Create a contract for family care

When the caregiver whom Amy Goyer, of Phoenix, hired for her 93-year-old father seemed particularly tired recently, Goyer realized she had been so busy she wasn’t aware her employee needed a vacation. As it happens, that caregiver is also her sister.

“A loved one who provides care can get burned out, too, just like any other caregiver,” says Goyer, who is also AARP’s family and caregiving expert. “We worked out ways for her to have paid time off.”

Goyer, age 56, and her sister, age 59, already had created and signed a simple caregiving agreement. And even though Goyer is “on the same page” as her sister, it’s still hard to get everything right. “It can get tricky,” says Goyer, who holds power of attorney for her father.

Family caregiver contracts, also called personal care agreements, range from informal, like Goyer’s, to complex professional contracts drawn up by lawyers. Families usually create them when one relative is handling most of the care for an elderly parent. A contract enables family members to spell out payment, a work schedule, and expected duties. Another benefit: members formalize the compensation for a relative who is making financial sacrifices in order to provide care.

Adding to the financial hit, a 2021 AARP study found family caregivers spend about $7,242 a year on out-of-pocket costs relating to care¹. And the contract may avoid future conflicts — assuaging any hard feelings, for instance, when a relative providing the bulk of care inherits a parent’s home. But, sometimes, drawing up a contract stirs up emotions tied to sibling rivalries and past disputes. Non-caregiving family members may resent paying a relative whom they see as living rent-free in a parent’s house. And families often don’t draw up contracts until a crisis arises. “Sometimes we have to call a mediator in,” says Springfield, Mass., lawyer Hyman Darling, president of the National Academy of Elder Law Attorneys.

Drawing Up the Documents

If your family is considering a caregiving contract, there are ways to avoid some of the acrimonies. First, the relative who is the caregiver should explain to the family how much work he or she is doing and what kind of help is needed, says Amanda Hartrey, a family consultant with the Family Caregiver Alliance, a non-profit caregiver resource and advocacy organization.

Call a family meeting to discuss the contract. Set an agenda, and keep it narrowly focused. At the meeting, make the point that “this should be treated as a business meeting and not a therapy session,” Hartrey says.

Note a starting date in the contract, and specify a work and payment schedule, such as hourly or bi-weekly. Check with local home health care companies to set a fair pay rate. Caregivers also should be required to keep a daily, detailed journal documenting their hours and care provided, says Kerry Peck, a Chicago elder law attorney. That will help if any questions arise about the contract, particularly if a parent later files for Medicaid. Families need to have written proof the money they paid a relative was for caregiving duties, not a gift to spend down assets to qualify for Medicaid.

Set boundaries, as you would for any other paid caregiver, Goyer advises. If a parent has a non-smoking household, specify whether the rule applies to family caregivers. Designate responsibility for expenses, such as whose car will be used to take a parent to appointments, and who will pay for gas and parking. Work out issues such as paid time off and sick leave.

Include an escape clause, Goyer says. A caregiver might find the work too overwhelming if a parent’s health or mobility declines. Or a parent may go into a nursing home or assisted living. Goyer says that she and her sister like working together. But “we’re sisters,” she says. “We’re still going to quibble.”