A Caregiver’s Journey: Getting Paid to Care for Family

This article features Carrie and Pat, composite characters created to represent the typical experiences of many family caregivers and care recipients. While their specific story is fictional, every situation described reflects real challenges and solutions encountered by family caregivers across the country.

Carrie always loved helping her father, Pat. A couple of years ago, he started needing more help. Pat used to have a great memory. Why was he suddenly leaving the oven on and forgetting to take his medicine? Eventually, Pat received a diagnosis of dementia. Caregiving was getting harder.

Carrie didn’t want her dad to go to a nursing home, and he didn’t want that either. 

Carrie helped her dad apply for Medicaid. She also helped him get a Home and Community-Based Services Medicaid waiver so he could get care at home. Soon, Carrie was taking care of her dad full-time, and she had to quit her job. She needed extra money. 

Keep reading to find out how Carrie became a paid caregiver and got her dad the care he needed.

Getting Information

Carrie wanted to learn as much as she could about Medicaid before she signed him up for anything. She went online and found answers to a lot of her questions on the AARP Foundation’s Paid4Care hub. This helped Carrie learn how to make sure that her dad was eligible for Medicaid. 

Pat knew he needed help, but he didn’t want to go into a nursing home, so Carrie looked for options that would allow her dad to stay at home. She found out they could apply for a Medicaid Home and Community-Based Services waiver. She read about self-directed services that provided her family with more control than other options, like agency-based care.  Self-direction would let her dad hire Carrie directly. This way, Carrie could provide the care her dad received and help him work with his Medicaid case manager.

Once Carrie understood the process, she and her dad were ready to get started.

Signing Up for Medicaid

Carrie and Pat applied for a Home and Community-Based Services waiver. The waiver said Pat could get help if he needed a nursing home level of care. Carrie was confused. Wasn’t she trying to keep her dad out of a nursing home? Luckily, Carrie learned that this didn’t mean Pat would have to go to a nursing home. Instead, a healthcare professional would give Pat an assessment to see what kind of care he needed at home.

Pat needed care around the clock. His memory was getting worse, and he started needing help using the bathroom. This meant he needed a Nursing Home Level of Care. This made him eligible for Home and Community-Based Services, and he didn’t have to go to a nursing home. 

While checking on Pat’s care needs, Medicaid also confirmed he couldn’t pay for healthcare on his own. Carrie had to share some financial documents as proof.

Carrie and her dad were worried that Pat’s house could stop him from getting Medicaid. He owned his house. Did that mean he couldn’t get Medicaid? Thankfully, this wasn’t an issue because in his state his house wasn’t counted as an asset for the purposes of qualifying for Medicaid. The assets Pat did have, including some cash and a checking account, were low enough that he was able to get Medicaid services. About six weeks later, Carrie and Pat got a letter from the Medicaid office. The letter said he could get Medicaid Home and Community-Based Services. It also said he could set up a self-directed plan.

Carrie and Pat were thrilled this letter came so quickly. They were lucky that there wasn’t a long wait list in the state where they live. In other states there are often much longer wait times for a spot to open on the waitlist for Medicaid Home and Community-Based Services. 

Becoming A Paid Family Caregiver

Carrie and her dad met with their Medicaid case manager. They worked together to make a care plan for Pat. They also completed the paperwork to hire Carrie as his caregiver. In their state, if Carrie had been her dad’s legal guardian, she could not be paid to care for him. Luckily, Pat did not yet need a guardian, and he could still participate in his care decisions.

Their case manager also made sure that a local home care agency was on call to support Carrie. Carrie was ready to take on more responsibility, but it still helped to have experts nearby. They could give practical and emotional support. They even provided training!

Carrie passed her state’s background check and was finally able to get paid for caring for her dad. She just needed to keep track of the hours she spent caring for him. Carrie had to submit a timesheet to the state’s approved payment agency, which then paid her. This helped make up for some of the income she lost by leaving her job.

Moving Forward

Your story is unique and will not be exactly like Carrie and Pat’s. Still, if you find it hard to work outside the house while being the primary caregiver for a family member, you might want to explore becoming a paid family caregiver. If you can help your loved one access self-directed Medicaid services, you may be eligible to get paid for your caregiving work through Medicaid.

Even though Carrie would take care of her dad for free, being paid for all her hard work helped her make ends meet. It felt good to take care of the man who had raised her, but it was also hard sometimes. With fewer money worries, Carrie could focus on being there for her dad and giving him the care he deserved.