"How Can I Get Paid for Taking Care of My Elderly Parents?"

What is the number one question caregivers ask on the AgingCare.com Caregiver Forum? "How do I get paid for caregiving?"

Unfortunately, there's no cut-and-dry answer. Programs and assistance vary widely by state and individual circumstances. But we hope to provide our caregivers with some options and programs to explore.

Administration on Aging
The AoA administers many national programs and services for elders, including health insurance counseling, legal assistance, protection from elder abuse and long-term care.

Area Agency on Aging
There is a federally-mandated Area Agency on Aging in your county or city. This agency is staffed by professionals who know every elder program and service, including available funding sources, in your area.

Gather up as much information as you can about you and your parent's situation and finances, and make an appointment to meet with a counselor at the Area Agency on Aging. The staff person can advise regarding programs and qualifications and even help prepare the necessary applications and documentation. You can find your local Area Agency on Aging in our directory and contact them directly to schedule an appointment.

Veterans
The VA Improved Pension was established to help veterans who are in financial need. A vet does not have to have had long years of service to qualify for the VA Improved Pension. The veteran needs to have been in service for at least 90 days of active duty with 1 day beginning or ending during a period of War and have been discharged honorably. There are three tiers of assistance:

  • Level 1: Basic Pension for those with the lowest income
  • Level 2: Housebound Benefits for those with a physician certifying the applicant is in need of some daily help
  • Level 3: Allows the highest countable income, provides the highest benefit, and is called Aid and Attendance(A and A).

The Improved Pension for A and A may be granted when the veteran or the surviving spouse requires the regular attendance of another person to assist in eating, bathing, dressing and undressing. It may also include individuals who are blind, in a nursing home or assisted living facility due to mental or physical incapacity. Learn more about Veterans Assistance.

Medicaid Cash and Counseling (Participant/Consumer or Self-Directed Programs)
If your elderly parent is eligible for Medicaid, Medicaid's Cash and Counseling program may enable direct payments to be made to you, the caregiver; however, the program is currently only available in a limited number of states (at the time of print, these states included Alabama, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia). To find out if your state has a Cash and Counseling program, contact your local Medicaid office. Cash and Counseling programs are often also referred to as "Participant/Consumer or Self-Directed Programs."

Medicaid
People with low income and few assets other than their home may be eligible for Medicaid health care coverage. This includes in-home care and personal care, such as help with bathing, dressing, cooking, cleaning, eating, moving around, and similar activities of daily living.

Medicaid does cover some of the costs of long-term care, but your elderly mom or dad must meet many eligibility requirements, including functional and financial requirements. Medicaid is a state-run program.

Each state has its own rules about who is eligible and what is covered under Medicaid. Medicaid planning often requires forethought, because a person must have very few assets to qualify for Medicaid coverage. The limit may be as low as $2,000, excluding the value of a home and possibly a car. A person must "spend down" before becoming eligible.

Medicare
Medicare is our country's health insurance program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease. Medicare has Two Parts:

  • Medicare Part A (Hospital Insurance)
  • Medicare Part B (Medical Insurance) (Most people pay monthly for Part B)

You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in Original Medicare.

In addition, if your elderly parent is a Medicare beneficiary, they might be eligible for Medicare prescription drug coverage, regardless of income, health status or current prescription expenses.

Our Medicare and Medicaid section will help you navigate through these programs.

Supplement Security Income (SSI)

Supplemental Security Income (SSI) program pays benefits to disabled adults. SSI benefits also are payable to people 65 and older without disabilities who meet the financial limits. SSI pays benefits to the elderly and certain family members.

Unlike Social Security benefits, SSI benefits are not based on your elderly parent's prior work or a family member's prior work. SSI beneficiaries may also be eligible for food stamps in every state except California. Your elderly mom or dad's living arrangement is another factor used to determine how much SSI they can get. Benefits may vary depending on whether the senior lives:

  • In their own home
  • In someone else's household
  • In a group care facility In an institution

Family Caregiver Support Program

Family Caregiver Support Program (FCSP) offers support services to family caregivers of persons age 60 and older, or adults of any age with dementia. Services include information to caregivers about available support services; assistance to caregivers in gaining access to supportive services; individual counseling, support groups and caregiver training; respite care; and supplemental services (such as emergency response systems and home modifications).

To access your local FCSP, contact your local Area Agency on Aging (can also be found in your phone book.)

Tax Breaks
If you're supporting an elderly parent, you may qualify for some tax relief. As a caregiver, you might be able to claim your elderly parent as a dependent on your taxes. You might also be able to deduct your medical expenses.

IRS Publication 501 gives details on dependency requirements, including caregiver income phase-out levels. In addition, you must be providing over half of their financial support for food, housing, medical, transportation, etc.

If the person lives with you, include a reasonable percentage of your mortgage, utilities and other household costs in determining your level of support. Those who are in an assisted living or long term care facility can qualify as dependents if the income and support levels are met.

Visit our Tax Tips for Caregivers section to learn more about the tax breaks available to family caregivers.

Counseling for the Elderly
The Tax Counseling for the Elderly (TCE) Program provides free tax help to people age 60 and older. Trained with IRS materials and certified by an IRS examination, a network of volunteers provide tax counseling and basic Federal income tax return preparation services at community locations across the nation. Many of these community locations also offer free electronic filing services.

Benefits Checkup
BenefitsCheckUp is the nation's most comprehensive Web-based service to screen for benefits programs for seniors with limited income and resources. BenefitsCheckUp includes more than 1,700 public and private benefits programs from all 50 states and the District of Columbia, such as:

  • Prescription drugs
  • Nutrition (including Supplemental Nutrition Assistance (SNAP)/Food Stamps)
  • Energy/utility assistance
  • Financial assistance
  • Legal aid
  • Health care
  • Housing
  • In-home services
  • Transportation

Government Benefits
GovBenefits.gov is the official benefits website of the U.S. government, with information on over 1,000 benefit and assistance programs. Gather up all the information you can on your elderly parent's health, disability, income, wealth (as in property owned), whether a military veteran, education level and more. Access this site and answer every question that you can. Then, push the button and, within minutes, the site will respond with a list, details and access information for many beneficial government programs and services.

Home Equity Conversion Mortgages (Reverse Mortgages)
The purpose of the program is to enable elderly homeowners to convert equity in their homes to monthly streams of income, or except for Texas, lines of credit. Home Equity Conversions are also known as reverse mortgages.

To contact these organizations, see telephone numbers and website links on the next page.

Links for organizations that can help caregivers get paid

How to contact the resources mentioned in this article that might help caregivers get paid for caregiving:

Administration on Aging
http://www.aoa.gov/

Area Agency on Aging
Contact the National Association of Area Agencies on Aging at 202-872-0888. To find your local Area Agency on Aging, visit: Listing of Area Agencies on Aging

Veteran's Association
VA Main website
Information sheet on VA pensions

Cash and Counseling
Call (617) 552-6582 or visit the Cash and Counseling website.

Medicaid
Call Medicaid at 877-267-2323, visit the Medicaid website, or visit the Medicaid section of AgingCare.com.

Medicare
Call the Medicare toll-free help line at 800-633-4227 or visit the Medicare website.

Supplemental Security Income (SSI)
Call 800-772-1213 or visit the Supplemental Security Income website.

IRS Free Tax Counseling for Seniors
Call 202-283-0189 or visit the IRS website.

Benefits Checkup
Visit the Benefits Checkup website

Government Benefits
Call 800-333-4636 or visit the Government Benefits website.

Reverse Mortgages
Call (800) 569-4287 or visit the HUD website.

Next: 10 Government Programs You Can Access for Your Elderly Parents
 Comments 1 to 10 of 176 

My mom had two houses in her name so we cannot get medicaid. Or anything else for 3 to 5 yrs. It is hard because I had to stop working to care for her full time. It cost more to pay for help than I made a month so it was cheaper for me to do it.After I used all my resources up we are now living on her S.S. So here we are. She just started Hospice . That is the only thing that saved us. They pay for all her needs and we have money leftover for bills and food. Thanks to Hospice.

If you have other brothers and sisters, you should ask them if you can get paid for the majority of the work. I am primary caregiver for my m-i-l who has Alzheimer's Disease (AD). I am getting paid--but only because my s-i-l who is Durable Power of Attorney agreed and she also went to a lawyer to iron out everything.

Family caregivers (children not spouses) can also get paid to help their aging parents through the VA Aid and Attendance Improved Pension.

I thought there might be a ray of hope for me in your multi-faceted answer. But there isn't. There is a maddening aspect to caregiving for a family member because even if they have money to pay you, it is NOT allowed. I understand why because of the threat of financial elder abuse. However, their "rich" situation puts the full time family caregiver in a dire situation. My mother was put under county conservatorship because of my two sister's financial elder abuse, and they made me 24/7 caregiver. Oh, after many months, they decided I could get $10 a day, but that was a stretch for them to allow that. But HEY, let's spend a fortune taking the cats to the vet because they are important to my mother. What am I? Chopped liver? If something happens to me, their concern is making sure my mom has A caregiver at all times. Even inheritance laws don't protect me. My thieving sisters, who of course split way before they were reported...they'll get their fair share. I'm waiting for SOMETHING. These are mostly ways to get more help for the CLIENT not for the CAREGIVER.

CJWright, I would really suggest that you find a good attorney. I understand your situation. My grandmother, who has Alzheimer's, lives with me and my family. Her son wouldn't take her in. My wonderful husband agree for her to move in with us. So, we bought a duplex and had it renovated into one house so that she could have her own living area. We thought we'd be able to sell our little 2br/1ba house, but three years later we still have it. We've lost all of our savings in having to pay two mortgages.... we won't ever recover that. We've also gone thousands of dollars in debt trying to keep up with everyday bills... and take care of our own two daughters. My grandmother helps some with the utilities, but we get no help otherwise; and we have to "prove" where that money is going. And as far as the school is concerned for the free/reduced lunch program, we have to count that money as income eventhough she is the one who uses the utilities. My uncle had everything of hers put in his name soon after my grandfather passed away. She never changed the will, so with my mother gone, everything goes to him. We probably will be paying off bills for decades just because we took her in. Because I'm only a granddaughter and not her daughter, I have no legal rights (according to an attorney I've spoken with) eventhough I'm the one caring for her. You, CJ, are your mother's daughter and you should have more legal rights over your sisters because you are her caregiver. I'd definitely seen an attorney's advice.

I know there are plenty of caregivers out there in much dire straits than I have here. Thank you for your advice. I have no money for attorney. I have been told by the public guardian that there is nothing I can do in this regard, and that family caregiving is considered a GIFT by the powers that be. You might actually be in a better position to be on the inheritance pipeline, so to speak, as the uncle could have manipulated the will and just told her to "sign here, Mom." It could be financial elder abuse. However, like my mother's will, she wrote it before my two sisters showed their true colors. As soon as it was obvious that Mom wasn't paying attention to her finances, and had no memory of giving permission for loans, etc., they started in on her money, esp. when reverse mortgage came through. So, there are these criminals who should be in jail for ten years...and they get equal inheritance. When the world isn't fair, it's infuriating, and added pressure on top of the obvious 24/7 caregiving gig. One of these evil gals just wrote the other "good" sister that all I do is sit at my computer all day. For 7.5 years. I really like how they "cherrypick" truths to stand on. There's the whole world of reality, and she is basing her relationship with her mother on bs like that. She's totally on a postage stamp size piece of illusion, when there is 25,000 mile circumf. territory of How it Really Is. Guess I got off topic. but it shows the stuff we have do deal with, fighting cruelty and delusion in others. ON TOP OF CARING FOR SOMEONE 24/7.

Get paid for your care work by writing down what you did, the date and time, and how long it took. Discuss compensation options from the estate with your parent. Then send a copy to siblings and tell them your hourly rate or that you wish to be reimbursed from the estate in the future. Christine

If you live in California, there is a program called the In-Home-Support-Services available to assist seniors who are disabled and on Medi-cal. Caregiving services can be paid for up to 100 hours a month and caregivers can be in the form of outside help provided by the agency and/or family members themselves. Check the website here: http://www.dss.cahwnet.gov/cdssweb/PG139.htm Due to the budget crisis in California, I'm not sure how much or if the program has been affected. So you'll have to check. ~Rose

Yes, the qualifications levels are set of the person needing the care, not the dire straits of the caregiver herself. There is another element to this mess as far as getting permission from parent to be paid caregiver. If the parent has been already declared demented, they may not have the legal right to agree to such an arrangement. That happened in my Mom's case, and the complexity increased when the person who had mom's personal POA in case of emergency was one of the two thieving sisters. And when i arrived to care for Mom, she had already written Mom's doctor a scathing letter of condemnation about Mom...and was demanding mom be thrown in a nursing home. I use those words because that is how cruel she is, and ironically, Mom deteriorated because of this sister's cruelty. At the time I came to the rescue, I should have had mom change the POA, but didn't even think about it (and the sister did not really show her true stripes until later). The county took over conservatorship proceedings because of this sister's (and another sisters) financial abuse. If Mom had been in her right mind she could have deemed me POA. My sister resigned being POA, but Mom wasn't legally able to name me successor. There was a bad legal limbo there.

 Comments 1 to 10 of 176 
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