Can I get paid to look after Mom?

If you’ve cut your hours to look after your mother, this isn’t a greedy question. It’s a practical one, and sometimes the answer is yes. But the paid routes are hidden in state programs with different names, and none of them starts automatically. Here’s how they work.

Start here: does your parent qualify for anything?

Almost every paid route depends on your parent, not on you. The money follows their eligibility:

• If they have, or could get, Medicaid, read the next section.
• If they’re a veteran or a veteran’s surviving spouse, read the VA section.
• If neither applies but they have money of their own, read about a written agreement.

Medicaid: the main route

Many states let people on Medicaid direct their own care. Instead of an agency choosing the aide, your parent can recruit, hire and supervise their own worker. In some programs they also decide how the budget is spent.

That worker can often be family. Federal training material from Medicaid says most states offer personal care that family can provide, and each state sets the conditions. In general:

• Adult children and other relatives can be paid if the state’s program allows it and they meet its requirements.
• Spouses are usually treated as legally responsible for each other. Paying them is the state’s choice, usually with extra conditions.
• You’ll have rules to follow. States can set qualifications, limit the hours a family caregiver works, and require records of time worked, sometimes electronically.

The programs have different names in every state, which is why this is hard to search for.

What to ask your state

Call your state Medicaid office or your Area Agency on Aging. The Eldercare Locator can find it: 800-677-1116. Then ask:

1. Does my parent qualify for home and community-based services?
2. Is there a program that lets them choose their own caregiver?
3. Can a son or daughter be the paid caregiver? Does it matter if I live with them?
4. Is there a waiting list?
5. What’s the pay, how many hours are allowed, and who handles payroll?

We’re building a state-by-state chart. Until it’s ready, your state’s own office is the place to check.

If your parent is a veteran

• Veteran-Directed Care. The veteran gets a budget and hires their own workers, which can include a family member. It isn’t available everywhere. Ask a VA social worker.
• Program of Comprehensive Assistance for Family Caregivers. This pays a monthly stipend to the primary family caregiver. The veteran must have a VA disability rating of 70% or higher, need at least six months of in-person personal care, and be enrolled in VA health care. You apply together on VA Form 10-10CG.
• Aid and Attendance. This adds to a VA pension for those who need help with daily activities. It goes to your parent, not to you, but it can help pay for care.

If your parent pays you themselves

This is allowed, and it can be fair to everyone. But do it properly, because of Medicaid’s five-year look-back. If your parent later needs Medicaid, money paid to you may be treated as a gift, which can delay their coverage. A written agreement is the usual way to show it was payment for real work.

Rules vary by state. Georgia’s Medicaid manual is a good example of what states look for. There, an agreement must:

• Be in writing, signed, dated and notarized.
• Be signed before the care starts. It can’t cover care already given.
• Spell out the services, how often and how many hours.
• Pay a market rate for that care in the area.

If an agreement fails those tests, Georgia treats the payments as transfers. Have an elder law attorney write yours, and keep a log of the hours and payments. If you have brothers or sisters, tell them first. Talk to the attorney before accepting a lump sum.

Taxes

• Your parent may become an employer. The IRS lists health aides among household workers. If your parent controls what you do and how you do it, and you’re 21 or older, Social Security and Medicare taxes generally apply once they pay you $3,000 or more in cash in 2026. They’d report it on Schedule H with their tax return.
• Some Medicaid payments can be left out of income. If you live in the same home as your parent and have no other home, certain Medicaid waiver payments can be excluded from your income. If you keep a separate home, they can’t.

A tax professional can tell you what applies to you.

Long-term care insurance

If your parent has a policy, read it or call the insurer. Ask whether it pays for care at home and whether a family member can be paid. Check before you assume either way.

If you can’t be paid

There’s still help for the person doing the caring.

• Unpaid leave. The Family and Medical Leave Act gives eligible employees up to 12 weeks of job-protected leave in a 12-month period to care for a parent with a serious health condition. You need 12 months with a covered employer and 1,250 hours worked in the last year, at a site with 50 employees within 75 miles. It doesn’t cover parents-in-law. You can take it in blocks or as shorter days when medically necessary. It’s unpaid, though you may be able to use paid leave at the same time.
• Paid leave. Some states and employers offer it. Ask your HR department and your state’s labor department.
• A break. The National Family Caregiver Support Program funds counseling, training and respite care for people caring for someone 60 or older. Ask your Area Agency on Aging what’s available near you.

What to do this week

1. Find out what your parent has: Medicaid, veteran status, long-term care insurance, savings.
2. Call your Area Agency on Aging and ask the five questions above.
3. If your parent served, call a VA social worker or the nearest VA medical center’s caregiver support team.
4. If you’re already being paid by your parent, or about to be, talk to an elder law attorney first.
5. Keep a simple log of the hours you spend. You may need it, and it shows the family what you’re really doing.