New Zealand’s Court Boosts Rights for Family Carers — What It Means for U.S. and Canadian Caregivers

In what some say is a historic win for family caregivers in New Zealand, the Supreme Court of New Zealand has affirmed that this work deserves the same dignity as other jobs. The impact of this ruling may be felt globally as more family members are forced to become caregivers for an older parent.

If you or someone you love has ever provided daily care for a parent, spouse, or disabled child, you know how demanding that role can be. As more people are living longer, more people around the world are needing help with activities of daily living or supervision due to memory loss.

Often, due to a lack of planning, the role of caregiver falls to the family. In Fleming v. Attorney-General, the highest court ruled in New Zealand that two parents caring full-time for their disabled adult children must be treated as “homeworkers” under the Employment Relations Act 2000.

What the Court Found 

• The Ministry of Social Development relied on families to provide extended care that the state would otherwise have to pay for.
• A formal employment contract was not required; the reality of the care work made them employees.
• The parents are entitled to minimum wage, holiday pay, and other employment protections.

The Public Service Association (PSA), which represents care workers, called the ruling “a significant and important win” that recognizes the value of full-time home care.

As a society we owe homecare workers an incalculable debt. This decision, which comes after six years of struggle for the families though the court system goes some way to ensuring we honour that debt, — National Secretary Fleur Fitzsimons.

For many New Zealand families, the ruling could bring back pay, new protections, and formal recognition of caregiving as real employment. With most long-term care involving older adults, these changes may significantly affect the cost and complexity of providing care in the future. Will U.S. and Canadian courts feel the same way in the future?

How the United States Treats Home and Family Caregivers

The U.S. offers a far more complicated and often weaker safety net for caregivers. You may assume caregiving is addressed like other work, but federal rules tell a different story.

Federal law in the United States often excludes home care workers. The Fair Labor Standards Act (FLSA) sets minimum wage and overtime rules for most workers. Yet under its Companionship Exemption, many caregivers who provide nonmedical support in private homes are excluded from overtime and sometimes even minimum wage protections.

New Federal Proposals Could Expand the Exemption

In July 2025, the U.S. Department of Labor proposed a rule that would allow agencies more flexibility to classify workers under this exemption. If finalized, fewer caregivers may qualify for overtime or wage protection.

What it means for families: even if your loved one needs hours of hands-on care, the person providing it may not be protected like other employees.

How Canada Handles Caregivers: More Protection, But Only When Employed

Canada’s approach depends heavily on provincial law and employment status.

Paid and live-in caregivers are considered "protected workers". Across most provinces, home care aides who are hired or live in the home receive:

• Minimum wage
• Holiday pay or leave
• Overtime rules
• Regulated room-and-board deductions (if they live with the employer)

Example: British Columbia requires employers to pay at least the provincial minimum wage and follow overtime rules.

Family Members Working Elsewhere Get Leave, Not Wages

If you work another job but must care for a seriously ill family member, you may qualify for unpaid, job-protected leave in provinces like Ontario under the Employment Standards Act, 2000.

Human-rights laws may require employers to offer flexible work hours for family caregivers.

However: these protections do not treat caregiving as paid employment. Unpaid family care remains just that — unpaid.

Who Pays the Family Caregiver Makes a Legal Difference

In North America, caregiver rights change depending on who is paying for the care. The rules are different if:

• The government pays the caregiver, or
• The care recipient pays privately (including with Long-Term Care Insurance benefits).

When the Government Pays a Family Caregiver

United States (Medicaid)

In some states, Medicaid may pay spouses or adult children to provide care. If you are paid through Medicaid, you are often treated as a provider under a state program. That typically means:

• Wages are taxable
• Payroll rules may apply
• Training, documentation, or agency enrollment may be required

Key point: When Medicaid pays, the government sets the rules.

Canada (Provincial Programs)

Some provinces fund family caregivers. When the government pays:

• Caregivers may become workers under provincial regulations
• Income may be taxable
• Training, contracts, or time tracking may be required

Key point: Government=worker classification under a program.

When the Care Recipient Pays Privately

This includes:

• Savings
• Retirement funds
• Family funds
• Long-Term Care Insurance cash benefits

In these cases, the family controls the payment, not the government.

United States (Private Payment)

If a family member is paid using personal funds or Long-Term Care Insurance:

• The caregiver may not automatically be an employee
• Families choose to treat it as employment or informal compensation
• Caregiver income may still be taxable, depending on how it is paid

Canada (Private Payment)

When paid privately, a family caregiver:

• May not be an employee under provincial law
• May still owe taxes on income received
• May avoid government training or documentation rules

Key point: Private payment offers flexibility, but income may still be taxable.

Australia’s Approach to Home and Family Caregivers

In Australia, home-care services are now regulated under the Aged Care Act 2024 and overseen by the Aged Care Quality and Safety Commission (ACQSC). Under this framework, providers of government-funded home care — whether agencies or private firms — must be registered and meet strict quality, safety, and staffing standards.

That said, many caregivers remain unpaid family members. According to the government’s definition, a “carer” is someone who regularly helps a relative or friend without pay. These unpaid carers provide essential support across the country — but under current law, they are not automatically treated as employees, even if they deliver extensive long-term care. Because payment (if any) often comes through allowances or informal contributions, the protections, pay, and oversight that come with formal provider status generally do not apply.

As Australia rolls out reforms under the new act, the official framework focuses on funded providers rather than formally recognizing family caregivers as employees — leaving a gap between regulated care and the unpaid care that remains the backbone of home support for many.

Where Long-Term Care Insurance Fits In

Long-Term Care Insurance benefits can pay for care in the U.S. or Canada. What matters most is the type of policy:

Cash Benefit Policies

These send money directly to you once you qualify for coverage. You can then:

• Hire professionals (usually the preferred method)
• Pay a spouse or adult child
• Combine paid care with family help

Flexibility: the insurer does not require invoices or licensed providers.

Reimbursement Policies

These only pay for approved services from licensed or agency providers by either the provider billing the insurance company and paying the provider directly, or the policyholder paying the provider and asking reimbursement from the insurance company.

In most cases:

• Informal family caregiving is not reimbursed
• Invoices or claims are required
• Agencies or licensed aides are needed

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Certifications and Licenses for In-Home Caregivers

In 46 states and the District of Columbia, some form of licensing or regulation is required for many home care providers or agencies.

In many of those states, caregivers must complete at least a minimum amount of training (for example, 75 hours including clinical instruction under federal home-health aide standards), especially when they work under Medicare/Medicaid–certified agencies.

Generally, an insurance company will only pay a provider who legally provides the service in that state.

Why LTC Insurance Matters

Even without government reclassification, insurance can:

• Compensate family caregivers privately
• Reduce financial burden on relatives
• Make it possible to hire additional help
• Protect retirement savings and assets

Health insurance and Medicare only pay for short-term skilled care. LTC Insurance, and for those who qualify for Medicaid because of limited financial resources, will pay for types of long-term care services.

Bottom line: Long-Term Care Insurance can support paid caregiving whether or not governments treat family care as formal employment. With an LTC policy, the policyholder will not have to worry that a family caregiver will have to have employee benefits.

Caregiver Policy at a Glance: New Zealand, U.S., and Canada

Protect Your Family, Your Income, and Ensure Quality Care Now

If you are caring for a loved one now, you understand the hardship that can bring for you and your family. It should reinforce your desire to plan for the future costs and burdens of aging, as well as the consequences long-term care will have on your family and finances.

If the United States or Canada adopt employee-level protections for family caregivers, the cost of home care and other long-term care services is likely to increase. Preparing early, including adding Long-Term Care Insurance, helps you protect your retirement income from rising care expenses.

Start by asking these questions:

• Will your family be forced into unpaid caregiving? How would that impact their family, finances, health, and mental well-being?
• If you needed extended care for years, would your partner or adult child have to quit their job? How long could you pay for professional care before it changes your lifestyle and adversely impacts your legacy?
• Would insurance benefits allow you to pay them or hire qualified help, allowing your family to have the time to be family instead of employees?

Long-Term Care Insurance helps you retain choice and control. It credits caregiving as real labor performed by trained caregivers, protects your family from burnout, and pays for professional support when you need it most.

Resources

Use the following tools and resources to help you and your family.

• Learn about how LTC Insurance works with the Long-Term Care Insurance Education Center.
• You can compare local long-term costs where you live by using the LTC News Cost of Care Calculator.
• Compare Long-Term Care Insurance Companies and Products through this LTC News tool.
• Looking for quality caregivers or long-term care facilities for a loved one? Search by zip code with the LTC News Caregiver Directory.