What are the options for getting paid as caregiver in California?

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What are the options for getting paid as caregiver in California.?I have recently become a caregiver to my elderly mother with dementia which is progressively getting worse. What are the options for getting paid as caregiver in California? Does living with her (or a percentage of the time) or not make a difference in qualifying and or the amount of payment received? What are my options? Where do I do to apply?



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MayK - your mom would need to apply to get IHHS (In Home Supportive Services) under her Medi-Cal. The $ she gets is used to pay for a caregiver (you). CA has a pretty organized & established system by county for IHHS. The amount seems to vary by county and the time is determined by an outside evaluation on caregiving duties required. If mom should get beyond a certain # of hours of care needed (like maybe needing over 40/35 hr a week) then IHHS will stop as she is needing a higher level of care in a NH as doing IHHS won't meet a cost effectiveness.

JJBB - if dad has a "good" pension and SS, then he should have funds to be able to have dad pay you an legal income as his caregiver and you get a personal needs contract done between you & dad to do this. He pays you, you pay taxes on the income and continue to increase your own future SS and retirement income. But if there is no $ to do this, well not to sound too harsh, but he is living beyond his financially ability. If this is the situation the choices are stark and limited. Most caregiving in the US is done by family for free without any compensation. The situation you are in is common, although usually its a daughter who leaves her paying job and living situation to become an unpaid caregiver for a parent at the parents old house. You chose to leave your job and do this and so you can choose to get out of the situation as well. You've declared Ch 7, you don't want to find yourself homeless as well. My suggestion is to careful review dad's $ cut dramatically back everywhere you can (nothing wrong with Ramen) and then either do a personal needs contract for a small period of time to build up a kitty for you to have as income and then after a few months Dad could probably get his income set up via a Miller Trust to get eligible for Medicaid either to be on IHHS at home or in a NH. If he truly needs 24/7 care, CA's IHHS program won't work for him & you. If you are living in his home then you need to look into getting the exemption to have his home inherited by you as his caregiver for 2 years prior & you have the atty who does the caregiver contract to deal with the house exemption as well. Dad pays for the elder law atty btw. You have to do something definite if DAD owns his home, otherwise it will have to be sold to repay the state for all Medicaid costs paid on his care (via MERP). Then you go out and get a job and try the best you can to rebuild your life, credit and retirement. Your dad would not want to find his son destitute and at-need from caregiving for him.
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I am my Dads full time care giver as he has Alzheimers. He has a good pension and social security so does not qualify for medi-cal. However, I had to leave my job and live in his home full time. I have zero income and its a financial burden to the respect that I have had to file Chapter 7. My Dad's income pays for living expenses but it does not provide me who is here 24/7 (I can't have him driving which he will do if I am not here and his memory is about 15 min long these days). Is there any way that I could get some financial assistance?
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Welcome to the forums, MayK. Your question is a very common one. Many people would love to (or at least be willing to) care for loved ones, but cannot afford to do so financially. Since it is a common question you can find other posts about this topic. But I'll start the answers here with my perspective.

1. Does your mother have assets and/or income that she could use to pay you for her care? It does not make sense (to me) to hang on to assets or save up income to be able to leave an inheritance. Adults should be self-supporting as long as they are able. If Mom can afford to pay someone, the two of you can decide whether it would be better to pay an outsider or to pay you.

2. Does mother have any long-term care insurance? If so, read the entire document carefully and see what it covers for in-home care.

3. If Mom has minimal income and not much in the way of assets and no applicable insurance, she may be eligible for Medicaid. It varies by state. An assessment would be done to determine what in-home aid might be needed and available. In many states the eligible services could be provided by an agency or by a family member. The pay is the same.

4. As you've already observed, dementia is a progressive disease. Unless she dies first, Mom will reach a point where she cannot live alone; where she needs 24/7 support. Medicaid and other programs generally try for the most cost-effective care. Providing one-on-one support in a private home is far more expensive than providing care in a care center. So while Medicaid (or some program) may provide a certain number of hours paid help per week, once Mom needs more than that, a family member provides it at no cost or Mom moves into a care center.
5. I'm going to share my family's experience. Keep in mind that we live in one of the most "generous" states with Medicaid administration.

Mom lived in a subsidized senior apartment building. Us daughters took her shopping, helped with apartment cleaning, etc. and she got along fine. She began having dementia symptoms. We stepped up our help and visiting schedule. It became apparent that was not enough. We called in Human Services for a needs assessment. They determined our mother was in need of and eligible for a number of services in order to keep her in her apartment. These were put in place. My handicapped brother was paid to do the laundry and housekeeping that was approved.

The dementia progressed, as did her mobility issues. All parties agreed that our mother needed round-the-clock care. One daughter had just retired and offered to take Mother into her home. She charged Mother room-and-board (amount Mother had been paying for subsidized rent) and she also got paid for caregiving through Medicaid. (She could also have chosen to have an agency send someone.) This lasted 14 months.

Our mother's medical problems progressed to the point where it was no longer feasible for her to be cared for in a private home with only one shift of workers. We moved her into a nursing home, paid for by Medicaid. She has been there two years and although the dementia is progressing she is content and thriving.

6. Based on our experience, if #1 and #2 above don't apply, the place to start is with a needs assessment by the county. There may be a wait for this appointment. Be patient. And be present during the interview. Older people sometimes hate to admit their limitations.

MayK, whether you and Mom should live together is a separate question. It is also a question that is debated often on this forum.

I think your first step is to find out what kind of financial assistance (if any) your mother is eligible for.
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Talk to Medi-Cal. She would have to be on Medi-Cal.
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