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My wife's sister has brain cancer, and her mental state has left her very confused, and scary--ie she gets up in the middle of the night to fix food,using the stove, doesn't remember doing it. Has my sister bring over food, eats it, then 30 minutes later asks why her food hasn't arrived. The family is thinking of asking younger family members to assist with watching her, paying $15hr, just to keep an eye on her. My concern is the tax implications for the younger members--anything over $600 a year must be reported. Or just do it "under the table".

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No don't do it under the table. If Medicaid s needed within five years the amount paid to the kids will be considered a gift and will be a penalty from Medicaid, dollar for dollar where SIL will not be eligible for Medicaid.
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Agree with do not pay under the table.  Also, check into younger person being able to set up IRA, tax cost may be minimal.
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Aside from the payment question, I am hoping your family is realistic about how this young relative can handle her behaviors, since they haven't much life experiences and therefore, have less common sense and pool of knowledge from which to draw. I suggest this young CG be given a primer of what to expect and what to do in worst-case scenarios, who to call, what constitutes a 911 emergency, etc. otherwise it may be scary for them or overwhelm them, especially since it is a LO they know. I am in favor of employing this young CG. Aside from the valuable life skills it will teach them, they will gain emotional stamina as well. I also think it is something worthwhile for their resume. I did the same with my 3 sons when we needed all hands on deck to help when both my in-laws were in elder failure simultaneously. I wish your family all the best, especially your sister. Peace to all of you!

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No, I would not hire an 18 to 25 year old to watch this woman without some experience. Why, I find very few 18 year olds mature enough to do something like this. Babysitting is nothing like caregiving. Will this be 24/7?

If this woman needs 24/7 care at $15 an hour thats over 10k a month. You may as well find a nice AL. Then she is safe and no worries. Let her money run out and then place her in LTC with Medicaid footing most of the bill.
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Update...Thanks to all that replied to my question, I got some answers we needed. My SIL, is on a pain pump with Dilaudid, so she is pretty much sedated all day. We learned quickly that younger family caretakers would not work well. It is hard to see family members go downhill so quickly, and once what was Auntie, is now a person we don't know. I very much enjoy reading the questions presented, and the well thought out answers.

Again, Thanks to you all
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Geaton777 Jul 2020
Thank you so much for the update... it is so helpful and gratifying. I wish you peace as you journey with your SIL down the difficult path.
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So sorry for your loss.
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