Deductions & credits

First, you can deduct medical expenses you pay for yourself, your spouse, your dependents, or an elder relative (such as a parent) but only if you provide more than half the parent's total financial support.  (Remember that a parent's social security may not be taxable income, but is counted as support they provide themselves.)   If this elder is not your dependent, you can't deduct costs even if you pay them, but the elder person may be able to deduct them.

 

Medical expenses include nursing services, and do not have to be provided by an actual nurse, but must be the type and kind of services usually performed by nurses, such as feeding, bathing, dressing, wound care, providing medication, and so on.  Costs for housekeeping, meal preparation and companionship are generally not deductible.  If the caregiver provides multiple services, you must allocate the cost proportionally.

 

The entire cost of an in-home aide can be considered a deductible medical expense if the person has a chronic illness that is permanent or likely to lead to death or has a cognitive impairment so that they would be a danger to themselves or others if left alone; and the person requires assistance with 2 or more activities of daily living; and the care is provided according to a written care plan developed by a qualified medical professional or social worker.  If these tests are not met, only the medical/nursing care portion of the caregiver is a deductible medical expense.

 

If the person is your dependent, and lives in your home, and is physically or mentally unable to care for themselves, and you pay for care so that you (and your spouse if married) can go to work (because they can't be alone), you may qualify to apply the non-medical part of the care toward the Child and Dependent Care Credit,