It is common for older adults, especially those with Alzheimer’s disease or dementia to have an informal caregiver, usually a family member, adult child, or other loved one. This can be a difficult role, as most care providers also need to be employed to make ends meet. However, all state Medicaid programs have a family caregiver program that allows recipients to hire their family members as paid caregivers. In Missouri, programs like Consumer-Directed Services allow care recipients to manage their own care by hiring loved ones. Consumer-Directed/Self-Directed Services is the most common model across all 50 states. Some states, like Missouri, Indiana, and Georgia have a daily stipend model for caregivers of beneficiaries needing 24-hour caregiver services. The person needing care must meet certain eligibility requirements, such as needing a nursing home level of care. They must also be eligible for Medicaid’s Home and Community Based Services waiver (HCBS waiver) program for in-home care. Enrollment in a Medicaid program does not guarantee that a family member can be hired as a caregiver, but it does guarantee some form of financial assistance for care needs.
Medicare often does not cover in-home health care. It should be noted that in certain states, spouses and parents of minor children are not eligible to be hired as their loved one’s caregiver.
In addition to providing training, many states’ Medicaid programs provide support services such as support groups and respite care for caregivers. These are known as the family caregiver support program, and they provide the caregiver resources to assist them in taking care of their loved one. Examples of personal care services that a family member might provide are assistance with activities of daily living (including eating, toileting, and bathing), and homemaker services. These services can delay or prevent the admission to a long-term care facility or assisted living facility. The caregiver may also be responsible for case management and creation of a care plan.
To see if you may be eligible for payment, contact your local Medicaid office to see if your loved one is meets the eligibility criteria for the Medicaid waiver program, and if so, whether in-home caregiving is an available service. If your family member is not eligible for paid caregiving, consider contacting your local area Agency on Aging (AAA), as they may be able to connect you with adult day cares, care referrals, and meal delivery programs.