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Liz, it really does depend on how wealthy the family is. Is there a realistic chance that Mother may run out of money and need Medicaid assistance at some point? (Dementia can be devastatingly expense to manage.) If so, then throw sentimentality aside and be compensated in a straight-forward way that recognizes the services you are providing. Medicaid has no problem with people paying their own way for care, for transportation, for room and board, etc. Medicaid has a huge problem with people giving money away and then expecting taxpayers to take over when they run out of money.

If money is never going to be an issue, no matter how long Mother lives or how much care she requires, then, hey, gifts are no problem. But that refers to a very substantial estate.

Emotionally it can be very satisfying to be "getting paid" for the very hard work of caregiving. That is not the reason for doing it, of course -- I can't imagine caring for anyone 24/7 EXCEPT out of love -- but it is also good for the ego and sense of dignity to get paid. This is not a "gift" -- it is something you earn. If there is anything left, then joyfully accept an inheritance as a pure gift.

A "gift" has no strings attached. "Compensation" is not a gift. Get compensation now, get a gift if there is anything left after Mother's death.
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Certainly. Mother can give her gifts. But be aware there will be tax consequences and also gifting may interfere with Mother's eligibility for Medicaid, if the time comes when that is necessary.

It is really much more practical to put it on a business basis. Have a lawyer specializing in Elder Law draw up a personal care agreement that spells out what the daughter provides and what the mother pays. There are law implications with this, too, which the lawyer can explain, but it will not interfere with Mother's eligibility for Medicaid.
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