How Do You Become Your Spouse's In-Home Caregiver?

You become your spouse’s in-home caregiver by taking on all their support and care responsibilities at home. You don’t need permission to care for your partner, but you must apply for public funding and meet eligibility criteria if you want payment in place of a home care agency.

A 2020 AARP and National Alliance for Caregiving report found that approximately 53 million American adults provide informal care for family members, including seniors and people of all ages with special needs. Almost 42 million of these caregivers look after somebody aged 50 or older, with prevalence increasing. Research shows that older caregivers typically support individuals of a similar age, with almost three-quarters of those aged 75 and older assisting someone in a similar age group. Moreover, around 12% of family caregivers support a spouse or long-term partner.

Because family caregivers, especially those of advanced age, have a significant risk of experiencing burnout and neglecting their own needs, individuals should access local support services. Examples include considering temporary at-home or residential respite care for their spouse, arranging home-delivered meals, joining in-person or online caregiver support groups, attending senior centers and delegating tasks to other relatives.

Typically, spouses support their partners to age at home rather than needing residential care, such as assisted living. Additionally, family caregivers may perform domestic and personal tasks for those receiving home health care services. Home health agencies deliver medical and therapeutic services in an individual’s home, often delaying nursing facility admission or preventing a prolonged nursing home stay following an injury, illness or surgery. However, such agencies don’t assist with everyday activities. Spousal in-home care commonly includes:

• Helping their partner bathe, brush their teeth, dress and use the toilet
• Running errands and completing domestic chores, such as housework and laundry
• Aiding their spouse to move around the home
• Preparing meals and helping their partner eat
• Taking their partner to appointments

Navigating financial support for informal caregiving can be complex, with various programs offering assistance under different criteria. Here’s a breakdown of the main avenues through which informal caregivers can receive financial support:

State Programs: Many states offer programs that pay informal caregivers. Check local guidelines through the Area Agency on Aging.

Medicaid and Waiver Services: Most state Medicaid and Home and Community-Based Waiver Services allow qualified individuals to select their caregivers. These include:

• Self-directed service options
• Community First Choice programs

Criteria for Eligibility: Most programs require meeting financial and functional criteria, and some require physician approval.

Tax Benefits: The Internal Revenue Service provides tax breaks for those caring for family members.

Veterans' Benefits:

• VA Pension and Aid and Attendance: Recipients may use this supplemental benefit to hire any caregiver, including spouses.
• Veteran Directed Care and Family Caregivers Program: These are location-specific and offer additional support for veterans to pay family caregivers.