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Delaware family caregiver guide
Last updated: 25 September 2026
Delaware has a real path for some family caregivers to be paid, but the older adult must first qualify for the right long-term care program. The clearest route is Medicaid long-term services and supports through Diamond State Health Plan Plus, usually called DSHP Plus.
Bottom Line
Start with the Delaware ADRC at 1-800-223-9074. Ask for screening for Medicaid long-term services and supports, self-directed attendant care, and other in-home services. If the older adult is already in DSHP Plus, call the health plan and ask for the LTSS case manager.
A current 2026 DSHP Plus handbook says a member using self-directed attendant care may pay a family member or friend to provide care. Payment does not start just because a relative is already helping. The service, hours, worker, payroll setup, and care plan must be approved first.
Need Help Right Now?
- If someone is in immediate danger, call 911.
- For suspected abuse, neglect, self-neglect, or financial exploitation, call Adult Protective Services at 1-888-277-4302. Delaware Relay users can dial 711.
- For urgent help finding safe in-home support, call the ADRC at 1-800-223-9074.
Start Here
- Write down the daily care needs. Note help needed with bathing, dressing, toileting, transfers, meals, walking, memory, medicine, or safety.
- Call ADRC. Ask which Delaware program should screen the older adult and whether self-directed care fits.
- Do not stop working yet. Wait until the plan confirms the approved hours, worker approval, pay setup, and start date.
| Situation | Best first route | What it can do | Main limit |
|---|---|---|---|
| Older adult needs frequent hands-on care | DSHP Plus LTSS | May authorize self-directed paid attendant care | Medicaid financial and level-of-care rules apply |
| Adult has a physical disability and wants control over care | Attendant Services | Lets eligible adults choose and manage an in-home caregiver | Financial and functional eligibility apply |
| Caregiver needs a short break | Respite or personal care | Provides relief or hands-on help | Usually not ongoing wages for the family caregiver |
| Working caregiver needs time off | Delaware Paid Leave | Replaces part of wages during approved family leave | Short-term leave, not long-term caregiver payroll |
What Has Changed
This September review replaces vague family-worker language with clearer 2026 plan guidance. The current DSHP Plus LTSS handbook says a member may pay a family member or friend to provide self-directed attendant care. It also says an Employer Representative cannot be paid as the caregiver. The guide now separates those two roles more clearly.
We also rechecked Delaware Paid Leave, 2026 Medicaid long-term care income standards, the ADRC and Adult Protective Services phone numbers, and the current three-plan Medicaid managed care lineup. No single statewide hourly family-caregiver wage is posted for adult DSHP Plus self-directed care, so the article does not guess a rate.
How Family Caregiver Pay Works in Delaware
Family caregiver pay in Delaware is usually not a grant and not a check simply because a relative provides care. The older adult first needs to qualify for a program that covers home-based long-term services. The care plan then decides which services are needed and how many hours are authorized.
The strongest public route is Delaware Medicaid long-term care. The state explains that Long-Term Care Medicaid can pay for nursing facility care or home and community-based services for eligible people who meet financial and medical rules. Delaware’s current 1115 waiver keeps DSHP Plus as the long-term services and supports system through 2028. The state’s waiver program page lists home and community-based services and participant direction as part of this system.
For broader benefits that may lower the household’s other costs, use the GFS Delaware senior benefits guide. Keeping food, housing, and utility help separate from caregiver wages makes it easier to see what each program actually does.
Who May Qualify
Eligibility depends on the program. For Medicaid long-term care, the older adult generally must live in Delaware, meet the financial rules, and need a level of care that Delaware Medicaid recognizes for long-term services. Needing help with bathing, dressing, toileting, transfers, meals, mobility, or supervision can be important evidence, but the state makes the formal decision.
For 2026, Delaware sets the long-term care income standard at 250% of the Supplemental Security Income standard: $2,485 per month for one person and $3,727.50 for a couple. The state also lists a $2,000 resource limit for an individual. Married cases can be more complicated because spouse-protection rules may apply. Delaware’s current Medicaid income limits and long-term care pages should be checked before anyone assumes they are over the limit.
If monthly income is above the long-term care standard, the state says a Miller Trust may be needed in some cases. Do not create one from an online template without case-specific guidance. Ask Medicaid Central Intake or a qualified elder-law professional how the rule applies.
| Rule | 2026 figure | Why it matters |
|---|---|---|
| LTC income standard, individual | $2,485 monthly | Starting financial screen for long-term care Medicaid |
| LTC income standard, couple | $3,727.50 monthly | Starting figure; married cases need individual review |
| Basic individual resource limit | $2,000 | Some resources may be excluded; spouse rules can differ |
| Paid Leave replacement | Up to 80% of wages, max $900 weekly | Short-term help for covered working caregivers |
These figures are screening information, not a promise of eligibility. The responsible agency makes the final decision.
DSHP Plus Self-Directed Care
What it helps with: DSHP Plus covers long-term services and supports for eligible Medicaid members. Depending on the care plan, services can include attendant care, respite, adult day services, home-delivered meals, home modifications, and other help that supports safe living in the community.
Family worker rule: The 2026 LTSS member handbook explains self-directed attendant care as a model in which the member hires and manages the caregiver. It states that a family member or friend may be paid to provide care. The handbook separately says the Employer Representative cannot be paid. This matters when a family is deciding who will manage schedules and payroll duties and who will actually provide the approved care.
Where to start: If the older adult is not yet on long-term care Medicaid, begin through Delaware ASSIST and ask the ADRC about the long-term care screening process. Delaware’s long-term care page also lists Medicaid Central Intake at 1-866-940-8963.
If the person already has DSHP Plus LTSS, call the health plan and ask for the case manager. Delaware currently contracts with AmeriHealth Caritas Delaware, Delaware First Health, and Highmark Health Options for Medicaid managed care; the state lists these plans on its Diamond State Health Plan page. The member should use the phone number on the current plan card.
Phone script: DSHP Plus case manager
“My parent needs daily help at home. We want to ask about self-directed attendant care and hiring a family member. What assessment is needed, how many hours can be approved, and what must the worker complete before pay can start?”
Reality Check
There is no single public statewide hourly wage for every adult family caregiver. The approved service, hours, and payroll arrangement depend on the member’s plan and care plan. Ask for the rate and start date in writing before changing work or household finances.
Attendant Services
Delaware’s Division of Services for Aging and Adults with Physical Disabilities also describes Attendant Services as self-directed in-home help. The eligible person chooses and manages the caregiver. Services can include bathing, dressing, mobility, meals, household tasks, communication, and other activities needed for daily life.
The current state page says the program is for Delaware residents age 18 or older who have a disability and meet financial and functional eligibility rules. An older adult with a significant physical disability may fit, but families should not assume this program is the same as DSHP Plus or that family hiring is automatically approved in every case.
The ADRC can help sort out which route applies. For more background on Delaware’s aging network, see the GFS Delaware aging agencies guide.
Phone script: ADRC screening
“I help an older adult in Delaware who needs hands-on help every day. Can you screen us for DSHP Plus LTSS, Attendant Services, personal care, respite, and any option that allows the person to choose a caregiver?”
Other Help That Can Reduce Caregiver Strain
Not every useful program pays the family caregiver. Delaware’s current in-home support page also describes personal care services for residents age 60 or older, or adults age 18 or older with a physical disability. These services may help with bathing, dressing, light housekeeping, meals, shopping, and errands.
The state also maintains caregiver support resources through DSAAPD and ADRC. Ask about respite when the family needs a break while a Medicaid or self-directed care case is being reviewed. The GFS respite care guide explains how respite differs from ongoing caregiver wages.
Veteran households should also check benefits that may change the care plan or reduce out-of-pocket costs. Use the GFS Delaware veteran benefits guide to keep veteran-specific options separate from Medicaid rules.
Delaware Paid Leave for Working Caregivers
Delaware Paid Leave went fully into effect on 1 January 2026. It is wage replacement for covered workers who take approved leave; it is not a long-term home-care payment program.
For family caregiver leave, a worker generally must work primarily in Delaware, have at least 12 months with the employer, and have at least 1,250 hours of service in the most recent 12 months. The current employee guidance says family caregiver leave can provide up to six weeks every 24 months. Approved benefits can replace up to 80% of wages, capped at $900 per week.
Most employers with 25 or more employees must provide full coverage; smaller employers can have different requirements. A caregiver should check the state’s employee information page and ask whether the employer uses the state plan, a private approved plan, or a self-insured plan. Claims are managed through the LaborFirst claimant hub.
Phone script: employer
“I need time away from work to care for a family member with a serious health condition. Is our workplace covered by Delaware Paid Leave, and do I file through LaborFirst or through our private plan?”
Reality Check
Paid Leave is useful during a hospital discharge, sudden decline, or application period, but it does not create ongoing weekly caregiver wages after the leave period ends.
How to Start Without Wasting Time
- Make a two-week care log. Record the tasks the older adult cannot do safely without help and how long each task takes.
- Call ADRC first. Ask for the correct screening route instead of calling several programs at random.
- Start the financial application early. Long-term care Medicaid can require income, resource, and medical records. Keep copies of everything.
- Use the right words. Ask about “DSHP Plus LTSS,” “self-directed attendant care,” and “hiring a family member.”
- Ask who owns each step. Find out who handles financial eligibility, level-of-care review, care planning, worker onboarding, payroll, and background checks.
- Wait for written approval. Do not assume past unpaid care will be reimbursed or that payment begins on the application date.
If the online benefits system is confusing, the GFS Delaware benefits portal guide can help you understand where ASSIST fits into the process.
Documents and Information to Gather
- Photo ID, birth date, and Social Security number.
- Proof of Delaware address.
- Medicare, Medicaid, and managed care plan cards.
- Social Security, pension, wages, annuity, and other income records.
- Recent bank and other resource records if long-term care Medicaid requests them.
- Medical records that show diagnoses, mobility limits, memory problems, and daily care needs.
- A current medication list.
- Power of attorney or authorized representative documents, if someone else handles the case.
- The proposed caregiver’s legal name and contact information.
- A simple care log showing what help is needed each day.
| Problem | Best next step | Why |
|---|---|---|
| Older adult needs daily care at home | ADRC + LTSS screening | Finds the Medicaid and home-care route |
| Already in DSHP Plus | Plan case manager | Can review self-directed care within the current plan |
| Caregiver is exhausted | Ask about respite | Can provide temporary relief while pay questions are pending |
| Caregiver must miss work | Check Paid Leave | May replace part of wages for approved short leave |
| Service is denied or reduced | Written notice + appeal | Preserves the reason, deadline, and review route |
Reality Checks and Common Mistakes
Family Care Does Not Equal Automatic Pay
Past unpaid caregiving does not create an automatic right to back pay. Payment generally begins only after the service, worker, hours, and payroll setup are approved.
- Do not confuse Medicare and Medicaid. Medicare may cover limited skilled home health care in certain situations, but it is not the usual route for long-term family caregiver wages.
- Do not assume a spouse is automatically eligible. Current 2026 guidance says a family member or friend may be paid, but it does not clearly spell out every family relationship. Ask the case manager before relying on spouse pay.
- Do not combine the employer and worker roles carelessly. The 2026 LTSS handbook says the Employer Representative cannot be paid as the caregiver.
- Do not quit a job before the payroll date is known. Ask for approved hours, current rate, onboarding steps, and the first payable date.
- Do not ignore backup care. Self-directed programs expect a safe plan when the regular worker is unavailable.
- Do not guess about taxes. The IRS Medicaid waiver guidance says certain payments may be excluded from federal gross income, but not every payment qualifies. Ask the payroll agent or a tax professional about the caregiver’s own facts.
Families dealing with mobility, equipment, transportation, or home-access needs may also benefit from the GFS Delaware disability help guide.
Denied, Delayed, or Overwhelmed
Ask for a written notice whenever Medicaid or the health plan denies, reduces, suspends, or ends a service. The notice should explain the reason and the appeal route. Delaware says people dissatisfied with a benefit decision can request a fair hearing. Read the notice carefully because appeal deadlines can depend on the action.
For problems with home and community-based service providers, the Long-Term Care Ombudsman can help at no cost. The statewide hotline is 1-855-773-1002.
Phone script: denial or delay
“My family member’s home-care service was denied, reduced, or delayed. I need the written reason, the appeal deadline, and the steps to keep services safe while the review is pending.”
If the delay creates an immediate bill, food, housing, or safety problem, the GFS Delaware emergency help guide can help the household look for short-term backup support.
Backup Options if Paid Family Care Does Not Fit
If self-directed family pay is not approved, ask whether agency-provided personal care, respite, adult day services, home-delivered meals, transportation, or home modifications could reduce the unpaid workload. A smaller mix of services can still make home care safer.
Some families also compare home care with assisted living or another long-term care setting. The GFS Delaware assisted living guide explains payment paths when home care no longer meets the person’s needs.
For adults age 55 or older who need nursing-home level care, Saint Francis LIFE is a Delaware PACE program in a defined service area. Its current eligibility page lists age, service-area, level-of-care, and safe-community-living requirements. PACE can coordinate medical and support services, but it should not be assumed to pay the family caregiver.
Official Delaware Resources
- Delaware ADRC: 1-800-223-9074 for aging, disability, caregiver, and long-term care navigation.
- Medicaid Central Intake: 1-866-940-8963 for long-term care Medicaid applications and questions.
- Adult Protective Services: 1-888-277-4302 for suspected abuse, neglect, self-neglect, or exploitation.
- Long-Term Care Ombudsman: 1-855-773-1002 for long-term care and home/community-based service concerns.
- Delaware Paid Leave: 302-761-8375 for claimant and program questions.
Resumen en Español
En Delaware, algunos familiares pueden recibir pago por cuidar a una persona mayor, pero primero la persona debe calificar para el programa correcto. La ruta principal es Medicaid de cuidado a largo plazo por medio de DSHP Plus.
La guía de LTSS de 2026 dice que una persona que usa cuidado autodirigido puede pagar a un familiar o amigo para dar el cuidado aprobado. Sin embargo, la persona que actúa como Employer Representative no puede ser el trabajador pagado. Las horas, el trabajador y el plan de cuidado deben aprobarse antes de que empiece el pago.
La mejor primera llamada es al Delaware ADRC: 1-800-223-9074. Pregunte por DSHP Plus LTSS, cuidado autodirigido, Attendant Services, cuidado personal y respite. Si un servicio es negado o reducido, pida la decisión por escrito y pregunte por la apelación.
Frequently Asked Questions
Can my adult child get paid to care for me in Delaware?
Yes, in some cases. A current 2026 DSHP Plus LTSS handbook says a family member or friend may be paid to provide self-directed attendant care. The older adult must qualify for the program, the care must be authorized, and the worker must complete the required setup before pay begins.
Can my spouse get paid as my caregiver?
Do not assume it. Current 2026 guidance says a family member or friend may be paid, but the public handbook does not clearly list every relationship. Ask the DSHP Plus case manager to confirm spouse eligibility for the specific case before changing work or finances.
How much does Delaware pay a family caregiver?
Delaware does not publish one simple statewide hourly wage for every adult family caregiver. Ask the case manager or payroll support agency for the current rate, approved hours, worker requirements, and first payable date.
Does Medicare pay family caregivers in Delaware?
Medicare is generally not the main route for ongoing family caregiver wages. Delaware Medicaid long-term services and supports is the main public path to check when an older adult needs long-term hands-on care at home.
What is the best first phone call?
Call the Delaware ADRC at 1-800-223-9074. Ask for screening for DSHP Plus LTSS, self-directed attendant care, Attendant Services, personal care, respite, and caregiver support.
What if the older adult is already in a nursing home?
Ask the DSHP Plus case manager about nursing facility transition services and whether the person can safely move to home and community-based services. If self-directed attendant care is appropriate, ask what must be in place before discharge.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections
Despite careful verification, errors may occur. Readers may email info@grantsforseniors.org with corrections.
Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 25 September 2026 · Next review: 25 January 2027
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