Family Caregiver Agreements?


Support For Home is a member of the national ElderCare Matters organization. In fact, I am one of the California State Coordinators for it. We are strong believers in what the organization is all about, and obviously fans of how it operates, or we would not be members. That having been said, no organization gets everything right, and we are not sure about a just published article.

The article is Caregiver Agreements: Making the Pathway of Caregiving a Two-Way Street and makes some very good points, including the following:

  • 37% of caregivers spend more than 40 hours a week providing care and another 30% spend 20-39 hours assisting with needs. Caregivers cope with physical, emotional, spiritual and financial challenges brought about by the demands of the job and the need to reduce or forgo employment to care for a loved one. These challenges affect the caregiver’s health and quality of life as well as the recipients.
  • Long-term caregiving has significant financial consequences for caregivers, particularly for women. Caregivers face the loss of their own income, loss of employer-based benefits, shrinking of saving to pay for caregiving costs and a threat to their retirement income due to fewer contributions to retirement vehicles.

Unfortunately, the conclusion the author draws from this data is, in our experience of working with many families and family caregivers, somewhat questionable. The primary recommendation is to create a “caregiver agreement” to pay the primary family caregiver for services they provide.

Contract

The advantages, according to the author, include keeping peace among the family members. Unfortunately, in our experience, the family dynamics which are in place before someone needs care are only emphasized when a loved one requires support. A family that communicates and teams up, emotionally and financially, will strengthen its ties. A family at odds will only see those tensions increase. A document (and, yes, we have seen them) detailing the family caregiver’s role does not change that situation.

However, there is another problem with the notion of a family caregiver contract. The family caregiver has just become an employee of the person receiving care and / or of various other members of the family. As such, there are now a number of legal obligations on the part of the employer(s), involving both federal and state wage and hour and other employment laws. Any attempt to ignore these legal obligations involves “misclassification of workers” violations, which the federal government is really clamping down on, hard, even recently giving out large grants to states to pursue such violations – including by families.

Depending on in which state the caregiver is employed, overtime provisions may override the federal rules. In any event, workers compensation insurance, unemployment insurance taxes, liability insurance, tax withholding and other requirements are now in play. If a family is ready – and able – to handle these obligations, great. If not, there is a fire waiting to be lit.

Where there is a primary family caregiver, sitting the family down to discuss that person’s burden and what can be done to help – and clearly define roles – is a very, very good thing. Before a family turns that person into an employee, make sure all the research has been done and the family is in a position to follow through on its legal and ethical commitments.

In many cases, it is better for the family caregiver to be able to return to their real profession, where they will probably earn more, including toward their own retirement, than to be compensated as a family caregiver. In addition, quite frankly, caregiving involves a lot of knowledge and skill. Not every loving family caregiver can deal with the personal care, incontinence, dementia, transfers, … needs of their loved one.

There are no simple answers. Look at all the variables. Get good, professional advice – there is a lot of it available at no cost. Then figure out which solution works best for you and your family.

Best wishes. Bert

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One response to “Family Caregiver Agreements?

  1. These are points worth considering, Bert, and families shouldn’t jump into the contract without thoroughly discussing their options. This is a very informative article, so we featured it in our Weekly Digest. You can read it here http://www.ltcoptions.com/weekly-digest-advice-caregivers-care-recipients/.

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