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Is it legal in Maryland to provide care for a disabled elderly non-family member in one's home as a cost savings measure (sharing a paid care provider and each family also contributing direct care to save costs). Much like a nanny share arrangement, but offering room and board to another elder. My sister and I are barely making it financially - she trying to survive on the income my mother can provide her for round the clock intensive care (is just covering her bills with no buffer) and me assisting 15 hours a week and working a PT job. I am picturing a cooperative legal agreement. But, I don't know if this would be legal without setting ourselves up as an assisted living home. I don't believe my mother would qualify as an assisted living recipient due to stage 3 pressure wounds sustained at nursing home that doctors say will never close...and the level of care that she needs. With current staffing levels in nursing homes and the inability to monitor and correct improper/neglectful care...we cannot place her in a nursing home.

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@jenlwren..
when you do hire caregivers keep in mind the ever changing needs of the person they are caring for.
A Competent, skilled caregiver this week may not be up to what needs to be done in 6 months.
My advice is when you have a contract with set duties and pay it should be reviewed fairly often. 6 months would be a goal.
As a person declines (this is not just dementia but any decline that comes with age or illness) they need more care, more things need to be done for them and many of these things take more time. What was an easy transfer with a Gait Belt from bed to chair or toilet can soon become a 2 person transfer or the use of equipment is needed. From a Sit To Stand to a Hoyer Lift. All the declines require more skill. Be ready to let a caregiver go because they can not safely care for your loved one.
As I have said many times SAFETY is priority. Not just your loved ones safety but the caregivers as well.
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jenlwren Feb 2021
My mother requires a very highly skilled caregiver. I was thinking of pairing my mother with someone who needs much less. But, I had not thought beyond to what my mother may need additionally...or the other party. It is what we do not know we do not know that is a difficult part of this journey.
Thank you for reminding me to plan and inquire in this area.
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Jenlwren, I congratulate you for attempting to determine the legality of the issue now.   But this is what is realistically involved with whether or not it's legal:  Someone would need to research MD statutes and probably some interpretive case law.   Otherwise, you're not really getting to the legal basics of the situation. 

If you really want a legal answer, and if there are Senior Centers in your area which offer weekly advice through volunteer attorneys, this would be a good option, before retaining an attorney and paying, if you could even find an attorney to focus primarily on this issue.    More than likely an attorney would want to leverage the issue and create a care agreement as well as address liability issues as Grandma1954 wisely advises.    And those liability and insurance issues are definitely ones that should be considered.
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jenlwren Feb 2021
Thank you. I plan to call the Senior Legal Help line in my state. I am not sure they can help with this, but will call. Yes, I can see how both issues will be so very important.
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You have an interesting idea and I like your outside-of-the-box thinking but this part of the plan jumped out at me:

“... sharing a paid care provider and each family also contributing direct care to save costs.”

One of the biggest complaints on this forum is family members not helping out equally, even when they had previously seemed to have agreed to do so. Seems like having to monitor and overseeing an entirely different family’s level of involvement would be daunting.
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jenlwren Feb 2021
@SnoopyLove. Good thought. And circumstances in families change also. We are not all so young either. I think this part of the equation would have to be a part that we are all not counting on too heavily. Thank you for the wise warning.
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As if we all didn’t have it tough enough to do right by those we love!

My mother sustained two severe pressure sores in my care (major guilt trip, one on her heel and another much larger one in her groin, and I’m sure they were staged, but I was only told that they’d “never close”.

Our Eastern European caregiver evidently didn’t understand that, so she made poultices of raw onions and the sores (down to the bone, the one on her foot) were both healed in less than a week, and she went on to live 5 1/2 truly blissful years in a superb residential care center a mile and a half away from me.

Nothing to do with your legal question, but I hope it’s at least a small consolation to know that sometimes matters can turn out better than we’re told they will. I’m hoping that will be the case for your mom, once you get things set to rights.
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jenlwren Feb 2021
Thank you, AnnReid. That is a remarkable story! Sometimes it is good to know that all of reality really isn't in our hands or scope of imagination.
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Before you even consider this check with a lawyer.
You will need a LOT of legal advice on this.
The state health department would be another place to check. But your local County and or Village/City may have different codes that you would have to follow.
I would then check with your Insurance company. You would need a lot of liability insurance. Workman's Comp insurance as well. And a Tax ID number so that you can file taxes for your employee(s).
Will your house have to be adapted in any way to make it safe? Will you need a sprinkler system? Automatic Alarms? (you could also check regulations for Group Homes in your area) Ramps? Multiple exits that are accessible.
This is a great idea, and needed but it is involved. A friend and I were talking about this very thing yesterday!

Side note.. Is your mom eligible for Hospice. Supplies and equipment provided by Hospice might make things easier. You would also have a CNA that would come in a few times a week to help out for an hour or so. As well as a Nurse that will come once a week, more often if necessary. AND Hospice will also have a specialized Wound Care Nurse that will help with the Pressure Sores.
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jenlwren Feb 2021
Thank you for your reply. I think many families are trying to find affordable, safe options during these trying times. Great idea to check with the health department. I already have my mom set up with a tax ID number, worker's comp, etc to pay my sister. Her "company" was set up before she went in the nursing home when I hired caregivers to help me, back when I was taking care of my mom. I think my mom would be eligible for hospice. We are looking at that now. I need to find some time to talk to the senior legal aid here. I am trying to picture all the potential pitfalls that would need to be imagined and planned for. It very much intersects with tenancy/landlord issues, as well as all the care issues. Our country needs a better solution than placing our loved ones in places that cannot do what they are paid to do. If you pursue this in your state, please give feedback. Thank you!
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