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If you are an employee or independent contractor that usually gets paid, the IRS considers anything over a "nominal" value i.e. $25 to be INCOME, not a gift. If you are bartering the car for caregiving, it could impact Medicaid eligibility down the line and open you up to family considering you as abusing an elder.
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What is your relationship with the client and what do the ethics and regulations of your profession say about things like that? Other factors are their mental state, competency, financial situation, etc.
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