As a caregiver for a loved one, you likely know the majority of caregiving doesn’t come with a paycheck. If new to caregiving or considering making a change in your current arrangements, you need to think about the differences between paid and unpaid caregiving.

Below is a consideration of both paid and unpaid caregiving, along with the benefits and drawbacks of each to help you decide.

Paid Caregiving: Benefits

1. Getting Paid for the Work

One of the largest considerations falls on the issue of financial compensation. Many family members provide caregiving while working. But many also either move to part-time work or drop out of the workforce to provide care. This can lower income and result in financial challenges. More than 30 percent of caregivers have financial difficulties related to unpaid care.

Paid caregiving can relieve some of the financial burdens for people who have had to reduce or end their participation in the workforce.

2. Creating Visibility

When loved ones need care, family members often step up to the plate and begin to provide it. Because this is an extension of family care and love, other family members and friends may tend to overlook the contributions, or not realize how much time and planning it takes.

Becoming a paid caregiver makes the role more visible and clear. The caregiver is not only helping an aged parent out occasionally but actively helping to maintain their health as much as possible. It can benefit families to realize how much time and effort a caregiver puts in when assessing how family members should share caregiving duties.

Paid Caregiving: Drawbacks

1. Low Pay

While it’s possible for a family member or friend to receive pay for caregiving, the pay can be on the low side. It may not equal what a caregiver has given up in the workforce, or the pay may not match the time caregivers actually need to spend on caregiving.

The people concerned may need to do a cost-benefit analysis regarding who is available to do the caretaking, whether it can be shared and who is the right person to do it. If it makes more sense for someone to stay in the workforce and earn an income, sharing care may be the best solution.

2. Tracking Down Payment Options

There is no single payment option for caregivers — many exist. While that can be good news, caregivers, other family members and friends need to realize that researching and finding payment options is time-consuming at first.

The search can be frustrating, partly because there is no consistency across the country. States, counties and even municipalities can offer programs to pay caregivers, but caregivers must research to find these. Once found, these can be highly beneficial, but legwork is required initially to find them.

In some states, Medicaid offers payment options in exchange for the caregiver taking classes and becoming certified in things like cardiopulmonary resuscitation (CPR). In others, they are offered through the state Department of Aging of through disability programs. If the person needing care is a veteran, the Department of Veterans Affairs (VA) offers some programs. Some insurance policies have provisions for long-term care payment.

Unpaid Caregiving: Benefits

1. Freedom of Choice

Unpaid caregiving is free of any requirement to certify or take courses. In government programs, the government specifies what the caregiver has to learn and may also specify other regulations and restrictions in exchange for the payment.

Unpaid caregivers may make any arrangements they wish in giving care. They have freedom of choice in making the arrangements, sharing the caregiving and so on.

2. More Flexible Options

If caregivers have an extended family in the same geographical area, it may make sense to share caretaking activities. If one person becomes certified or entitled to be a paid caregiver, for example, it may actually result in a limited menu of options, because only that person can provide care.

Caregiving is a stressful job, and caregivers need to practice self-care as well. One option to provide self-care is to rely on volunteers or paid help once in a while, to give the caregivers a respite. This may become more complicated if the primary caregiver receives pay.

Unpaid Caregiving: Drawbacks

1. Financial Constraints

Unpaid caregivers often suffer financially both in the short and long term. Short term, if they have dropped out of the workforce or moved to part-time work, they may earn less. Earnings affect long-term considerations, such as Social Security contributions and potential private retirement contributions. Caregivers may inadvertently hurt their own retirement security.

Caregivers need to remain cautious not to withdraw any existing retirement savings or otherwise harm their long-term financial security to support their loved one who needs care.

2. Invisibility

In our society, paid work is more visible than unpaid work. People who take on unpaid care — especially women, on whom emotional caregiving often disproportionately falls — can be taken for granted. Other family members and friends may not grasp how time-consuming the care is, or how stressful it can be.

One solution is to have open meetings with other people concerned with the care. The loved one’s issues, needs and financial situation need transparent discussion.

The decision about whether to be a paid or unpaid caregiver is a complicated one. People in the situation need to consider these issues carefully.

Written by Kayla Matthews
Kayla Matthews writes about medical technologies and news developments for publications like The Week, BioMed Central and Kareo's Go Practice Blog. To read more posts by Kayla, visit her on Twitter @KaylaEMatthews or check out her website:

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