Page 2 of 4 Personal Care Agreement Updated 07/2017
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Basic Components of a Personal Care Agreement
Three basic requirements:
The agreement must be in writing.
The payment must be for the care provided in the future (not for services already performed).
Compensation for care must be reasonable. This means it should not be more than the cost for a
paid caregiver from a local home care agency.
Other Components:
Date the care begins.
Detailed description of the services provided (for example: food preparation, transportation and
errands: driving to medical, dental, and other appointments).
How often will services be provided.
o Allow for flexibility in care needs by using language such as “no less than 20 hours per
week.”
The location where the services are to be provided.
How much and when the caregiver will be compensated.
If the plan is for the caregiver to live with the care recipient, will room and board be free as part of
the compensation? If not, include details on how living expenses will be covered (for example, the
caregiver will pay a proportional share of utilities, mortgage, insurance, taxes).
How long the agreement is to be in effect.
o Examples: one year, two years, over a person’s lifetime.
A statement that the terms of the agreement can be modified only by written mutual agreement.
Signatures of the parties, including the Power of Attorney for the person with dementia and date of
agreement.
Additional Details to Consider
Consider creating an "escape clause" in the event that one of the parties wants to terminate the contract.
Use a term such as "this agreement remains in effect until terminated in writing by either party." Consider
a provision for back-up care that "springs" into action if the caregiver becomes ill or wants a vacation.
When an agreement has been made to cover room and board costs when the caregiver lives with the
care recipient, consider what happens if the care recipient moves into a care facility. Will health insurance
or a long-term care insurance policy be purchased to cover the caregiver? If so, include that in the
personal care agreement and be specific without being inflexible. Consider adding an allowance for easy-
to-overlook out-of-pocket expenses.
To determine the level of care required, consult with a local homecare agency, physician, geriatric care
manager, hospital discharge planner or social worker. There may be a fee involved to conduct a care
assessment in the home. Because the care recipient has dementia, it is important to plan for disease
progression. This assessment will also help in anticipating any future care needs.
When preparing an agreement, address what each care task means. Define, for example, what "personal
care" is: does it include bathing, dressing, and dental hygiene? The result will be a more realistic
caregiving assessment if care tasks and the time required to complete them are clearly defined.
Caregivers should maintain a detailed daily log and have a concise job description. Documentation will
support the intent of the contractual relationship if for any reason it comes into question.
The personal care agreement is a contractual relationship between employer (care recipient) and
employee (caregiver), a relationship that requires withholding and paying taxes. Other considerations are