I get this question at least three times per week, sometimes more. A son or daughter will call and say they need to give up their own current position in order to take care of their parent 24 hours per day. The caller goes on to say they heard that their neighbor’s cousin’s friend was doing it and they wanted to as well. While it CAN be done, there are rules. Also, being paid to take care of your loved one is not going to be the financial panacea that you might think it will be. CMS (Centers for Medicare and Medicaid) does not like for family members to care for family members exclusively for several reasons. Let’s talk about those first:
Reasons CMS Will Not Reimburse:
1. Chances are greater for caregiver exploitation, abuse, and neglect of Consumer (your loved one)
2. Caregiver Burnout increases exponentially.
3. Chances of CMS reimbursement fraud is higher.
Reasons Some States will Allow in Certain Situations:
1. Consumer lives in an extremely rural area. Mileage is not reimbursable under CMS rules so if your family member lives several miles out of town, that’s a really high mileage roundtrip that the Home Health Aid must eat every day. No one will want to do that so family placement as caregiver may be approved.
2. Consumer requires very specialized care that only family member can perform.
3. Occasionally, if the consumer is blind and fearful of strangers, it is possible.
4. Consumer lives in region of the state that is impossible to staff. For instance: In Western Oklahoma there is now an oil boom. Oil pays very well when things are going well. Wal-Mart is having to bus in employees from 60 miles away just to have staff. Home and Community Based Services (HCBS) suffers greatly during this time. This is an instance where a family member MAY be allowed to be a paid caregiver.
Reasons Consumer will not be Considered for Family as Paid Caregiver:
1. Because they are uncomfortable with strangers.
2. Family member has been convicted of felony, but “that’s okay with them”.
3. Because that’s who they would prefer take care of them.
4. Because they paid their taxes and want it this way.
5. Because they are afraid the family member will leave the home and nursing home placement might occur.
6. Because the family member feels it is too hard to hold down an outside job and care for the family member as well.
7. Because the doctor said the family member was best.
Misunderstood Concepts of the Program:
1. Family members often think they will be paid for a full day’s work.
2. Family members often have no idea how low the pay is.
3. Family members think the $$ will be enough to sustain the family financially.
4. Family members think they will only have to take care of their loved one and that’s it.
5. Family members think they can work through the local Social Service Agency instead of their local Provider Agency.
So, you see it is NOT the easiest thing in the world to become a paid caregiver if you are the family member and if you are financially responsible for the consumer, you will not be considered at all. An instance of this would be a wife wishing to be paid in order to care for a husband. Also, even if you are eligible to care for the loved one, you will only be paid for the time the case manager or nurse says is required to keep the loved one out of a nursing home. That may be less than an hour per day.
I hope this has cleared up any questions you may have about a family member as a paid caregiver. If you have any questions, please post them here and I will answer!