Caring for parents can squeeze budget
By Pamela Yip
Dallas Morning News
Barbara Earp's 87-year-old mother is in a nursing home, has Alzheimer's disease and is unable to speak. Helping take care of her, though, is a calling that she lovingly takes on.
Earp, 59, said she wouldn't think of leaving her mother completely in the care of others.
"I get an enormous sense of satisfaction when she gives me a kiss the times she's able to respond to that, when she pats me on my back when I'm holding her, when I lay my hand on the side of her face and on her cheek and she just lays her head over it," said Earp, a legal secretary. "If I'm not there, I would miss those things."
You can't put a price on those moments. Unfortunately, they do come with a very real cost.
Many people find themselves single-handedly caring for a parent. In those cases, caregivers pay out-of-pocket expenses averaging $19,525 and lost wages and benefits totaling $659,139 over their lifetimes, according to a 1999 MetLife study, the most recent available.
Earp, who's single, is one of millions of Americans — many of them baby boomers — who are or will be taking on the role of caregiver for their parents as the population ages. Experts say the burden can be alleviated somewhat with careful financial planning.
Many caregivers are members of the "sandwich generation" — those caught between caring for aging parents just as they're trying to pay for their kids' college and save for their own retirements.
"The very wealthy families will be able to weather a long-term care situation, and the very low-income may get some help from Medicaid, but it's those of us in the middle who really have a large financial burden with long-term care," said Bonnie Lawrence, spokeswoman for the Family Caregiver Alliance in San Francisco, a caregivers advocacy group.
What's unique about caregiving is that it often is thrust upon a person by the sudden illness of a parent or by a phone call from the loved one's doctor that sends an adult child rushing to the parent's side — often from far away.
"Few people have the luxury of planning in advance for their role as caregiver," said Donna L. Wagner, director of the Center for Productive Aging at Towson University in Towson, Md.
Few caregivers are ready for the economic hit they may have to take. Many caregivers dig into their own wallets to help buy items and services for loved ones, with food, transportation and medications being the three most common expenses.
Adjust your budget
If you've suddenly become a caregiver, it's important that you begin making adjustments to your budget as soon as possible.
Help from the government is limited. When it comes to long-term health care, many people incorrectly assume that Medicare, supplemental policies or standard health insurance will cover the expenses.
In fact, Medicare, the federal health insurance program for the elderly, doesn't have a comprehensive long-term care component and generally doesn't cover assisted-living costs.
Medicaid, the joint federal-state healthcare program for the poor, has become the major payer of services for nursing home care. Medicaid will pay for nursing home care and medications for people who meet the eligibility requirements, which are financial and medical.
"Because of the complexity of the federal and state laws, various tax laws, you need to go to someone who's familiar with Medicaid," said Michael Cohen, an elder-law attorney in Dallas. "It's not like a one-size-fits-all. You have to know the rules to plan to save the assets that people have worked for their entire life."
Learn as much as you can about your loved one's ailments, because that will give you an idea how much you can expect to spend out of pocket.
"You've got to learn what's coming down the pike for you in terms of the disease, the medications required and the costs," said Tom Dwyer, a certified financial planner and certified senior adviser at Financial Design Group.
Try to spread those expenditures out over time.
Seek information and help from community organizations and support groups associated with your parent's illness.
"Don't sit there as a victim," Dwyer said. "Everybody says, 'I'll take it one day at a time.' Your budget immediately changes."
If your parents are still healthy but aging, start saving money for future care expenses.
"If you have the slightest idea that you may be a caregiver, set up a special account to where you can put away an extra $50 or $100 on a systematic basis so you have that cushion, because everything is going to change dramatically,' Dwyer said.
Ask for help
Check with your employer to see if the company offers elder-care benefits. More companies are doing this.
Don't be afraid to ask your siblings to chip in and help.
As far as Earp is concerned, the time she spends with her mother makes it worthwhile.
"My mom deserves to be treated with respect and dignity," she said. "She doesn't deserve to be put somewhere and shut the door to her life."
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Definitions of elder-care terminology
Activities of daily living (ADL): Describes daily activities, such as dressing, bathing, eating, using the toilet, getting out of a bed or chair, and walking. Inability to perform one or more ADLs is often used as eligibility criteria for long-term-care services.
Adult day care: Community-based group programs that provide a caring, homelike setting for people who can no longer be safely left at home alone. The programs are designed to meet the needs of functionally or cognitively impaired adults.
Area agency on aging: Area agencies on aging are a nationwide network of programs serving the needs of the elderly. Services include information and referral, nutrition, employment, in-home services, counseling and legal services.
Assisted living facilities: A residential apartment complex that caters to older adults by providing built-in care services and 24-hour on-call assistance. The facilities help seniors maintain their independence, but don't provide skilled nursing care.
Caregiver: Family members or friends who provide unpaid assistance to an elderly person.
Chronic condition: A disease or condition that lasts over a long period of time and typically can't be cured, often associated with disability.
Custodial care: Care to help individuals meet personal needs, such as bathing, dressing and eating.
Home healthcare: Services for occupational, physical, respiratory, speech therapy or nursing care. Also included are medical, social worker, home health aide and homemaker services.
Nursing home: A licensed facility that provides general nursing care to those who are chronically ill or unable to take care of daily living needs. May also be called a "long-term care facility."
Sources: MetLife Mature Market Institute, CareGuide Inc. and the National Association of Insurance Commissioners
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Caregivers of seniors can receive help online
Here's a list of sources for help on elder-care issues:
The San Francisco-based Family Caregiver Alliance addresses the needs of families and friends providing long-term care at home. The phone number is (415) 434-3388.
This is the Web site of the National Alliance for Caregiving, a national support organization based in Bethesda, Md., for family caregivers and the professionals who help them. Its goal is to increase public awareness of issues facing family caregivers. The phone number is (301) 718-8444.
This site, sponsored by the U.S. Administration on Aging, helps you find local services for seniors. You may also call the Eldercare Locator toll-free at (800) 677-1116.
If you're looking for an elder law attorney, this Web site of the National Academy of Elder Law Attorneys Inc. can help you find one in your area. The national office is in Tucson, Ariz., and may be reached by calling (520) 881-4005.
This is the Web site for Medicare, the federal health insurance program for the elderly.
This Web site provides information on Medicaid, the federal-state program that helps pay for healthcare for the poor.
The Caregivers Marketplace is a free cash-back and discount program designed to offer savings to caregivers. The organization works with manufacturers to negotiate cash-back and discounts on products and services that caregivers buy on a regular basis, such as products to assist with daily living, bathing supplies, mobility and home-modification equipment. The marketplace doesn't sell products but instead gives caregivers a savings card that they can use to buy products.
— Dallas Morning News
