We live in rural Maine and my wife is well into her third year of dementia.

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Why would they cover an independent?
Have you checked with them?
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Reply to AlvaDeer

You will need to negotiate this with the insurer before you go this route as there is no guarantee they will reimburse you for this arrangement. They may need to have a vetting process to cover themselves in terms of liability.

One "pitfall" of privately hiring is that in most states it can mean the IRS sees you literally an employer, meaning you need to have a written contract, have to do tax withholding and reporting on their paychecks, and submitting a W2 to your employee. So, bookkeeping. Plus you will need to make sure your liability insurance is enough if the aid gets injured while working for you (or you may need to carry Worker's Comp). FYI my MIL worked for an agency and broke her back on the job. No subs if the aid gets sick or goes on vacation (so you should always use 2 people whenever possible, IMO).
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Reply to Geaton777

You become an employer.
You have to do all the paperwork.
You have to make sure that back ground checks are done.
You have to make sure that the IRS is happy.
Make sure that your homeowners insurance will cover an employee that is injured on the job.

Depending on the coverage of the Long Term Care Insurance will it cover Memory Care?

How much help do you need?
Hospice could be a "stop gap" a Nurse would see her each week.
A CNA would come at least 2 times a week to give her a bath or shower.
Both would order the supplies and medications that you would need.
You would also get the equipment that you need to care for her.
While it is not full time help you could also ask for a Volunteer that could come and sit with her while you go out for a few hours.
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Reply to Grandma1954

Why not consider a facility and bypass individual caregivers? There you will receive care from a professional staff 24/7. You can oversee her care as her advocate.

If you prefer to hire privately, make sure that you have a written contract regarding your wife’s care.

Don’t expect one caregiver to do everything. That’s impossible. They will need off for their own personal needs.

Hire more than one caregiver, if possible. This way, you always have someone with your wife if one of the caregivers can’t come in that day.

Pay a fair wage.

Best of luck to you and your wife. Contact Council on Aging in your area for an assessment of your wife’s needs. They can help guide you through this process.
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Reply to NeedHelpWithMom

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