@poetesq
Not having issued a 1099-MISC will not prevent goldiegirl56 from deducting the expense. If it's a valid medical expense she can deduct it if she itemizes deductions. She needs a record of the payments, just like for any other medical expense.
Whether the "personal care" qualifies as a medical expense is a separate question, and we don't have enough information to determine that. Only the cost of "nursing services" is deductible as a medical expense. The cost of "personal and household services" is not deductible under any circumstances.
