Keep the Care Receipts Yourself or Hand Them to a Preparer: Where the Line Falls
Some care costs can be claimed on a tax return and some cannot, and the choice between keeping the records yourself and paying a preparer depends on the question you need answered.
Care costs pile up in small amounts: an aide's invoice, a pharmacy receipt, a mileage log, a supply order. Most of them are never claimed because nobody kept them in a form a preparer could use. The decision in front of you is whether to build that record yourself or to pay someone else to do it. The answer depends on how much of the work is sorting and how much is judgment about what counts.
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 you can do yourself
Set up one folder and one ledger. For each payment, record the date, the payee, a plain description of the service, the amount, and the proof of payment such as a receipt or a bank record. Keep the originals or clear copies. Note which payments were made from which account, because the tax treatment can depend on the source of the money. This work is clerical, and a family member with a steady hand can do it well for years without outside help.
Where the judgment starts
The question of which care costs are deductible is not a clerical question. IRS Publication 502 lists which medical and dental expenses count, and some in-home care costs qualify while others do not. Whether you can claim them also depends on whether you itemize deductions on Schedule A, which is a choice made on the whole return. That is the point to pay a tax preparer, or to ask for help from a free source. Bring the ledger to the preparer already sorted by category, and ask which items they would claim and why. Ask them to show you the publication line that supports each answer.
Free help that stops at a line
The IRS Volunteer Income Tax Assistance program offers free return preparation for people within an income limit, but its volunteers do not prepare complex returns and cannot give advice on how a particular expense should be treated for your situation. If the return involves business income, a sale of property, or a dependent claim, pay a preparer. For broader planning questions, the local help page on this site lists the free and low-cost resources in the St. Louis area, and the Missouri SHIP counselors can answer Medicare-related questions at no charge.
This article is not tax advice. The rules are set out in the IRS publications named above, and a preparer or the IRS is the right source for how they apply to your return.