If you struggle with the high costs of providing home care to a loved one, you may have thought once—or twice—of getting paid to do it yourself.  So far, you probably have been caring for mom out of love and duty.  But it has its toll.  You’ve been taking time off from work and sacrificing personal time.  Friends may have told you that you need to take care of yourself.  You might be wondering if you can get paid for what you do.

The short answer is yes, but it always depends on the details and where the funds  are coming from.

Medicaid is one option for paying for home care, but the options and benefits vary widely from state to state.  At this writing, we understand that 15 states have programs that give Medicaid recipients a budget they can use to cover care expenses, including family caregivers.  Navigating the bureaucracy and paperwork of Medicaid can be arduous, but there are indeed pots of money available.

In our relatively affluent area of Chapel Hill and Durham, many people will never be eligible for public assistance.  If they have long-term care, it is possible that their policy has provisions for family caregivers.  In some cases, we have seen “workarounds.”   The LTCI policy requires that care be provided by a licensed agency.  The family contacts an agency and proposes that the son or daughter be employed by the agency to provide care for mom.  Technically, it seems legal and may work.  In these cases, we recommend having an attorney or other advisor review the policy language in detail to assure that the workaround does not constitute fraud, which could invalidate the policy.  Assuming the arrangement works, the downside is that you are paying a portion of the benefits to the agency and the rate of pay you receive will be lower than what you’d pay a private, direct caregiver.

Certainly, mom can pay you directly.  We see this with many of our clients.  The biggest issue here is to be aware of employment and tax laws.  You may want mom to pay you “under the table” and that may well work.  A large percentage of home care is an informal industry.  A CPA might tell you, however, that such an arrangement places your mom in violation of her duties as an employer.   Employers need to pay social security, and federal and state taxes.  If you want to formally become an employee, there are many “nanny tax” services that will manage the process for you for a modest service fee.

In all cases, one of the issues you may need to address is your relationship you’re your siblings.  They may object to you getting paid, or they may question the amount of work you do.  A good practice is to draw up a simple agreement that outlines the tasks, expectations, and rate of pay.   Keeping things transparent and above board will help.  Caring for mom or dad is already can place strains on family relationships.  There’s no need to add an unnecessary complication.

(photo via AARP)

Caring Corner

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About the Author:

Lorenzo Mejia and his wife, Mary Lynn Ryerson, are the owners of Acorn, a caregiver registry located in Chapel Hill.

They founded Acorn based on their experiences caring for his mom, who suffered with Alzheimer’s Disease.  In 2013, he became a Qualified Dementia Care Specialist.  In 2014, the Alzheimer’s Foundation named him the Dementia Care Professional of the Year in the United States.

Lorenzo is the founder of Dementia Friendly Orange County an effort to make local businesses more accommodating to people with dementia.

Lorenzo speaks often on dementia and the challenges associated with caring for loved ones.  He has been interviewed by ABC News and National Public Radio.  He is an advisor to Orange County’s OC-CARES Dementia Capable Community Project.

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