Caregiving--How Do I Prepare?

The need for Caregivers continues to grow in our society. Presently there are 33 million Americans who are over the age of 65 and the continued advances in medicine assure us that life expectancy will continue to rise. With the first of the Baby Boomers reaching age 60, it is predicted that the 33 million will DOUBLE by the year 2030--making the senior care industry the biggest growth market.

Along with the increased needs of older Americans comes the economic reality--the majority of homes now have two working adults. Long gone are the days of the 1950's where Moms had the opportunity to stay home and raise the children. Financially that was no longer a viable option and women became more an more interested in their own education and careers. What society found was a generation of working women who were trying very hard to balance both a family and career. And now? Well many of these same women now fall into the 'Sandwich Generation.' Not only are they still raising their own children but now they find themselves needing to care for aging parents. Over the last decade this has become a new phenomena in our society.

So how do you cope? First, you must recognize what your limits are--but sometimes that sense of 'duty' or 'guilt' becomes overwhelming and you immediately think 'I need to be all things to all people'. Take a good look at your limitations--is distance from your parents a factor? Do you have room to house them in your own home? Will your home need to be remodeled to accomodate them? How do the other family members feel about this? What will their roles be? What are your other obligations during the day---a job? Children's activities? What is your support system? Are there services you can put in place to help your parents while you work?
Do you have the energy to add an additional major responsibility into your life? Have your parents purchased Long Term Care insurance? Does their retirement health plan provide any special coverage? Also, you may find the benefit of a Caregiver Support Group to be invaluable. It's a place to share your frustrations, your solutions, services that have worked for you, and to speak with others who are in the same circumstances. Very often your circle of friends diminishes during the role of being a caregiver because SOMEthing has to give in your life! And if your friends have not gone through the same experiences then you will find comfort in sharing with those who have and who are also in that same stage of life.

Now let's look at this from your parents view point. Do they want to leave their home or would they prefer to have services come to them? If they leave their home would they do well with the hubbub of family life? Do they want their independence? Is it safe for them to remain in the home? Can it be modified to make it safer? Would a system like Life Line monitoring device be enough to ensure their safety? Do they need help with meals? Could this be provided by Meals on Wheels or by a service? What about groceries? Is there a local delivery service? Or could this be provided by a contracted person? Laundry? Are they able to lift their laundry, change their beds, and are their washer and dryer in an easily accessible location within the home? Or, does it make sense to find a service provider who can help with that aspect? What about getting to medical appointments? Can they depend on someone else to get them there? Does their local senior center have volunteers who drive elders? Is there a service you can contract with to provide transportation? Will they need help with some daily chores like dressing, bathing, housekeeping? What types of services are available in their area?

Finding quality care at an affordable price is often one of the biggest concerns facing elders and their children. There are many alternative health programs available to people now, but how do you know if they will fit your needs or provide quality care? Your local Council on Aging, or Senior Center, should be able to help direct you to viable progams. You might also check with discharge nurses at the hospitals or with your parents' physician.

There are also some wonderful rehab programs that may be appropriate after an injury or illness. And many of the Assisted Living and Nursing Homes have space for temporary respite care. Respite care provides your loved one, with a safe environment in which to stay for several weeks while you may be on vacation with your family, are away on business, or face your own medical circumstances.

Often the role of caregiving is thrust upon you overnight as in when someone breaks a hip, has a heart attack or stroke. I always recommend that you have conversations with your parents BEFORE any of these things happen to know what their wishes would be if they become incapacitated. Learn what their health care will and will not provide. Ask them if it would be a wise decision to consider Long Term Care insurance. Ask if you can go over their finances with them so you know what is, and is not, available. This is also a good time to discuss their donor wishes, whether they want to be on life saving equipment, and if there are any circumstances under which they would not want to be resuscitated. Yes, these are difficult topics to broach but very important to know.



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Assessing the Costs of Caregiving

The average amount of time spent being a caregiver is five years. Unless you are aware of a terminal illness that may cause a death prior to that time you should figure your costs for a five year plan.

Will you need to take off work in order to provide care? Can you afford to do this? You will likely need to be available to take your loved one to medical appointments--which can be frequent. Do they need someone to be with them all day, or can they be independent while you are working?,

Does your community have an Adult Day Program? The typical costs are $40 a day. Does it provide transportation or is that your responsibility? Is there an active Senior Center in their community that they could spend some time each day?

What about meals? Will you make the meals for them? If you work will you leave a prepared meal? Do you have Meals on Wheels delivery available? These are on a sliding scale fee and frankly, I find them neither nutritious nor appetizing. Typically they are very high in sodium with a high tomato sauce content which can be irritating to a sensitive stomach to add all that acid. Can you afford to hire a personal chef who would cook 10 meals a week and leave them in their freezer?

Can you contact a local agency to do home care during the day? Or can you afford a private hire? In any case, you want to make certain that not only do you do a careful search but also a background investigation before you bring someone into your home to work with your loved one.

If you make the decision to keep your loved one at home, you will need to find a resource for a break. You will need a vacation time during the year. Will you have the support of other family members while you go away? Is there a nursing facility that has a respite care program that would be able to accomodate them for a week or so?

The average cost of a nursing home care is $50,000 a year--and that's without special services. The majority of the population still do not have long term care insurance so is this an amount you could afford? Because this is a long-term commitment, planning for the future is key. Take into account your loved one's financial resources, what opportunities there are in your community, and your emotional health.

In a great plan, you would have had this discussion with your loved one long before they need your help. You'll know what they want, be able to talk about what if you are unable to do that and what options they'd like. I also think it's a good idea to have them put it in writing so you can refer back to it with them if need be. With careful planning, being a caregiver can not only be doable but also rewarding for both of you.