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How critical is it for them to participate in decisions made on their behalf? Attending all or part of the meeting may allow the care receiver to build trust in the caregiving team. This can help later with their cooperation when tougher decisions must be made. If possible, record your meeting or have someone take notes. You might distribute meeting notes to other family members for future reference.

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One person should facilitate the meeting to keep the discussion moving or to set boundaries if the discussion gets out of hand. More than one meeting may be necessary. Should the meetings not reach desired goals, family mediation is a growing trend in the U. For more information, see the National Care Planning Council noted in the Resources section at the end of this fact sheet. You don't necessarily need to hire an attorney, but it may be advisable when entering into a contractual relationship. It depends on your set of circumstances and how complex an agreement your family requires.

If you are considering a pre-paid, lump-sum caregiver contract, you may want to consult with a lawyer. A lump-sum contract is complex, and it's more difficult to show compensation in terms of "fair market" value for care services. A monthly or bi-weekly salary for care services is easier to track, especially for Medicaid purposes. If you are not comfortable with these transactions, consult an attorney to avoid conflict later.

Another legal consideration is if the care receiver lacks capacity to sign the agreement. The person holding the Power of Attorney or the guardian or conservator may sign. If the family caregiver also holds the care receiver's Power of Attorney or legal guardianship, consider consulting with an attorney. If you feel there is no need for an attorney, see examples of agreements in the Resources section. Medicaid Medi-Cal in California is a state and federal program that may pay for long-term care costs for people with limited income and assets.

Check your state for Medicaid rules since regulations do vary from state to state. These regulations are complicated, and you may want to consult an elder law attorney for help in qualifying for Medicaid or Medi-Cal. Family Caregiver Alliance FCA seeks to improve the quality of life for caregivers through education, services, research, and advocacy. Through its National Center on Caregiving, FCA offers information on current social, public policy, and caregiving issues, and provides assistance in the development of public and private programs for caregivers.

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Medicaid www. National Care Planning Council www. All rights reserved. Learn more.

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Skip to main content. Search form Search. You are here Home. Order this publication. How to Compensate a Family Member for Providing Care: Introduction Many families reach a point when they recognize that an ill or older relative needs help. What Is a Personal Care Agreement? Basic Components of a Personal Care Agreement A personal care agreement has three basic requirements for a person to pay a family member for care: The agreement must be in writing. The payment must be for care provided in the future not for services already performed. Compensation for care must be reasonable. This means it should not be more than what would be paid to a third party for the same care in your state or geographic area.

Allow for the location of the care to change in response to increasing care receiver needs. How to Discuss Personal Care Agreements Within the Family A stressful conversation for any family is what happens to the money when a parent becomes ill, and who will serve as the primary caregiver. Financial changes to the family estate present and future impact Who holds Power of Attorney?

Who will serve as a backup should the caregiver become sick or need respite? Is there a Health Care Directive? Is a physician on the team? What are their wishes?

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What is the plan if it becomes time for placement in a residential facility? Below are a few examples of what documents that may be helpful: Documentation showing the median hourly compensation for a caregiver in your area Call local home care agencies to get a sense of costs. Medical records relevant to caregiver tasks The completed care assessment documenting level of care Additional legal documents such as Health Care Directive, Power of Attorney Financial documents and will and trust agreements Should the meetings not reach desired goals, family mediation is a growing trend in the U.

Do I Need a Lawyer? Other Organizations and Links General information regarding personal care Medicaid www. In this Section. Understanding your liability exposure when employing independent home care companions can be a complex task. While the access to this apparently inexpensive pool of help for an aging parent may at first glance be an attractive option for many families seeking to help their aging parents remain at home, the ultimate risks to the family could be devastating. Further, as the level of care increases over time, it is often much less expensive and more advantageous to seek healthcare professionals to deliver this care in a safe, homelike environment where the quality of life can be very high.

Sunday, July 31, Quiet the Guilt. Feeling a Little Guilty? Today's seniors enjoy a life expectancy longer than any generation in history. An American who turned 65 in could expect to live nearly another 18 years beyond their 65th birthday. And while additional years are generally considered a blessing, it is also true that the older one grows, the more likely it is that they will need health care services.


Today's seniors, who often consider themselves among the best informed, would do well to learn about three crucial areas that pertain to their future health care needs: the potential that they may need long term care, the cost of long term care and the limited federal and state aid available. According to a study by the Agency for Health Care Policy and Research, more Americans than ever will expect to utilize some type of long term care during the remainder of their lives.

And with the number of people over age 65 expected to grow to 20 percent of the U. The cost of long term care can be significant, regardless of the setting in which it is provided. Medicare has two Parts: Hospital insurance Part A which helps pay for inpatient hospital care and certain follow-up services; and Medical Insurance Part B which helps pay for doctors' services, outpatient hospital care, home health care, hospice and other medical services. Senator David Durenburger told the U.

Senate Special Committee on Aging, Medicaid "dictates that people must effectively impoverish themselves in order to receive government assistance.

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Medicaid Waiver Programs. Department of Health and Human Services to waive certain Medicaid statutory requirements. These Medicaid Waiver programs enable States to cover a broad array of home and community-based services HCBS for targeted populations as an alternative to institutionalization. Waivers may also include services not covered through the State Plan such as respite care, environmental modifications, or family training. To be a waiver participant, an individual must be medically qualified, certified for the waiver's institutional level of care, choose to enroll in the waiver as an alternative to institutionalization, cost Medicaid no more in the community under the waiver than he or she would have cost Medicaid in an institution, and be financially eligible based on their income and assets.

In addition, most Assisted Living Communities that do participate in the waiver program allocate only assisted living apartments for this not dementia units in their special care unit.

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They may however receive supplementation from their family or from an irrevocable trust to cover the cost of an upgrade to a private room. Those assisted living communities who do participate in the program offer it first to their existing residents and normally require two years of private pay to even be considered for it. Though 38 states pay for some assisted living, the programs are miniscule, covering fewer than , poor people, so waiting lists are long.

Medicare covers home care, but just visits in the weeks following a hospital stay.

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Contact your state Department of Health and Senior services to learn more about waiver programs. The White House recently authorized Medicare coverage for the treatment of Alzheimer's disease. This means that Medicare beneficiaries can now receive reimbursement for mental health services that were formerly denied because the government rationalized that people with the disease did not respond to mental and physical therapy; this has since been proven incorrect, hence the reversal of their position. Medicare covers certain care procedures, and some limited rehabilitation therapies. Veteran's Benefits.

Veterans and surviving spouses may be entitled to V. Aid and Attendance. To Qualify : The Veteran must have been "honorably" discharged. The Veteran must have served at least 90 days, 1 day during wartime. Individual must be over age 65, or permanently and totally disabled. Limits on Net Worth. The cash value of life insurance is countable. If assets exceed the allowable amount, this is where a good Elder Attorney comes in to play, i.

Have the right documents in hand before calling the V. Prepared Consult the Veteran's Administration on benefit and qualifications.