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The Honolulu Advertiser

Posted on: Sunday, July 4, 2004

Caregiving can take heavy toll

By Anne Mitchell
Fort Myers News-Press

As much as America and the world sympathized with Nancy Reagan over the loss of her husband, many of the 22 million Americans tackling the job of unpaid caregiver do so with far fewer resources and very little help.

Despite her loss, Nancy Reagan was fortunate to have been able to pay for help in caring for President Reagan during his decline from Alzheimer's disease, according to experts in long-term care.

Advertiser library photo • February 2000

And it's a daunting task.

If the former first lady were to have taken care of her husband single-handed, as many caregivers must do, she could have died before he did, said Sue Piirainen, a certified long-term care professional in North Fort Myers, Fla., whose clients include people caring for ailing parents or a spouse.

She has seen such scenarios play out many times.

"Caregivers many times die and the other person doesn't," Piirainen said. "Their health deteriorates dramatically."

President Reagan died June 5 after a 10-year decline because of Alzheimer's disease.

Piirainen advocates long-term- care insurance as a way to prepare for such eventualities. The sooner you take it out, the less it costs, she said.

A client of hers who took out $150-a-month coverage three years ago at age 69 is covered for $143.75 a day — which is about enough for nursing home care. If he had bought the coverage at age 59, the premium would have been halved, she said.

While caregivers focus on the emotional and physical needs of their loved ones, some neglect the individual's financial planning needs and often their own as well, said William L. Anthes, president and CEO of the Colorado-based National Endowment for Financial Education.

"Caring for a loved one who is ill or aging can be challenging financially," Anthes said. "However, successfully managing one's own financial resources while helping a loved one manage his or hers is vital to the monetary security of both parties.

"It often can help reduce the stress and anxiety that often accompany caregiving."

If you're in a caretaking role, or expect to be someday, here are suggestions for addressing money issues with a loved one, along with guidelines for managing one's own finances.

• Where are the important financial and legal documents kept, and where is the key to the safe-deposit box? Consider asking to add your name as a signer on the safe-deposit box.

• Is your loved one's will up to date? If there's a trust, what about that? Without a will, the state — not the individual — decides who will inherit the property.

• Are all beneficiary designations up to date? The named beneficiaries override a will.

• Does your loved one have insurance? If there is inadequate coverage, consider buying additional insurance.

• What are his/her sources of income? If your loved one is unsure, contact former employers or the Social Security Administration at www.ssa.gov. If money is tight, options include borrowing against a life insurance policy or withdrawing some of the cash value, a reverse mortgage, or applying for government assistance such as food stamps and veterans benefits.

• What expenses does he or she have? Help put together a simple budget so you both know where the money comes from and where it goes.

• Who will handle the affairs if your loved one becomes incapacitated? Options include a revocable living trust, special needs trust, durable power of attorney to make money, property and healthcare decisions, a living will and guardianship.

• Has he/she thought about hiring help or living somewhere else? Keep in mind that if your loved one hires a caregiver, you may be responsible for paying state and federal withholding taxes and Social Security taxes.

• Who else could help? Make a list of family, friends and neighbors who could assist.

To get started, call the Eldercare Locator, a free service of the U.S. Administration on Aging, at (800) 677-1116, or go to www.eldercare.gov. You'll be put in touch with state and local sources of assistance for older Americans.