The Importance of Caregiver Contracts
October 2, 2014
A goal that my clients bring up in meetings time after time is that they wish to stay in their own homes for as long as possible. Many people, however, find the cost of bringing help into their homes to be daunting. Elders are increasingly turning to their adult children for in-home care. As thanks, to reimburse the child for their time and expenses, or a combination of both, elders often wish to “pay” the child. But should the elder need nursing home care in the future, MassHealth will view informal payments as gifts, which could prevent the elder from receiving public assistance. So the question is, what is a family to do?
One solution is a “caregiver contract.” This is a written agreement between the elder(s) and their adult children, laying out tasks the child will perform and a rate of pay. Set up along with worker’s compensation and the usual payroll deductions, this provides an income stream to the caregiver while giving the parent what most elders want – being cared for by his or her own family.
Caregiver contracts benefit both parties. The caretaker child gets the benefit of worker’s compensation, in addition to reportable, reliable income for state and federal income tax purposes. (You may not think that’s a benefit – but paying taxes can be much better than the consequences of being discovered as delinquent!) The elder gets to remain in his or her home with a familiar caretaker, often at a rate much less expensive than those charged by home health agencies. Should the elder require MassHealth to pay for nursing home care, he or she can prove that the payments were just that – payments – and not gifts.
Only an elder law attorney familiar with the ever-changing MassHealth rules should draft a caregiver contract, so that it will protect the elder in the event he or she needs nursing home care in the future. If you believe a caregiver contract would be helpful to you, please do not hesitate to contact my office.
Statewide Transition Conference for Parents
August 28, 2014
The Arc of Massachusetts is holding a transition conference for parents of children with disabilities between the ages of 14 and 22. Attendees will be able to choose from a variety of workshops focused on the best practices of creating seamless transitions from school into the adult world.
The conference will take place from 8:00 a.m. to 4:00 p.m. on Saturday, September 20th at the College of the Holy Cross in Worcester. Registration is $75.00 per person and includes breakfast and lunch, as well as all-day access to a “technology playground,” where attendees can learn about iPads, iPods, tablets, and the best apps to prepare children for adult life and independence.
Workshop topics include employment, benefits eligibility, financial seminars, transportation, housing, the parent role in the transition process, and more. There are over 25 workshops to choose from; each attendee may select four. The descriptions can be found here. JoAnn Simons, President of the Cardinal Cushing Centers of Massachusetts, will deliver the keynote address and Maria Paiewonsky, Transition Specialist at the Institute for Community Inclusion, will give the lunchtime presentation.
If you have a child with disabilities, this event is a must-do. The Arc of the South Shore can help defray the cost of attendance for qualified local families; contact Daryl Cook-Ivan or Katie Hanley at 781-335-3023. For general questions regarding conference registration, dietary concerns, or special accommodations, contact Pat Pakos of the Arc of Massachusetts at 978-440-7609.
Caregivers are Depressed
August 12, 2013
Interesting concept in this article – one of those things that you don’t think of on your own, but when someone else verbalizes it, you say, “of course.” The idea is that caregiver stress is in part driven by a tension in the caregiver’s own psyche between giving up who she has been, while at the same time both embracing and rejecting the role of caregiver. It’s a lot for one heart to handle. Read the New America Media article here.
Department of Public Health Survey on Health Needs for People with Disabilities
May 20, 2013
Caregiver Holiday Wish List
December 21, 2011
My favorite columnist, Michelle Singletary (The Color of Money) has done it again. She always has something spot on and practical to say. This week she cuts to the chase when it comes to caregivers – they are tired. They don’t want bling or stuff that will end up on a shelf. They want help. They want a rest. They want someone to just listen. Michelle’s column borrows from an aarp blog full of gift ideas which you can read here.
Help your friendly neighborhood caregiver take a break. Happy Holidays!
Thrown into the Deep End
May 18, 2010
Did you see Michelle Singletary’s column this weekend in the Boston Globe? I like her column, The Color of Money. She writes in a straight-forward, honest manner, with guidance targeted at “regular folks” like myself.
This weekend she wrote about essentially being thrown into the deep end of the pool of elder care. If you read her column, you saw that her feelings, questions, fears, and sense of being overwhelmed and without direction are those very same feelings that most children of seniors (or healthier spouses of seniors) are experiencing every day.
While I can’t make your parent or spouse healthier, and I can’t bring back their memory skills, I can make it easier for you to handle your new caretaking role. The elder law attorney’s job has many aspects – for one, I help elders stretch out their assets to stay at home for as long as possible.
How do I do this? We look at MassHealth benefits and Veterans Benefits as a way of bringing more help into the home. We look at selling the home and building an in-law apartment on a child’s house. We explore setting up a contract between parent and child that allows the child to quit her job and care for her parent but still earn some income. And if nursing home is a possibility, we explore ways to maintain a healthy spouse at home and also explore various methods of safely and legally transferring some assets to children.
But the elder law attorney’s role goes beyond this – my job is also to pull in other professionals who can help you become a better – and more sane – caregiver. I may invite in an Alzheimer’s coach to teach a family how to work with a family member who is changing before their eyes; a geriatric nurse to guide a thoughtful conversation on wishes for end of life care; a geriatric care manager to create and manage a schedule of home health aides – and more.
I can’t get you out of the deep end of the pool. Life takes our parents and spouses in certain directions. But I can teach you how to swim.
More Reasons to Write up a Caregiver Contract
November 13, 2009
Paying Your Children to Care for You? Put it in Writing.
August 30, 2009
Always Keep Time & Expense Records When Helping Another
August 6, 2009
So many children, nieces and nephews, and good neighbors pitch in to do heavy lifting for an aging or disabled family member or friend. You may be running errands, cleaning out a basement, doing weekly grocery trips. We do these things on a volunteer basis, usually receiving just reimbursement for purchases made. And when the hours pile up – like cleaning out a house or overseeing home remodeling – elders often insist on paying their helpers for their time.
If you are doing this sort of work for an elder or disabled person, it is imperative that the person you are helping (or you yourself, if she can’t), keep good records of expenses and time spent.
While this may feel wrong to you – afterall, you are doing this work out of kindness, it’s not a business arrangement – a lack of records can spell big trouble for the elder or disabled person later. If they will ever be turning to MassHealth (Medicaid) for care, whether at home, assisted living, or in a nursing home, MassHealth will examine the last 5 years of the applicant’s bank records. She will need to explain – and document – why she was paying you.
Without accurate records and receipts, MassHealth will likely reject the elder’s application. At that point, the only way for her to get the care she needs from MassHealth will be for you to return all the funds she paid you.
While it may feel awkward, do yourself and the person you are helping a favor and keep good time records and all receipts. And carry on with your good work.
Caregiver: Care for Yourself, Too
June 1, 2009
Caregiver burnout is a dangerous side-effect of dedicating your time and energies to the care of a loved one. All the physical activity, combined with the worry, isolation, and frustration, make for a dangerous recipe. Families frequently come to me when Mom got sick from the exhaustion of caring for Dad. Another common scenario is a child becomes worn down and finds herself spending lots of time in doctors’ offices for her own ailments, and the family asks me to make different arrangements for the parents’ care.
It’s hard work caring for another – physically, emotionally, mentally. If you are a caregiver, you must take time for yourself. Go for walks, take an art class, join a support group where you can let off steam and also get some ideas and encouragement from other souls in the same boat. To take time for ourselves, most of us need it to be compulsory: so sign up for an exercise class or a walking group, or find your own buddies to cycle with a few mornings a week. Whatever the activity, if you’ve scheduled a time and others are expecting you, it’s more likely you will follow through.
There are many places to look for support and ideas, just spend a few minutes online and you will find them. One good place to start is the Alzheimer’s Association Caregiver Stress Check. Joining a caregiver support group is an excellent thing to do and can often result in long-lasting friendships. Call your local senior center for a list.
Most importantly, get outside! It’s the perfect time of year for that. Take good care.