The cost of housekeeping services are never a deductible medical expense; only personal care services may be deductible under certain conditions. However, the cost of housekeeping services incurred to enable you to work may qualify for a dependent care tax credit. To be eligible for this credit, the nonworking spouse must be physically or mentally incapable of self-care. Whether your wife meets this condition is up to your doctor.
A business method of accounting requiring income to be reported when earned and expenses to be deducted when incurred. However, deductions generally may not be claimed until economic performance has occurred.