Your loved one is aging and requires assistance with daily living. Thankfully, he or she is eligible for government assistance for a caregiver. Still, you wonder, who could possibly be trusted with the physical care, emotional dignity, and financial responsibilities of your family member?

What if they won’t understand her agitation when someone wears a green sweater, which reminds her of great-aunt Tracy?

How will she get accustomed to being served her nighttime tea, deeply steeped yet lukewarm, by a stranger?

You wish it could be one of you, a loving member of the family. Still, each of you has a job to maintain, and a family to sustain, and becoming a full-time caregiver is not a viable option.

Nothing Like Family

By now, programs in many states allow for family members to receive compensation as the caregiver of qualifying loved ones facing old age. You may no longer have to choose between salary and family.[1] 

According to the National Family Caregivers Association, over 50 million Americans provide care to family members in some way, comprising 80 percent of all home care services. The value of this care is estimated at more than $306 billion per year.

Family Member as the Hired Caregiver//The Upside

For the individual receiving care:

·         Familiar faces and family traditions

·         Trust with personal and financial privacy

These perks are vital for both the physical and emotional wellbeing of an elderly and fragile patient.

For the Caregiver:

·         Financial stability

·         Rewarding care

Both benefits are crucial to avoid burnout which typically goes along with the constant care of an elderly family member.

Caregiver Compensation//Are We Eligible?

Since each participating state has its own set of eligibility requirements, due diligence is necessary to determine whether you, too, can take advantage of this incredible initiative.

Below are some of the basic regulations by state:

Hiring Family Members as Caregivers//Programs and Requirements

Below are some programs, categorized by state, which allow residents to hire family members as paid caregivers. Caregiver resources are available with a limited budget, and are contingent on the income and financial assets of the individual receiving care.[1] 

The option of paying spouses as caregivers varies from state to state, as well as program to program.

New York

·         Medicaid Consumer-Directed Personal Assistance Program
A Medicaid program, CDPAP is the most broadly used program of its kind in NY.

·         Non- Medicaid Expanded In-Home Services for the Elderly Program

·         Aid and Attendance Pension
Benefitting war-time veterans or their surviving spouses who require assistance with activities of daily living.

·         Veteran Directed Care (VDC) Program
Previously called the Veterans Directed Home and Community-Based Services (VD-HCBS)

·         Long-term care insurance
The policyholder can hire a family member to care for them, provided that the policy meets certain requirements, including the option to pay for personal care provided outside of residential care communities as well as make the payouts to the policyholder directly instead of to a care provider.

·         Create Your Own Home Care Agency
A possible option for those ineligible for other programs. Click here for more information.

New Jersey

·         Assistance for Community Caregiving (JACC)

A non-Medicaid program providing daily living activities assistance, including paid family members, to qualified individuals.

·         Medicaid Managed Long Term Services and Supports (MLTSS)
A Medicaid program providing similar services.

*Residents may not obtain services from these programs and the New Jersey Alzheimer’s Adult Day Services Program or New Jersey Statewide Respite Care Program simultaneously.

Connecticut

·         The National Family Caregiver Support Program

Providing funds and resources for caregivers, as assessed by the Area Agency on Aging staff.

Pennsylvania

·         Medicaid Waivers Program
Commonly referred to as Home and Community Based Services (HCBS) Waivers, 1915(c) Waivers, or even Section 1115 Waivers.

Massachusetts

·         Medicaid or Mass Health
Individuals aged 60 and above, or individuals diagnosed with Alzheimer’s disease or dementia are eligible.

 Rhode Island

·         Global Consumer Choice Compact Waiver
To qualify, individuals must be above 65 years of age.

·          Program for All-Inclusive Care PACE
With this program, some exceptions apply for individuals aged 55 and above to qualify.

Family as Caregiver//Dealing with the Drawbacks

As with any family endeavor, hiring a family member as a loved one’s caregiver involves some loose ends. If ignored, these details can often result in a messy family tangle.

Many families who were thrilled at the prospect of this caregiving model at the start, admit to small drawbacks that you should take note of. Preventative measures are the best antidote to problems.

·         Responsibilities and Expectations
Be sure that the caregiver’s responsibilities are clearly determined and expressed at the start, so that the parent or grandparent receives optimal care, even if the caregiver isn’t perceived as hired help’.

·         Hours and Safety Limits
You don’t want to breathe down the back of your hired relative, but arriving on time and leaving as agreed  upon is vital to assuring the elderly individual’s safety.

Giving and Getting

As always, being proactive and diligent is key. As Rachel says, “I have learned from my mistakes along the way, but all in all, this setup provides me with the opportunity to provide loving care that works for both my Mom and myself.”