It often happens at a moment's notice. You are busy living your life, and you get a call or text message about your Mom or Dad. Perhaps your spouse has a health event. Maybe it was in the back of your mind, but you are probably not prepared physically or emotionally. You now find yourself being a caregiver or managing care services for a loved one.
People require long-term care services and supports (LTCSS) due to an illness, accident, or the impact of aging. Sometimes the decline happens over a long period of time. You might be able to prepare for the time you must fill the role. Too often, nobody thinks about it. There are no conversations. No Long-Term Care Insurance policy is in place. Now, the day has come, you are in crisis mode.
The crisis is real. Your adult children, who have careers, families, and other responsibilities, now must make decisions for you. They face tremendous pressure and anxiety. Will one of your adult children become your caregiver? Will their spouses help? How will this new role affect their life? Caregiving is physically and emotionally demanding.
Sure, you could avoid a crisis with advance planning, but you may find yourself with no plan like many American families. What do you do?
Evaluate the Needs
The very first thing is the assessment of needs. What will the care recipient require? Typically, it involves activities of daily living (ADLs), Instrumental Activities of Daily Living (IDALs), and supervision due to cognitive decline. Some people will require actual hands-on help, or, in some cases, just stand-by assistance, and you watch over them as they do their normal activities.
The commonly recognized ADLs:
- Dressing, Grooming, and Hygiene
The commonly recognized IDALs:
- Homemaker activities
- Laundry and dressing
- Managing finances
- Meal preparation
- Medication management
- Shopping and running errands
- Telephone and communication
Develop a Plan of Care
Getting a plan of care in place will be very helpful for both the family and the care recipient. Most Long-Term Care Insurance policies have benefits to pay for such a person; however, you will be on your own without insurance.
There are many available case managers, otherwise known as Geriatric Care Managers, Elder Care Managers, Aging Care Managers, or Personal Care Managers. No matter the name, age has little to do with the help they can provide as not everyone who requires long-term health care is older. The help they can provide will ease the stress on the family.
The National Care Planning Council lists some of the things a case manager can help with:
- Arrange legal and financial advisors help and assistance
- Assess the level and type of care needed and develop a care plan
- Assist with Long-Term Care Insurance claims
- Assist families in positive decision making
- Assist with the medication management
- Become an advocate for the care recipient and the family caregiver
- Conduct ongoing assessments to monitor and implement changes in care
- Coordinate medical appointments and medical information
- Coordinate the efforts of key support systems
- Develop long-range plans for older loved ones not now needing care
- Find appropriate solutions to avoid a crisis
- Help with Medicaid qualification and application
- Make sure care is received in a safe and disability friendly environment
- Manage a conservatorship for a care recipient
- Manage care for a loved one for out-of-town families
- Monitor the care of a family member in a nursing home or in assisted living
- Oversee and direct care provided at home
- Provide assistance with placement in assisted living facilities or nursing homes
- Provide personal counseling
- Provide transportation to medical appointments
- Resolve family conflicts and other family issues relating to long-term care
- Take steps to start the care plan and keep it functioning
Some of these items are things you may have never thought about unless you have been already through this with a loved one. The help is essential if family members are in the role of being a caregiver.
You can find a case manager by going visiting the National Association of Professional Geriatric Care Managers website.
Caregiver Duties and Responsibilities
Being an unpaid family caregiver is not going to be easy. If Long-Term Care Insurance is available – use it. Sometimes families want to 'save the benefits for a later date.' Use the benefits right away since it will benefit both the care recipient and the family.
If no insurance benefits are available, see what financial resources can be used to pay for professional home care services. Even if used on a part-time basis, the professionals will provide quality care and ease the family's stress.
Keep in mind the cost of long-term care, including home care, is expensive. The LTC NEWS Cost of Care Calculator can show you the average costs of all types of long-term care services in your area.
Now, what will the family caregiver face in their role? Here are just some of the jobs the family caregiver will have to take care of:
- Assisting with personal care ADLs like bathing and grooming, dressing, toileting, and exercise
- Back-up care (or respite) services: providing other caregivers a break
- Basic food preparation: preparing meals, shopping, housekeeping, laundry, and other errands
- Elderly care services: orienting or grounding someone with Alzheimer's disease or dementia, relaying information from a doctor to family members
- Emotional support: being a stable companion and supporter in all matters personal, health-related and emotional
- General health care: overseeing medication and prescriptions usage, appointment reminders, and administering medicine
- Health monitoring: following a care plan and noticing any changes in the individual's health, recording and reporting any differences
- Home organization: general house care and cleaning, inside and outside
- Mobility assistance: help get in and out of a bed, chair, wheelchair, car, or shower
- Personal supervision: providing constant companionship and general supervision - especially important with those with dementia
- Transportation: driving to and from activities, running errands, and help to get in and out of a wheelchair-accessible vehicle
The role of being an unpaid family caregiver will take a major toll on your job and family life, not to mention your own physical and mental help. Be prepared.
Adult Day Care Centers and Assisted Living
One-way families make it easier for the caregiver and provide socialization for the care recipient to use adult day care centers. Just like childcare, adult day care offers many services that can be used once-in-a-while or on a more regular basis.
Adult Day Care Centers can be used to give the primary family caregiver a break for a day or two. The facility can ensure the care recipient receives the proper care in a safe, friendly environment. Generally, they operate during normal business hours five days a week, although some offer additional services during evenings and weekends.
According to the National Caregiver's Library, adult day care provides many services and activities, including:
- Assistance with ADLs like eating, taking medications, toileting, and mobility
- Counseling services
- Educational programs or mental stimulation
- Exercise programs
- Health monitoring (e.g., blood pressure, food or liquid intake)
- Podiatry care
- Preparation of meals and snacks
- Social activities
- Therapy (occupational, physical, speech, etc.)
- Transportation services
Social activities in adult day care centers can include:
- Field trips
- Holiday parties
- Music therapy
- Pet therapy
- Relaxation techniques
At some point, assisted living might be appropriate. Families can review the living environment of the care recipient. Is the home 'age-friendly'? Is there a bedroom and bathroom on an accessible floor, generally the ground level? Is the home too big to maintain? Perhaps the needs of the care recipient are too great for family caregivers. Assisted Living Facilities may be the perfect option.
Assisted Living Isn't Cheap
The problem is, assisted living is expensive, although usually less so than a nursing home or 24/7 home care. Long-Term Care Insurance will usually provide benefits for assisted living. However, if no insurance is available, you must find the financial resources to pay for this type of care.
The home can be sold. The money can be used to fund the assisted living facility. The normal living expenses also disappear as the person is no longer living in their home. Income from social security or other retirement accounts can also be used to pay for care in an assisted living facility.
There is a lot of work and expensive when it comes to long-term care and aging issues. Being a family caregiver is an enormous responsibility. Caregiving is also financially challenging for the caregiver and their family. You must consider the health issues that come with being a caregiver.
Do You Think About Your Future Extended Care?
With all this in mind, why have you not yet planned for your future aging? The financial costs and burdens of longevity impact you, your family, your savings and income, and your lifestyle and legacy. If you are in your 40s or 50s, you are in the best age group to plan.
Affordable Long-Term Care Insurance gives you control and independence. You will not have to place your loved ones into the role of caregiver. You will have the tax-free resources to pay for your choice of quality care in the setting you desire without draining large sums of your hard-earned savings.
However, Long-Term Care Insurance is medically underwritten, so you need to have reasonably good health. A qualified Long-Term Care Insurance specialist can review your health, family history, and other factors to develop an appropriate and affordable plan by shopping all the major insurance companies.
Insurance companies have different underwriting rules. Premiums can vary over 100% for the exact same benefit. Because of all these variables using an experienced LTC Insurance specialist is essential. Don't make the mistake of using a general insurance agent or financial advice who lacks the skills and experience necessary.
Find a trusted and qualified specialist by clicking here.
Be prepared before the crisis starts. If you are dealing with your Mom or Dad's current care, seek the right help, and do not place the full responsibility on just one person.
About the Author
Linda is a freelance writer interested in retirement planning, health and aging.
Contributor since October 31st, 2017
The resources on LTC NEWS will help you prepare your family and finances for the financial costs and burdens of longevity. As you prepare for your future retirement, better consider the consequences long-term care will have on you and your loved ones.
Access the many resources by visiting our resource page, LTC News Resources.
Using a Long-Term Care Insurance specialist will help you save money and give you peace-of-mind knowing you have the best coverage at the best value. Discuss these issues:
Items to Discuss with a Long-Term Care Specialist
- Partnership – Most states offer special policies that provide dollar-for-dollar asset protection. The Long-Term Care Insurance Partnership Program might be one of the best-kept secrets in retirement planning. Make sure the specialist explains this program and how it might help you.
- Tax incentives – There are federal tax incentives available for some people. If you own your own business be sure to ask.
- Health Savings Accounts – If you have an HSA you can use the pre-tax money in your account to pay for the premium.
- Asset-Based or Hybrid policies – These are life insurance or annuities with a rider for long-term care. Careful, only a handful are actually a long-term care benefit. However, one of these policies can provide you with the flexibility of both a long-term care benefit or a death benefit. They are expensive but can be paid with a single premium.
- Health and Family History - Make sure the specialist asks you detailed questions about your health, family history, and retirement plans. Underwritingcriteria varies with each insurance company. If they are not asking you detailed questions then find another specialist.
Should you use your financial advisor or a general insurance agent for your long-term care planning? Probably not - click here. Find a qualified and trusted Long-Term Care Insurance specialist by clicking here.
Take a moment and find the current and future costs of long-term care in the area you live in. This will help you decide the amount of coverage is appropriate for you in your situation. For example, if you have a defined pension when you retire the amount of benefits you would need for long-term care would be less than an individual who will fund their future retirement with earnings off investments. In that case, protecting the principal is essential since that will produce your future income.
Find your state and use the LTC NEWS cost of care calculator by clicking here.
It is always best to start planning before you retire. Once you have your plan in place you will enjoy peace-of-mind and your family will thank you decades from now.
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