Self pay home care. Can I use as a deduction if I paid cash?

This is general note, not tax advice. The. biggest question is whether they declared the income. Cash based payments not declared as income by caregiver are typically treated as gifts by IRS and sometimes Medicaid. You can’t deduct gifts as an expense for caregiving.

You need to speak to a tax account/tax professional about this. It is not a cut and dry situation.