Would you be more comfortable living in your own home or in a care facility?  Do you want to feel in charge of your daily routine or have it dictated by someone else?  These are questions that seem to have obvious answers; however, staying in one’s own home with the challenges of aging can prove to be difficult.  With older populations growing rapidly, the need for caregiving is rising, just as a brutal economic downturn is making money increasingly tight.  

As an alternative to institutional care many families are looking toward in-home caregiving as an option.  To that end, setting up a caregiver agreement is vital for protection of all parties involved.  Agreements need to be extensively documented and must stand up as arm’s length contracts. Furthermore, family members involved in the process need to be sensitive to how the arrangement might affect relationships among family members. Here are some tips on setting up these necessary agreements:

Carefully define care needs. The first step is to conduct an assessment of your loved one.  Consult family members on what they perceive to be caregiving needs.  Find out the physician’s opinion of whether needs can realistically be met in a home-based setting.  After assessing, you need to clearly outline the duties and responsibilities the caregiver will be required to provide.  It immediately defines the caregiver role and helps families avoid communications problems later.  Keep in mind that agreements need to anticipate future changes depending on health and environment of the loved one.

Create a care plan. A care plan is a set of instructions for the caregiver to follow when assisting the care recipient with the activities of daily living. It includes instructions on personal care, exercise, meal preparation and household activities. The plan should be based on insights and considerations from your loved one, the medical community, friends, and relatives and can be developed by the family caregiver or a home care professional. The end goal of a care plan is to help an older adult live safely and comfortably at home, taking into account their individual needs or limitations.

Make a financial plan. Conduct a financial assessment based on current and future resources.  Properly developed caregiving agreements enable compensation payments that do not adversely affect Medicaid eligibility. The payments can also reduce the assets subject to estate taxation of the person receiving care.  The U.S. Administration on Aging has an elder care locator (http://www.eldercare.gov/Eldercare.NET/Public/Home.aspx) to help connect you to local agencies.

Put it in writing. Whether a family member or a hired helper, the contract must be in writing.  Include a medical report with specific medical services needed from a doctor.  To protect everyone involved it is recommended that the family use an attorney to help with the agreement. Take a look at the National Academy of Elder Law Attorneys for their elder law attorney locator (http://www.naela.org/MemberDirectory).

Get input from family members. Caregiving situations can create tension among other family members, including disagreements over how an ailing parent’s assets are being used.  Talking about it before the agreement is signed will clearly set out the plan and will alleviate ill will later on from family members.

At all times, remember, the care plan is an ever-changing document. You will need to evaluate and modify the care plan based on feedback from your loved one, your own assessment or a professional caregiver’s observations.

About the Author:  Suzanne McNeely, MSW, NCG, CLPF, CMC, is president and founder of Senior Planning Services (SPS) in Santa Barbara, CA.  She began SPS in 1989 after many years of working in social services and hospital administration.  Suzanne designed SPS to help advocate and provide guidance in all aspects of daily life for the elderly, including psychological, physical, financial and legal issues.  She can be reached at smcneely@seniorplanningservices.com.