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Yes, the spouse can pay their husband or wife to be their Caregiver. Set up an employment contract stating the number of hours per day, the wage per hour, what days off, if the spouse will pay for sick days for the Caregiver, and if the spouse will pay payroll taxes, or would the caregiver need to pay quarterly estimated income taxes to the IRS.

If the spouse cannot pay, check to see if the spouse would qualify for Medicaid. Depending on where you live, your State might offer some type of program where you could be paid [I know California has this]. Otherwise, majority of family Caregivers are not paid.
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