Many families pay a relative for care before anyone writes anything down. That is when the paperwork matters most. A written agreement protects the caregiver, the parent, and the family members who are not providing care, and it gives everyone one place to look when the arrangement changes.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

What the agreement has to say

The parent and the caregiver, by full name, and who signs for the parent if the parent cannot sign.
The tasks in plain words: companionship, meals, errands, transportation, and medication reminders. A paid family caregiver does not hand out, sort, or manage medicine, which stays with the family, the doctor, and the pharmacist.
The hours and days, and how hours are recorded.
The pay rate, and how and when it is paid.
What happens when the caregiver is sick or away, and who covers.
How changes are made, which should be in writing and signed by both sides.
Who keeps the signed copy, and where it is kept.

The hours log is the second paper

Keep a written log of hours worked, signed by the caregiver and countersigned by the person managing the parent's money or, if the parent can sign, by the parent. Without the log, the family has an agreement on paper and no proof of what happened under it. The log is also the record the family will need for tax questions and for any program that asks how care was paid.

Check the tax papers before the first payment

Paying a household worker can create payroll duties for the family, including withholding and reporting, depending on the pay and the arrangement. IRS guidance on household employment explains the thresholds and the forms. Read it before the first payment, not after the fact, and ask a tax professional to confirm how it applies to your household.

Check the program rules before you sign

Paying a relative can affect a parent's eligibility for some programs, and some programs set their own rules for paying family caregivers, including whether the caregiver must be enrolled as a provider. Ask Missouri DSS in writing about any Medicaid rule that applies before you sign. If the parent receives Social Security, ask SSA how the household arrangement and any payments could be reviewed. The Who Pays for Care at Home in St. Louis page sets out the main payer questions to ask in order.

Check the rate line like a quote

The rate line is the price term in the agreement. Confirm whether it is an hourly figure, whether it covers travel, overtime, and sick days, and whether any money comes as reimbursement for expenses. Every figure in the agreement should match what the family will actually pay. If a figure is missing or unclear, leave the agreement unsigned until it is written out.

Where the lawyer takes over

Ask an attorney to review the agreement if the parent has a conservatorship, a power of attorney, or a will that touches the money, or if other family members dispute the arrangement. The Missouri Bar can refer you to one. The agreement should not promise any medical care, since medical decisions belong to the physician.

Pay a Family Member for Care Only Under a Written Agreement: The Terms, the Hours Log, and the Tax Papers