Abstract
Michigan operates one of the most extensive programs in the nation to pay relatives for providing personal care to their elderly family members. However, in 1988 the Health Care Finance Administration proposed regulations that would explicitly disallow such compensation, requiring that family care givers be replaced with professional, medically oriented providers. This qualitative study examines the potential effect of this policy change through interviews with 49 high-need elderly clients and care-giving relatives in the Michigan program. Dimensions explored include familial and moral obligation, the means-tested nature of the benefit, whether autonomy or dependence was enhanced by the reimbursement, and perceptions of the adequacy of care. Client and care-giver comments graphically illustrate the value of this small payment (less than $333 per month) to the household.
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