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A Caregiver Contract can prevent arguments and misunderstandings among other family members who can't or won't help out. Without a written agreement, the elder (and other people involved in care such as physicians and health care providers) aren't sure who is responsible to maintain the needed level of care. Without a written agreement, the elder who pays cash to a family member for care can be disqualified from Medicaid coverage if they need nursing home care in the future.

Understanding these elements puts you on the path to preparing a document that establishes the compensation and services in a format that Medicaid can understand and accept.

As others have said here, it's worth hiring an elder law attorney in your state to put together the contract elements that best serve the elder, and protect you, as you provide these valuable services.

In my state (Massachusetts) Employers must give domestic workers who work 16 or more hours a week a written agreement.
https://www.mass.gov/service-details/domestic-workers

The laws in your state, and every other state, will be different, and Federal wage and hour law overlays all 50 states.

Even if your Caregiver Contract involves only members of your family, compliance with the labor and tax laws, and workers comp, provides protection and benefits for all the parties.
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Reply to John L. Roberts
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Some people will adamantly declare that a family member should never be paid, I'm not one of them! But figuring out what is fair is complicated and depends on each individual circumstance, including:
-how well off the care recipient is,
-how much and what kind of care
-has the caregiver given up paid employment
-have they had to make significant alterations to their home, or are they residing in the care recipient's home
- what would the care recipient be paying outsiders if the caregiver wasn't available

And take the time to think about an exit strategy for when the level of care needed becomes too much - it is better to discuss a plan B early on than after you've reached burnout.
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Reply to cwillie
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An Elder Lawyer will know exactly how to calculate that. We are in Florida and since Mom lived with me and my husband and I took full care of her at the time, we wrote a Service Care Agreement. The lawyer used the following figures (2 years ago) in order to derive the correct amount for me:

- Court-appointed guardians, who render services in this country, generally receive $40.00 to $80.00 per hour per Court Order.  
 
- Professional geriatric care managers typically receive $100.00 to $150.00 per hour for performance of their services.  

- Nurses’ aides receive $18.00 to $22.00 per hour for performance of their services.  

Thus, since the various services required by Mom are the services provided by guardians, professional care managers, nurses’ aides, drivers and companions, a blended rate of $35 was appropriate in my case.

I need to NOTE that this agreement was used to transfer funds from her savings to me, ahead of applying to Medicaid. It was not set up for a continual hourly payment. Yet, I hope this overview helps you.
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Reply to balancedCaring
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It really depends on what state you live in. Many states differ with pay rates for caregivers. However if your drawing up just a contact to pay a friend or relative I would say it’s up to you. I would definitely take into consideration what kind of care you are asking the caregiver to do. I mean it really varies from there. If your just asking someone to sit with your loved one then I would start at the lower level ($9-10)but if your asking a caregiver to sit,make meals, clean the house, bath, dressing, help with toileting ( changing adult diapers) and help with medication ( never administer unless they are a RN) you need to pay on the high side ( at least $12.00 or more) you have to remember are asking the caregiver to do a lot. As someone with experience in this field this is what I know with a private pay case. If you are going the route though a Homecare agency then you will have to pay whatever rate they are asking no matter what the caregiver is doing. You can see if the health insurance will help pay for this type of care too. If you go this route the Homecare agency comes into your home and does an assessment to find out what type of care you loved one needs and helps you get the right fit for your needs. They can also provide you with hospice care if needed but this is a whole different route.
I hope this has helped you somewhat. I took care of my mom so I know how hard this is. My loved one had a rare form of vascular dementia. Please remember that you may need a little break too. I really didn’t have help so I learned really fast and hard that when someone came to visit I took a breather. It was the hardest thing I have ever done. I am sorry you are going through this. Please stay strong and know that you are doing a great job. Good luck.
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Reply to Caringangel
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The rate will depend on what the going rate in your area is.
Keep in mind the rate for a "companion" or "caregiver" will be different than if you are a "CNA" or a Nurse. Both of these require certifications and the pay would reflect that.

When I was using a program through the VA called VIP I could NOT get paid because I was the spouse. However I could have paid any other relative with funds provided by that program. I do not know if a spouse in general can not get paid for caregiving services that might have to be answered by your Eldercare lawyer.
When I did hire the 2 best caregivers I had I contacted the local Community College and ended up hiring 2 people that had just finished getting their CNA Certification and they were waiting to begin Nursing School. I told them both that I would be able to work with and around their school schedules. But I ended up getting 2 very qualified people that were able to get some good experience while between semesters. I paid them what they would have been paid if they were working at a facility. And they had better working conditions, and the care of 1 person compared to the 8 or more they would have had at a facility. And my Husband had 2 more caring people to make sure he was comfortable.
So bottom line..check what the facilities in your area are paying. You could also check a local agency and ask what they pay. You may not get an answer but you can ask what they charge and know that the care giver is not getting that full amount.
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Reply to Grandma1954
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I think the answer will differ based on where you live. Try calling some companies in your area that provide services to get hourly rates for companion care, personal care and overnight care. That should give you a base to work with. In New York, the hourly rates have varied from $15 to $25, depending on the services required.
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Reply to Marcia7321
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In my community, the average compensation is $15/hour for companions and $20/hour for caregivers. The difference being is that a companion is basically a “sitter” and a caregiver is basically a “practical nurse.” An internet search will provide the nationwide, statewide, and community averages/medians.
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Reply to thomas0612
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Mother lives with me and my family. I travel with her between states, about 600 miles one way, about one month at her place three times a year, the rest of the time with us. I have up my job to do this, but it's still work. I free up a contract for $350 each week plus one tank of gas per month and stated that when we travel back and forth she picks up the traveling expenses. I also stated that she will pay for any respite care when needed. I stated my duties, i.e., managing meds, making meals, bathing, laundry, companionship, etc. We both signed and had it notorized.
If you feel uncomfortable drawing up your own contract because there may be problems with others, you should seek counsel from an eldercare attorney.
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Reply to MumsHelper
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shirleyeason Oct 16, 2018
Thanks!
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Is she still competent?

Medicaid does not disqualify you if you can prove fair share of living expenses. You can set up a careging agreement as well as a rental agreement. For caregiving, check with your state's DOL requirements. For the rental agreement, calculate her "fair share". The rental will be taxable income to you but it can be offset by expenses incurred.
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Reply to tacy022
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Is she living in your home? If so, does she pay for rent, utilites, food, etc? What type of care does she need?
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Reply to tacy022
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shirleyeason Oct 16, 2018
Yes she lives with me moved her in july - she can't really take care of herself- stares at the wall or whatever is in front of her for hours at atime - won't eat - she is down to 80 lbs - I took a leave of absence from work to try to get some food into her- she ran off the other day and fell down in the street - a nice passerby called me and brought her home after a medic checked her out. I can't leave her alone and don't want to mess up her chance of help from medicaid by disqualifying her by using her funds
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