.) We paid her day hours only. If I went on a mini vacation she got $15.00 per hour but no "sleeping time pay."
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If you live in New York State there is a program called community medicad which will pay for home care. You will have to look it up under New York State. Good luck
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worriedinCali Jan 2020
Every state has community Medicaid. Medicaid is a federal program. Every state has it :)
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PatienceSD is mistaken. Medicaid does pay family members.
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I am the primary caregiver for my mother. Medicaid will NOT reimburse a family member, nor will long term insurance policies.

I assume you will be living with her or she with you 24/7. If your mother agrees she will need to pay you cash and going rate is about $15 to $18/hr. You absolutely will need respite or you will burn out in just a few months. Plus you will need to shop. I cannot see siblings not being okay with it. If so then ask them to split the time with you. As for your ability to do the job, there is no doubt. Hired caregivers are rarely RNs or CNAs anyway and if they are they usually ask $20 to $25/hr. You know your elder better than anyone. You will learn what she can and cannot eat etc.

Understand that if you choose to do this you will be giving up outside income(including paying into SS), a personal/social life, free “you” time, and you become the cook, housekeeper, driver, launderer and keep track of her meds and doctor appts. It’s a full time job of about 110 hours a week. And that’s not counting 8 hrs a night for sleep, which hired caregivers don’t do if they sleep over. They get paid for the time they’re in the home

Most homeowner insurance policies will cover anyone who lives in the house if you get hurt there. But you will need to maintain your own health coverage.

This is is a “labor of love” not a job. I tried for 6 months to do it alone and realized I couldn’t do it alone. Even with a sibling helping with doctor appts and outing. I was fortunate my mom paid for long term insurance so my sister worked on that and it finally kicked in. I now have a hired caregiver 35 hours a week.
If I back out what I would pay for room and board and the hours a caregiver is here it comes to me making about $6.50/hr.

Remember, as your mother ages she may get dementia and that puts a whole new light on your situation. She will get confused and afraid of her memory loss, as she feels she is losing control. This job will never get easier just more complicated. From my perspective, if you’re doing it for the money, don’t do it. If you’re doing it because she needs it and you care money becomes a non issue. When you shop for her get your own personal items too. Don’t expect new clothes (you won’t need them anyway) and make sure she is okay for you to have an occasional visitor because you WILL need some kind of outside conversation.

Good luck and think very very hard about this chapter of your life.
Love and light, Sabrina
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worriedinCali Jan 2020
Medicaid does in fact pay family members to be caregivers. You are in California and our Medicaid program called medi-cal has a program called in home support services that does pay family caregivers.
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One thing to remember, anyone who is a self-employed "employee" in a household, the homeowner needs to contact their homeowner's insurance carrier as it is important to have a "workman's comp" policy in case the caregiver gets hurt.

This isn't required if the caregiver is from an Agency if the Agency has their own workman's comp policy.
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disgustedtoo Jan 2020
Yes, that can be an issue, I missed that one! I was concerned about whether OP would still have medical insurance, if she is giving up employment outside the home. I haven't had to do any of this, just compiled some minimal information along the "journey" with mom.

Question about the workman's comp: What if the care-giving is providing the care in their own home, aka in this instance OP takes mom in. Would that still be needed? I think you might be correct as this is generally a state mandate - it might be best to inquire with EC attorney or tax consultant who is knowledgeable in these cases.

Usually a homeowner's policy has coverage for injuries in the home, in which case it might be good to check how much coverage there is, what it would cover, increase it if needed, etc. Actual workman's comp may be something that has to be purchased outside the homeowner policy. Quick lookup says:

"Workers’ compensation insurance is required in almost every state for businesses that have employees. It can cover medical costs and lost wages for work-related injuries."
In this instance, no other employees, but it also says...

"People who work for themselves and don't have employees are generally not required to purchase workers' compensation insurance. However, someone who is self-employed might purchase a policy to:
...
Guard against medical bills and lost wages"

Sounds like in this case it wouldn't be absolutely necessary. It also appears that many insurance companies offer this, so OP could call and inquire about it.

Include the cost in the determination of wages/pay rate?
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The general concerns about this kind of arrangement are:
1) is the caregiver competent to do this kind of work
2) can the caregiver manage 24/7
3) Medicaid issues
4) family issues
5) sensible rate of pay
6) tax/SS-FICA requirements

#1 is probably covered since you are an RN
#2 only you can answer that question
#3 if mom ever needs Medicaid, you will need to have a legit caregiver agreement, specifying duties and pay rate, and keep track of what you do/spend
#4 if all family members are okay with this fine, otherwise... beware!
#5 See #3 and I think you already realize this will be a pay cut.

I don't see an issue with you providing this service for pay. Family members may not be okay with it, but if they are, move to the other concerns.

If this is or will become a 24/7 task, you will need some respite care and/or assistance to cover some of the time. Work that into the contract.

If Medicaid is in her future, you should get a qualified attorney to draw up the contract, with very specific details about duties/pay and have it notarized.

Also, there are tax implications even when it is family doing the care-giving. A good EC attorney and/or someone who specializes in elder tax can guide you. I have read that there has to be 1099 issued, taxes paid (federal and state, if applicable), FICA paid, etc.

Additionally, if you are not working, will you have your own medical insurance available?

While many have said $20 is about the going rate (it can vary by state/region), this is the general rate for a CNA, not an RN. You can probably earn/charge more, as the rate for hiring an RN through the agencies would be more than hiring an aide. Call a few places and find out what they charge for an RN. Again, a good EC atty or tax consultant could probably guide you in determining what is a sensible rate. IF Medicaid wouldn't ever be needed, you can probably work out any hourly rate with family/POA. I would still recommend having a contract, just to CYA in case anyone ever questions anything!

Note: Just thought this - if the duties are currently not 24/7 and/or not too intensive, you should anticipate a big increase in care-giving needs as time goes on. You could/should build some kind of rate increase into the contract too. CYA!
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Each state has their own rules, anticipating or expecting compensation for the care of your parents may not be as easy to acquire if they have already been declared unable to make an informed decision. Consult with an elder law attorney. There may be financial reasons beyond the normal that may create issue in future. There are many gray areas, make sure you cover your tracks. Check to see of your being paid will affect their ability to receive Medicaid should their money run out etc.
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Depending on your state you can go online and and look up a Care Contract. We also went to an elder lawyer and asked for an example, drew one up, and had it notarized. My brother is the POA so he signed. How much I get paid is in the contract and this is very legal to do. I will have to pay taxes though. If there is no POA then your mom or dad or whoever has to agree and sign.
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When my over-90 mother still lived "independently" in her condo, I wasn't a paid caregiver. I had to drive her places, mostly, which took hours of time. When she was hospitalized and I was there during the day, I informed my out-of-state POA brother that I could no longer keep it up without compensation. He offered to give me back-pay for the 2 years prior that I had to take her places, and I jumped at that. So I figured an approximation of my past hours, and kept track from that point forward. No taxes were taken out, as it was a "gift" from the trust to me. (There was no chance of Medicaid qualification, so an official contract wasn't necessary.)

It's very important to be paid as you do the caregiving, as any future claims on any inheritance could be problematic (and sometimes there isn't any inheritance left). One of my brothers wanted to wait until the trust was settled, but I said no. The trust documents read that anyone contesting the four way split between my brothers and me would get nothing. So if I started demanding more than my 1/4 after her death, I could be cut out entirely (not that I think any of my 3 brothers would have done that).

I had mentioned compensation to my mother, but she got very angry at me and said, "You don't pay family!" So I waited until she was no longer competent, and my brothers agreed that I should be paid (and the two POA brothers came up with the same hourly pay that I did).

I was paid $20/hour.
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Seems you are asking can you pay yourself as care giver. - Of Course! and it probably best that you do. It avoids problems and resentment later.

You need to have a negoitated agreement - just like you would with a stranger or another family member. What are you going to get paid for doing?

Your payment should be no greater than the Fair Market Value. Of course, it can be less, but it should never be more. I would avoid getting paid in heirlooms or inheritable items to avoid family squabble about taking all the stuff.
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After Mom died Over a year Ago, at FIRST, My sister was getting a 100 dollars a month. However, Being POA and Caregiver, She stopped it bcause she wanted to make sure Dad had enough money to suffice himself. I do belive a 100 dolar bill out of their pocket is good to help pay for gas and things of this Nature and in helping them out. If they had to pay a Price out of Pocket, It would be Big Bucks.
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I am a paid family member caregiver. It was 7 weeks training by an inept RN for a local home health agency to get certified. The company that trained me also hired me, is holding my certification hostage to ensure I work 400 hours before leaving them for a better company. Not many companies hire family members though. Some companies pay live in family 34 hours per week. Mine only pays me 2 hrs per day but thats on his medicaid/medicare carrier. They are the ones who dictate my dad only needs fed one meal a day. Certification is easy. All the girls who showed up high or didnt show up at all got their certifications. I was already the caregiver, just get paid for it now. You can NOT be POA and also be a home health aid caregiver.
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Dollie1974 Jan 2020
Hi ShenaD,

I am just starting to look into this, I left my full time job as an Accountant to take care of mom full time with Vascular Dementia and I’m living off of my savings (my mom barely has enough money to pay her own bills). We live in the same house in NYS.

I called one of the CPAP plans to ask questions, right off the bat, the Rep stated, that if I hold a Durable Power of Attorney that I am not eligible to be a family paid caregiver should my mom be eligible for Medicaid and get that benefit. I can however choose another person to get paid to do this but the whole point was for me to take care of my mom. I need to research some more to make sure if this is correct.

Can you please let me know if you are aware of these rules of eligibility?

Thank you.
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I was paid a small amount when my grandparents lived with me. I was also running child care out of my home. I reduced the population by two and charged the same daily rate as a 3 year old but for 7 days. My CPA said this was completely ok. I also reimbursed myself for everything I bought for them and special food. I kept all receipts and kept detailed records. My family was completely fine with the set up- mom is a Princess and so is my little sister. It worked well with my Grandparents. I got to know them well as did my kids. They had lived 3 hours away all my life.


I manage my mother now. I reimburse myself for specific tasks and all out of pocket expenses. I do all her book keeping, investing and tax work and charge the low end of the going rate. Again she and my sister are thrilled I am taking care of it.
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There is no amount of money that anyone could pay me to be a full-time caregiver. If being paid, then the family will expect the caregiver to be able to be faster than a speeding bullet, more powerful than a locomotive, and be able to leap tall buildings in a single bound. That means taking on the chores of 3 full-time caregivers every single day. Hello, burn-out.

Caregiving is exhausting work. It is better to have one 8 hour shift, and have someone else come in the next 8 hour shift, and again for the 3rd shift. Otherwise, I have read where up to 40% of family caregivers, especially one caring for a love one who has Alzheimer's/Dementia, will die leaving behind the love one they were caring.
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I am a paid care giver for both parents in late eighties. They live nearby and I arrange meds, make 4 meals a week for them, take them to doctors appts, clean do laundry etc etc. My siblings either work full time or live out of town. I very much appreciate being compensated. It’s time consuming and emotionally exhaustive at times.
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Does the caregiver contract need to be notarized or reviewed legally?
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FloridaDD Jan 2020
My understanding is the agreement has to be notarized for Medicaid to respect it as "spend down" of loved ones funds
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Two of my mom’s caregivers were relatives, one hired herself before my brother & I knew it (we also didn’t have POA at that time) but she was a very unstable, drama seeking liar to start with. Thankfully she quit when she realized taxes would have to be paid, but she tried starting lies to our cousins who hadn’t even seen Mom, literally, in over a dozen years. The other was her younger sister, who we didn’t want to hire because of her sister, but we gave her a chance. We had her sign a HIPPA form of sorts & let her know she’d be fired immediately if it she shared any financial or medical information at all about Mom. She ended up being a really great worker. We also paid her more than she would’ve made anywhere else.
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I am currently going threw this. We had to get my Mother on Medicaid, she could not have more than $2000 in the bank or in assets. It is alot of paperwork but anything to do with the State (Michigan) usally is. I could not be her POA so my brother stepped in for that. Not sure of how much I will be paid but anything will be better than nothing. I could not go to work because we had no one willing to come in and stay with mom.
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I am currently a "paid caregiver" to my 93yr father. Every situation us different. I took a LOA from my job in April when he took ill and nursed him back to health. Nothing too serious, be lived alone and was forgetful and wasn't eating/drinking properly and ended up in the hospital with dehydration. I live in Florida and dad lives in Michigan. I took my LOA and spent the summer with dad till we (me and my brothers)had a plan. Dad is now currently with me in florida for the winter. I was the one who was best suited for the job as we didnt want dad in an assisted living. I am also dads poa/health surragate/trustee.
It's not for everyone. I drew up a plan/contract with my wages and duties and we all agreed. I get paid thru my father's Trust. Yes you can and should be paid if applicable. If there is no Trust, there are programs out there to help you get paid..VA, Medicaid/Medicare..do your research.
Having a family member that you can put your trust in, is knowledgeable, and your parent knows, is an honor to have. And it's an honor to do the job. There are assistance that can help with caregiving. Get everyone involved. Make a plan, it's not for everyone. Yes there are agencies you can hire. But like I said, every situation is different. I'm able to leave my fulltime job and be with my father fulltime. I do reach out to support groups and I ask alot if questions. Between me and my fathers doctor we are doing great. I get to spend everyday with my dad, he has been diagnosed with dementia so that can be challenging. But i educate myself, read up on it alot, talk with other caregivers and counselors/doctors. If things get to be too much than we'll deal with it at that time.
I am a paid caregiver. It's an honor to do so. But it's not for everyone. You do what's best for your situation.
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worriedinCali Jan 2020
Medicare is not a program that will help OP get paid. They do not pay family members.
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You will still need a plan when they are home sick or leave on vacation. IMO it is better to hire through an agency. It is more money but generally you will get better quality and more reliable care. They are more knowledgeable in medical areas, so as your senior ages and their health declines and they are a fall risk or need to be given medications or injections, you will need a different level of care. They have experience with cognitive challenges, like dementia or ALZ, and a relative probably won't. They won't know how to get a resistant person into the shower or to change their soiled pants, etc. They will take it personally when the senior starts to say very unfiltered things. I own a business and we have a policy to not hire friends or relatives ever.

If you have youngish relatives (like young teens) you could "hire" them on occasion to be companions to your senior, to come over and play games, show them funny animal videos on their phone or tablet or just keep them company. Yes, I did say hire them. Whatever it takes to get them there, I'm not opposed to "bribery" ;-) They will learn something in the process, and both they and the senior will benefit.
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It is easily enough done. Write a caregiver contract. Spell out the duties and hours, also the wage compensation.

someone will have to hire a payroll processing firm to handle all the withholding etc. with just one person, it will be cheap enough to do this.

now, on the practical side.....I found that family members and close friends would slack off...taking advantage of the whole situation because they are close.

my rule...whether hiring or renting. Avoid family and friends. They end up feeling entitled. You need to start the relationship on a strictly business basis, this cannot be done with family and friends,
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Cece55 Jan 2020
I generally agree about the family & friends... but I am an RN and so it is a "professional" thing... except I will be taking a great pay cut.... to be able to have my Mom as my only patient.
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I did try this for my husband, it did not work out, too many no shows and family disfunction.
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NeedHelpWithMom Jan 2020
I get it, Dolly. I didn’t get paid and everyone tried to tell me what to do. Even if I had been paid, still would never have been worth it.
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