I know less than you do about Medicaid (I could use a crash course on that!), but, with us caring for my father-in-law and me now caring for my husband, I've faced that looming issue of giving up my own income to provide care, still needing to pay bills, yet not wanting to take in-laws money to make it work.
When it reached the point where something had to give, my husband's only sibling, who lived across the country and never even visited, objected - primarily because he considered those assets half his, and did not want us to "take them." As a result, I had to go back to work. FIL had to go to assisted living, as hiring and monitoring 24/7 caregivers was prohibitively expensive. I'll feel bad about that for the rest of my life; he did not want to be there, and he never fully adjusted.
The bottom line? FiL spent his last years in a place he did not want to be, the A.L. cost more than twice what I earned, and his assets were nearly depleted by the time he passed. All because we couldn't get past that issue of it somehow being wrong for FIL to pay enough to allow me to provide the care he needed.
I don't have answers for you. I don't know what your barriers are in accepting payment. But, I think we made the wrong decision. Maybe considering our failure can help you reevaluate before things hit the wall.
