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Getting Paid for Caregiving

Caring for a loved one with dementia is a full-time commitment that often comes with significant emotional, physical and financial challenges. The good news is that in many cases, you can get paid to serve as their primary caregiver, allowing you to provide personalized care at home while receiving compensation. 

1. Medicaid Self-Directed/ Consumer-Directed Programs (Most Common Option)

Many states offer Medicaid programs that allow individuals (including those with dementia) to self-direct their long-term care. This means that your LO (or a representative, like a family member with POA) can choose their own caregiver - often a spouse, adult child, or other relative - and use Medicaid funds to pay them.

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  • Key Programs: Home and Community-Based Services (HCBS), Waivers, State Plan Personal Care Services, Community First Choice, or Programs like Cash & Counseling / Self-Directed Services.

  • How It Works: An assessment determines the needed hours of care (i.e., helping with bathing , dressing, meals, supervision due to dementia). You may need to register as a provider, pass a background check, and submit timesheets.

  • Pay Rates: Typically around 75% of the local professional caregiver wage (often $15-$25/hour, varying by state and county).

  • Eligibility: Your Loved One needs to qualify for Medicaid (low income/assets) and require a nursing-home level of care but prefer to stay home.

  • Best For Dementia: These programs support supervision and personal care, which are critical as dementia progresses. 

2. Veterans Affairs Programs (For Eligible Veterans)

If your LO is a veteran with dementia requiring significant assistance, the VA offers strong support for family caregivers.

  • Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides a monthly stipend to primary family caregivers, plus health insurance (if needed), respite care, training and counseling. 

  • Eligibility: Veteran must have a service-connected disability rating of greater than 70%, need ongoing in-person personal care (including for dementia related needs like supervision) and be enrolled in VA healthcare.

  • Stipend: Based on the General Schedule pay rate (adjusted by location); can equate to $1,800+ monthly depending on the needs and area. 

  • Application: Submit VA form 10-10CG online, by mail, or in person at a VA facility. Contact the Caregiver Support Line at 1-855-260-3274 for help.

3. State-Specific Incentive Programs

Some states have enhanced or additional programs that pay family caregivers, often through Medicaid partnerships or standalone initiatives.

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  • Examples: California's In-Home Support Services (IHSS) allows family members (including spouses in many cases) to be paid for caring for Medi-Cal eligible seniors with dementia; pay rate varies by county. Other states offer Structured Family Caregiving (paying live-in relatives for supervision/personal care) or similar waivers.

  • Emerging options: Programs Like Washington's WA Cares Fund may allow paid family caregiving for qualified individuals.

4. Additional Possibilities 

  • Long Term Care Insurance - Some policies reimburse family caregivers for in-home care

  • Personal Care Agreements - A legal contract where your loved one pays you from their own funds (consult an elder law attorney to ensure Medicaid compliance).

  • Paid Family Leave - In certain states, you may qualify for temporary wage replacement if taking time off work to care.

Steps To Get Started

  1. Assess Eligibility - Contact your state's Medicaid Office, local Area Agency on Aging  or VA Caregiver Support Team

  2. Gather Documentation - Medical records showing dementia diagnosis and care needs, financial info for Medicaid, or VA records. 

  3. Apply - Start with an assessment. Many programs require a home visit or functional evaluation. 

  4. Seek Help - Use free resources like Guidelight Dementia or the Alzheimer's Association for guidance.

 

 

 

Getting paid as a primary caregiver can ease financial strain while letting you keep your loved one safe and comfortable at home. Programs change, so verify current details with official sources in your state. Remember: you're doing important work! Explore these options to see what support is available.  

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