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Issues of Paid Family Caregiving


Paid family caregiving is a widely discussed and controversial issue, which requires appropriate research to support or refute the necessity to continue this practice implementation. It is possible to outline several valid reasons, which clearly define why this care method can potentially deteriorate the quality of service and cause unproductive expenses and should be prohibited.

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The first reason the policy of paying the family caregiver has a negative influence is the possibility of unintentionally exposing the household member’s care, initially based on relative bounds, as something marketable. It may arise an exploitation phenomenon when the client and the worker are vulnerable to an inadequate balance between the difficulty of care tasks and the payment level. It can directly deteriorate the quality of care and family relationships.

The second reason is the possibility of fraud and abuse, as this practice can be used for personal purposes. Blaser (2018) discusses a case when “the client and the granddaughter colluded to defraud the state of more than $48,000 in service payments”, which shows the severe financial risks for the state because of the practice (245). Moreover, there are two more difficulties, which complicate the issue. The additional administrative expenses for family caregivers’ preparation are complemented by the greater required efforts to monitor the process. In addition, the increase in program funding is not expected to improve the situation as a significant part of the care is already being provided by family members, which makes increased expenses unnecessary.

How Payment Changes the Caregiver-Care Recipient Relationship

It is possible to notice that payment can change people’s attitudes toward the work they do. The desirable outcome of the program is high-quality care from a close person. However, the family member’s initial care, which is valuable on its own, can be undermined by paying for the formal providing that can deteriorate social bounds. Potential ways to commit fraud and abuse also can be a reason which can influence the relationships, as some persons might make efforts to use the situation for financial benefits, which can affect unpredictably. Therefore, in some cases, the caregiver-care recipient relationship can be deteriorated because of the financial stymie to care, which undermines the value of family members’ even unprofessional care and non-mandatory care.

The Changes’ Positive Influence

On the other side, the positive contribution from the policy of paying the family caregiver also exists. The clients report that they and their relatives feel more secure, which is desirable, in the view that patients hire persons they know and trust. According to Kunkey et al. (2018), “Empowered consumers seem to be successful at managing their workers” (250). It is even possible to balance these relationships based on determined roles, making the client and the worker behave accordingly, which leads to improved quality of care. Therefore, the practice leads to greater client satisfaction and potentially strengthened family bonds.


Blaser, J. (2018). Reading 24: The Case Against Paying Family Caregivers. In H. R. Moody & J. R. Sasser (Eds.), Aging: Concepts and Controversies (pp. 244–247). Sage Publishing.

Kunkel, S., Applebaum, R., Nelson, I. (2018). Reading 24: For Love and Money. In H. R. Moody & J. R. Sasser (Eds.), Aging: Concepts and Controversies (pp. 247–250). Sage Publishing.

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