INDEPENDENT AGING > Home Care > Home Care 1
As the number of family members providing care for aging parents increases, the solutions to find help with loss of income because of time off from employment for caregiving has become a major concern for many.
The demands on both the time and energy needed to provide the needed care can make it impossible to maintain both a full time job with full time caregiving.
Seeing a need to give support to family caregivers the federal government Administration on Aging created the National Family Caregiver Support Program.
State Area on Aging division manages this program on the state and community level to offer support services that include:
- Information to caregivers about available services;
- Assistance to caregivers in gaining access to supportive services;
- Individual counseling, organization of support groups, and caregiver training to assist caregivers in making decisions and solving problems relating to their roles;
- Respite care to enable caregivers to be temporarily relieved from their care giving responsibilities; and
- Supplemental services, on a limited basis, to complement the care provided by caregivers.
Medicaid Cash & Counseling Program
A Medicaid approved assistance program called Cash & Counseling may be used to provide funds to hire personal care aides as well as purchase items or services, including home modifications that help them live independently.
The PayingForSeniorCare.com website gives the following information about the program:
"For Medicaid eligible seniors, the process begins with an assessment in the home to determine the senior's home care needs; this includes interviews with caregivers and possibly the senior's physicians. A determination of how many monthly care hours are required is made. The benefit amount is calculated using that determination and cost of care for that geographic area. This amount can be increased or decreased as the senior's needs change. A family care giver may need to qualify as a home health aid by the state to receive these funds."
This program is executed by each individual state Area on Aging Services division. It is a relatively new program and is not yet available in all States. Check with your state Area on Aging Services department for availability.
Using the Veterans Aid and Attendance Pension Benefit
A totally overlooked source of money to pay family caregivers to provide care at home is the Aid and Attendance Pension Benefit. This money is available to veterans who served during a period of war. Pension money is also available to the widows of these veterans. This benefit, under the right circumstances, can provide up to $1,949 a month in additional income to pay family members to provide care at home.
Getting the aid and attendance benefit to pay for family caregivers is not an easy task. This is because there must be a caregiver contract in place, a physician medical evaluation done, income and asset qualifications met and proof of medical expenses provided. Submitting the correct forms and documentation can easily be completed with the help of a VA Accredited Consultant who understands the process.
Long Term Care Insurance Benefit
If the senior being cared for has a long term care insurance policy that covers home care, payment to the care giver from this source could be arranged. Some policies require the care provider to be through a licensed home care agency, but others will pay for individual aides certified as such. This would require some training by the family member to become certified. There are policies that pay a daily benefit amount to the insured to use as they want to pay for their care. Check with a long term care insurance professional about types of policies.
In some cases the senior parent has the funds to pay for care. If a family member is giving care it is very important that a caregiver contract be in place. A signed and dated agreement will outline the services provided as well as the amount of pay for these services. The contract will eliminate questions about what is expected from both parent and caregiver as well as providing a legitimate contract and payment record of services to qualify for Medicaid.
Attorney John L Roberts, in his article titled "Caregiver Contracts that Protect Elders and Their Family Members" states:
"A written Caregiver Contract is a good idea for every family that wants to protect family harmony, and make sure everyone in the family understands how care is being provided to an elder.
The family member who provides care can save an elder from needing nursing home services, and may also protect assets if nursing home care is needed in the future. Elders who want to cover all of these bases must have a written Caregiver Contract. Whenever adult children and other family members are providing valuable care, only a written agreement will protect assets from nursing home care costs and qualify the elder for Medicaid."
In having the parent pay a family member for caregiving, it will be an employer/employee situation and payroll records must be kept with payroll taxes paid.
This can also be set up by an elder law attorney at the time the contract is done.
Taking the time to create the caregiver contract, research the government and state services that are available to caregivers and using community resources will make the family caregiving experience less stressful.
"The 4 Steps of Long Term Care Planning" from the National Care Planning Council