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It's one thing to slip a neighbour or cousin Sue $20 to sit with grandma for an hour, but I don't think that anyone willing to work off the books would be someone I would trust as an elder caregiver, at least not on a long term or full time basis. Aside from the ethical considerations there are real legal consequences if caught and no safety net available if there is any kind of problem. There will also be difficulty explaining where the continuing drain of money was going if the elder ever needs medicaid funded long term care, because medicaid will want to examine the books from at least the previous 5 years.
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Problems for your loved one, IRS, the Department of Labor.

If Medicaid is needed in the next five years, loved one's accounts will be audited for funds spent that could appear as gifts. To avoid that you need a caregiver agreement that should be prepared by an elder law attorney in order to protect your loved one.
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Also should there be any sort of accident, like caregiver has slip&fall, the homeowners insurance will not cover the incident. The caregiver can sue the property owner.

As another aside on this, years ago I hired caregivers thru an agency for my mom - still living at home - for several weeks after she had rotor cuff surgery. Part of what they did was to take her to rehab & orthopedic appointments. We were required by the contract with agency to have caregivers drive my mom’s car to do these runs. Could NOT use their car. I called State Farm to see if this posed any issues for policy coverage. What I as told was as long as mom was in her car with whomever, policy in force. But if they drove car solo and there was an accident, the claim would like be denied as they were not a listed drIver or member of the household.
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Hi there, what’s your question?
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