Who determines caregiver pay when POA is the caregiver? Any tips?

As mentioned by another community member, an elder who pays a family member for care could be disqualified from Medicaid coverage if they need nursing home care in the future. Your state's Medicaid agency could view the payments as disqualifying transfers. A written agreement, with records of payment to you, would provide verification to the Medicaid agency that the payments are not disqualifying, and that the payments provided value to your mother.

In my state (Massachusetts) you can not make retroactive payments for work done before the Caregiver Contract is in force, ad expect Medicaid to honor the Contract.

Other reasons to create a written Contract are the vultures you mentioned. Without a written agreement, the family member(s) providing the care are vulnerable. The Caregiver Contract recognizes and rewards the time and effort that you give to care, and helps to prevent arguments and misunderstandings among other family members who can't or won't help out.

Without a written agreement, the elder (and others people involved in care such as physicians and health care providers) aren't sure about who is responsible to maintain the needed level of care. The Caregiver Contract can include a written organization of care and other services.

Talk with an elder law attorney in your area to prepare the document that serves your mother's interests.

I was advised by my attorney that Dad should still sign the contract, even with his level of dementia. I had two people present, and the contract was explained to him, then he signed and they witnessed. My understanding was that it could be construed as a conflict of interest to sign a contract with myself on his behalf. His logical reasoning wasn't completely gone, and the explanation included a comparison of the contract price vs. SNF pricing, just to make it clear to him that it was fair. I even left him alone with the witnesses for awhile so that he could ask questions and be very comfortable about it before signing. We did it on one of his good days. (I assume your mom has good and bad days with regards to her dementia). I would suggest a consult with an attorney. It shouldn't cost more than a couple hundred dollars, and it's well worth it.

The fact that you are essentially writing a contract to yourself makes it ethically challenging, as to the legality I think you would need to consult someone better versed in the law than those of us on this forum. Personally I don't see anything wrong with you being paid a fair wage for the work you do, in fact I did what you are proposing but without the formality of a contract. The thing is, my own family was in 100% agreement (in fact they thought I wasn't paid enough) so there was no chance of it being called into question.

Annie my POA is worded the same, but to be on the safe side get a lawyer,, for future possible issues. Do keep records,, you never know when your sister may get "interested: in things.

An Elder Lawyer will define your pay per hour/ per week of care giving. They can create a Service Contract Agreement which will acknowledge your pay over time (to match her savings, etc.) and then you can move her bank account funds over to your name as payment.

This step will save those funds from being taken over by Medicaid when the time comes to apply.

This agreement CANNOT be done by your self. This MUST be done by an elder lawyer as they know all the financial trappings of Medicaid, and can word it appropriately. And Medicaid will only recognize this particular service agreement.

Good luck!

Your mother would have determined your pay via a written contract signed by you and her.

Don't discount the possibility of medicaid, I never dreamed my mom would hang on so long or become so debilitated that I couldn't care for her at home, but it happened. Other than that who do you need to satisfy in regard to your salary, do you have fractious siblings?

I looked into drawing up a caregiver contract for my brother and saw 2 elder law attorneys to plan for Medicaid (it didn't work out.. he was looking to be paid way more then what would have been allowed.... with a ton of time off) Anyway..... A couple of things to consider is that you have to be considered an employee and pay Fed income taxes, the other as I understand is that you need to be paid equal to or less then the going rate of caregivers in your area.

My biggest concern was also Medicaid.. if it was ever needed.

My mom's lawyer said to keep a log for 2 month & at minimum wage or $100 per month for every $100,000 she has - so you keep the books & know her net worth - then figure it out - I am about to give myself a small raise as mom's assets are going up not down as I stay on top of things

Also is she paying rent or utilities? if not those are legitimate expenses that she should be paying - what would you charge to rent suite out? - a real estate agent should be able to help you set what the going rate is - she has been there for years so even if you had her pay her share have you increased it to cover higher prices in the intervening time

POA does not authorize you to write a contract. My concern is if she needs medicaid then a contract would explain where that money went to