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Can I privately hire a 24 hour home care aide on my own and not thru an agency. Would I still be able to write this off on taxes, and would I give the aide a 1099 to pay her taxes?

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Talk to your tax preparer. I believe the MD would have to Rx the 24 hour care. Otherwise, people would be writing off their housekeeper.
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I wouldn't, I don't trust going that route whatsoever. With elder abuse on the rise, you never know what kind of person you're letting in the home of your vulnerable love one. I would only use an agency because it's safer that way and more guaranteed you're getting someone qualified and reputable. By only hiring through an agency, you can always ask the agency about the worker and see if there's anything you need to know about them. You can also see if there have been any complaints against the worker.

I'll give you another good example of why this is a good idea:

One time and agency actually fired someone just because one of the patients said the worker stole from him. Come to find out when I was falsely accused, I figured out how the worker who was fired may have been wrongfully fired due to false accusation. Agencies will fire a worker anytime there's a major concern. I think the situation in my town should've been investigated if it wasn't. It could've saved that lady her job. When I was eventually falsely accused, I was able to contact the agency can let them in on what happened and my suspicion that the worker they supposedly fired may have been wrongfully fired over a false accusation. I was able to suggest that they reconsider this worker and possibly restore her job there. This is why I only trust caregivers from actual licensed agencies. If they're not from an agency, I won't even consider them
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Oh, I just noticed you wrote 24-hour Aide. Please check on the labor laws in your State. http://www.dol.gov/whd/homecare/agencies-what-are-requirements.htm

If you use an Agency for a 24-hour shift they would have either 2 or 3 shifts within that 24 hours. The overnight shift is required to be fully awake. Then when the next shift takes over, the overnight shift can go home and get a good night [day] sleep.
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Yes, you can hire an "independent contractor", be it a friend, relative, or someone you found on a website. Be sure to have an employment contract that states what hours the person works, what is the hourly rate, what are the duties, and who would be responsible for the payroll taxes. Here is more information https://www.agingcare.com/articles/personal-care-agreements-compensate-family-caregivers-181562.htm

Yes, at tax time you would need to give the caregiver a 1099. As for writing the cost off on taxes, you would need to contact the IRS or a CPA to see what are the rules.

Please note, if you hire outside of an Agency, you would need to place a "workman's comp" rider onto your homeowner's insurance.... this is in case the caregiver becomes injured on the job [such as hurting his/her back].
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