Eldercare as a Medical Deduction?

Ainer & Fraker, LLP: Eldercare Can Be a Medical Deduction

With people living longer, many find themselves becoming the care provider for elderly parents, spouses and others who can no longer live independently. When this happens, questions always come up regarding the tax ramifications associated with the cost of nursing homes or in-home care.

The entire cost of nursing homes, homes for the aged, and assisted living facilities are deductible as a medical expense, if the primary reason for the individual being there is for medical care or the individual is incapable of self-care. This would include the entire cost of meals and lodging at the facility. On the other hand, if the individual is in the facility primarily for personal reasons, then only the expenses directly related to medical care would be deductible and the meals and lodging would not be a deductible medical expense.

As an alternative to nursing homes, many care providers are hiring day help or live-in employees to provide the needed care at home. When this is the case, the services provided by the employees must be allocated between household chores and deductible nursing services. To be deductible, the nursing services need not be provided by a nurse so long as the services are the same services that would normally be provided by a nurse such as administering medication, bathing, feeding, dressing etc. If the employee also provides general housekeeping services, then the portion of employee’s pay attributable to household chores would not be a deductible medical expense.

Estate Planning for Parents of Special Needs Kids


Estate Planning is important for all families.

However, it is especially critical for families with one or more children with special needs.  Without proper planning, valuable government resources may be jeopardized, or worse, lost forever.

How Can I Prevent what Happened to Terry Schiavo from Happening to Me?

On March 31, 2005, Terry Schiavo passed away, after a fifteen (15) year legal battle over her fate. During this time, her case became a national lightning rod for the discussion over end-of-life issues.

In brief, Terry had collapsed in her home on February 25, 1990. When the EMT’s arrived, she was not breathing and had no pulse. Various emergency medical procedures were immediately enacted, however, her brain suffered from a lack of oxygen, and she fell into a Persistent Vegetative State (PVS).

In the months and years that followed, a protracted legal battle ensued between her husband, Michael Schiavo, and her parents, Robert and Mary Schindler, about what Terri would have wished for herself. Michael argued that Terri would have wished for treatment to have been withdrawn. The Schindlers argued that Terri was a devout Roman Catholic, and would never have wished to violate the Church’s teachings on euthanasia by refusing food and water treatment.

A Completely Unnecessary Tragedy

Beyond the personal and medical tragedy that befell Terry Schiavo, what made matters even worse is that the fifteen year legal battle which ensued was completely unnecessary.

To completely over-simplify the legal case: both sides argued that they knew best what Terry wanted for herself.

What was completely missing in this case was a clear and unambiguous declaration by Terry of her own decisions in this matter.

Because there was no living will in effect, both sides were forced to argue that they knew what she wanted. Had there been a valid living will, it would have been executed, and the entire legal drama could have been avoided.

What is a Living Will?

In the legal world, there is a legal document known as a living will, or here in California, an Advance Health Care Directive.

This document is designed to do two things: (1) Make your decisions regarding health care, and end-of-life decisions, perfectly clear and then (2) Nominate another person (an agent for health care) to carry out your wishes, on your behalf, if you are not able to do so yourself.

With a living will, the decisions remain your own. Your agent is not allowed to substitute their judgment for your own, their only role is to carry out your wishes. Without a living will, the hospitals and Courts will have to substitute someone else’s judgment for your own.

What Can You Do to Protect Yourself?

We understand that these types of decisions are difficult to think and talk about. However, they are far too important to leave to others.

]Here are a few guidelines for how you can protect yourself:

(1) Talk about these issues with your spouse, your family, your pastor, your spiritual mentor(s). Pray over these decisions, but also let others know what you would want.

(2) Execute a Valid Living Will or Advance Directive. As important as it is to discuss with your loved ones, it is equally important to put your wishes into legal effect, through a validly executed Living Will or Advance Directive.

(3) Tell your doctors and your family that you have executed such a document, and make sure it can be found quickly in an emergency. A recent study shows that as many as one-half of all living wills fail because they can not be located in an emergency, when they are needed most.

(4) Most importantly, don’t try to do this alone. We encourage everyone to work with appropriate legal counsel, who can provide guidance, answer questions, and ensure that your documents are legally valid.

These decisions are far too important, too personal, and too spiritual to leave in the hands of a Court, a hospital, or a third-party. You need to take control of your own decisions, by executing a valid living will or Advance Health Care Directive today.

(c) 2009 Ainer & Fraker, LLP.