Where is there care for the caregivers?
October 25, 2021

Question: I am very much part of the “sandwich generation,” squeezed by responsibilities on both sides! I find myself struggling to care for my elderly aunt, who lives with me and has severe arthritis. In addition, I work two part-time jobs. I can’t afford to cut my work hours, but my aunt requires a great deal of care and I’m exhausted. What can I do?

Answer: Caregiving is time-consuming and demanding. Without adequate support, it can become very disruptive to an individual’s personal and professional life. You are to be commended for all that you do but it’s important you take care of yourself as well.

Elder Services has two programs that may be of assistance: The Personal Care Attendant (PCA) Program, which may pay you for the work you are performing for your aunt; and the Consumer Directed Care (CDC) Program, which allows and pays for friends and family members to assist.

Personal Care Attendant (PCA) Program

If your aunt receives Medicare and MassHealth Standard or CommonHealth benefits, she may qualify for the PCA Program. This allows individuals to hire their own personal care workers. These workers can be non-relatives or relatives other than spouses, parents, legal guardians, or PCA Program Surrogates. PCA Program Surrogates are appointed by people who are unable to manage the program—the details of scheduling, paperwork, etc.— by themselves.) To qualify for the PCA Program, your aunt must have a chronic, disabling diagnosis that causes her to require physical assistance with two or more activities of daily living such as eating, toileting, or getting dressed. Her primary care physician must authorize her to receive PCA services.

Consumer Directed Care (CDC) Program

You may also be able to work for your aunt on a paying basis through the Consumer Directed Care (CDC) Program. This service, part of the Massachusetts State Home Care Program, allows participants to hire, supervise, and dismiss their own workers. Elder Services’ role is to provide participants with advice, support, and information. Those eligible for the CDC Program must live in Massachusetts, be age 60 or over, and have an income that falls within the guidelines specified by the State Home Care Program. In addition, they must meet the need eligibility requirements for State Home Care services. All workers must complete a background check. Paid at a rate established by the state, they may provide chore, companion, homemaking, personal care, home health aide, and/or transportation services. These workers can be non-relatives or relatives other than spouses or legal guardians.

For more information about either of these programs, call our agency at 800-892-0890 or email

Are you struggling to care for an older adult or having difficulty locating resources? Our experienced staff is available to help. Visit us online at for more information. You can also call us at 1-800-892-0890 or email Joan Hatem-Roy is the Chief Executive Officer of Elder Services of the Merrimack Valley and North Shore.

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