I have never had a client tell me that they want to go to a nursing home. Almost daily in my practice I hear that my clients want to remain in their home as long as possible. Unfortunately, some clients do not want to bring outside caregivers into the home for a myriad of reasons. The old days of the children taking care of the parents needs to make a comeback. Caring for parents to keep them home is extremely rewarding for both the child and the parent.

Being a family caregiver is one of the most rewarding, amazing experiences that children can provide to their loved ones. I have heard time and time again from children who are able to provide caregiving how rewarding it is, particularly in cases when it keeps their loved ones out of a nursing home.

For a number of reasons, children who provide caregiving should enter into a written caregiver agreement with their parents.

First, it is the best way to ensure that there are not mis-expectations and hurt feelings later.

Second, if done properly, it will actually provide, for both VA purposes Medicaid purposes, a legitimate spend-down of resources which would otherwise go to the government, and the monies paid will not be considered a gift. Therefore, no penalty will be assessed for the money paid to the child.

The one thing to remember is for the child caregiver monies that are received will be income taxable to the child; it is very important that the child claim those monies as income on their tax return so that it clearly shows that it was not intended to be a gift.

However, family caregiving is certainly not without its downsides to caregivers. In most cases the caregivers could make more money if they stayed in the workforce and did not leave to provide care. In a situation where they are trying to continue to work and provide care, the increased stress added to the caregivers can be detrimental their physical and/or emotional health.

There are often cases where family dynamics become an issue, either because one child is doing the caregiving and that child feels like they’re being taken advantage of, or others feel as though that child is taking advantage of Mom and Dad because they are getting paid.
Either way, a lot of times it provides an additional stress to family members that they weren’t expecting. There are times where a caregiver will be out-of-pocket as well for certain costs, and getting reimbursed may surely be an allowable thing under the law, but having other children understand why money is being distributed to one child versus them is often not an easy conversation.

There is no doubt that for those people who are able to provide care to their loved ones, care in the home it is a wonderful gift. However, I highly recommend that everything be put in writing for all of the reasons stated above, but mostly so that there are no missed expectations among the people receiving the care, the people providing the care, and the other family members.

To those who have been able to keep their family members home, thank you for everything, all that you do is appreciated. To those who are considering it, give it a try. It could be the best decision you have ever made.