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My mom has advanced dementia. She lives with a 24/7 caregiver, to whom I pay cash. Yes, I know this is bad on many levels, but it is the situation we are in and it allows mom to live in her home with her little yard and birds, and be cared for personally and kindly. We have exhaustively gone through all the options and just cannot afford what she needs from an agency, at all. My question is, if at some point she needs to be in a home and Medicaid needs me to prove that mom's money went for care, would signed receipts and proof of me sending the money to Russia to her family via western union suffice? I just want mom to live as best a life she can and right now this seems to be it, but I want to minimize future potential problems. Thank you very much for any advice.

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No it will not suffice. If you are sending it to Russia and it’s not taxable income reported here it’s gifting.
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I would not send money overseas. If your Caregiver wants to send her family money than that is up to her.

You should be taking taxes out of the Caregivers wages. Social Security should be matched. I hope she has a green card.
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There is no way to prove the money actually went towards caregiving since it went first to an individual and not even a facility in Russia.

FYI the Medicaid application "look-back" period in NJ is 5 years. Please read up on it since there is a lot to know in order to qualify.

https://www.medicaidplanningassistance.org/medicaid-eligibility-new-jersey/#:~:text=One%20important%20consideration%20when%20applying,away%20under%20fair%20market%20value.
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