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They are considered employees and you need to withhold taxes, match social security and Medicare, provide unemployment insurance and worker's compensation insurance and what ever else your state requires for employees.

Unless you are a bookkeeper, cpa or other this really needs a professional to ensure that you are handling everything properly.

You can use a payroll processing company and they will do everything for a fee. Some even offer other benefits to your employees such as medical insurance. Well worth checking out several in your area.
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If they are doing in-home caregiving, they typically will NOT meet the requirements for being an Independent Contractor as per IRS rules.

They are instead Household Employee.
IRS publication #926 Household Employers Tax Guide has details on this. & You need to take FICA (taxes, etc.) out each pay period for them & submit plus whatever tax authorities for your city / state. Whether or not you can DIY for you / your elder using a program, like Intuit, or use a payroll agency, is to me dependent on your ability to deal with the paperwork.

Imho whatever path you take, You want them to fill out an W-9 & I-9 this month so you have a hard copy with signature on both on file for 2019. & you make a copy of the IDs they used in Section 2 of the I-9. Should something arise, say 3 years from now, an I-9 gives you extra ways to track them down.

If Medicaid is going to be involved in your elders future, the “caregiver agreement” is just a part of establishing that they are in fact a caregiver and not having “gifting” done.
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