Do You Know This Person?

April 19, 2012

If you are a Caucasian woman, aged 50 or older, possibly married, very likely working full or part-time—then there is a good chance that you are also (or will soon be) serving as a caregiver for an aging parent or relative. At least this is what a recent report released by the National Alliance for Caregiving, AARP, and MetLife indicates.

The entire report, entitled “Caregiving in the U.S., A Focused Look at Those Caring for Someone Aged 50 or Older” is 73 pages long, but you needn’t read the entire thing to get an insider’s peek at the state of caregiving today.  And the report isn’t limited to caring for an aging relative; it includes statistics on those caring for special needs children, as well as family members of any age.

Some of the more interesting statistics listed in the report are:

* 40% of Caregivers are aged 50-64, and 26% are even younger (35–49).

* 63% of those receiving care are over the age of 75.

* 67% of Caregivers are women.

* 76% of Caregivers are Caucasian.

* 89% are caring for a relative (36% of the time it is the caregiver’s mother.)

* Over half of caregivers are employed while caregiving; and…

* Caregivers provide an average of 19 hours of caregiving per week (in addition to their regular employment.)

It is worthwhile to note that according to this study most of these caregivers are unpaid for the care they give, as they are caring for a family member and are doing it voluntarily—but a full 43% said that they felt they did not have a choice to take on the role.

Our office can’t prevent you from one day needing a caregiver (or one day having to serve as a caregiver) but we can help you plan for when that day may come.  Thinking and planning ahead can keep you—and your loved ones—from ending up in a situation where you feel you have no choice.

What to Do When Dad’s Ability To Manage His Finances Begins To Slow Down

May 27, 2011

One of the most difficult aspects of caring for an elderly parent (or helping an aging parent who lives far away) is keeping one step ahead when that parent begins to lose the ability to manage his or her own finances. Many seniors can be very resistant to discussing what they feel is an extremely private and sensitive topic.  Furthermore, according to this article in AgingCare.com, “for many elders, being able to take care of their own finances is an important symbol of independence and self-worth,” and one that they are not likely to relinquish easily.

Unfortunately, an elderly parent’s ability to manage their own money may cease before they are willing to ask for help. In these cases, it may be up to their children and loved ones to step in and help as best they can.  What follows is a list of some non-invasive, non-offensive steps adult children and caregivers can take to help aging parents manage their finances.

  • Ask for a list of important people and information you might need in case of emergency. This list would include contact information for an attorney, financial advisor, primary care physician, and insurance agent.
  • Ask where your parent keeps important documents and how an executor or advisor could access those documents upon your parent’s death or incapacity.
  • If your parent is willing, discuss their estate plan with them, including who they have chosen as their agent or executor, and what you can do if something happens.
  • Ask your parent to make a list of monthly bills, expenses and account numbers. Although your parent may not want to hand over this information right away, the list should be stored with other important estate planning documents so that it can be accessed in case of emergency.
  • As you keep track of your own financial deadlines (tax filing deadlines and the like) set up reminders for your parent as well.
  • Ask that your parent list you as an “emergency contact” with their utility services, so that you would be informed if your parent’s service is in danger of being terminated.
  • And finally, talk to your parent as often as you can. Keeping open lines of communication is the very best way to stay informed about the abilities and well-being of your aging parent.

Adult Children and Elderly Parents: Caring for Each Other

December 24, 2010

The idea of adult children caring for aging parents or grandparents is not a new one. In fact, with the aging Baby-Boomer population, adult children giving up free time or extra hours at work to care for relatives is a growing trend. But recently families have begun creating “caregiver compensation agreements,” something which can end up benefiting both parties in a number of ways.

According to a recent article in the Wall Street Journal, “the high unemployment rate, the rising cost of nursing-home care, an aging population, and a 2006 change in Medicaid law that makes it harder for people who wish to qualify to give away assets” are all contributing factors to the growing trend of these compensation agreements among family members. Note:  Medicaid is called “Medi-Cal” in California.

How can it help you?

If you’re a caregiver the benefits of a caregiver compensation agreement are fairly self explanatory. “Some 37% of caregivers surveyed by the NAC in 2007 said they had quit a job or reduced their hours to accommodate their responsibilities,” some kind of compensation seems only fair.  And if you feel uncomfortable taking “wages” from your parents, there are other ways to arrange for compensation. “Attorneys say many families pay an hourly wage. As an estate-planning tactic, others opt for annual gifts or a lump-sum payment designed to cover services over an extended period. Some arrange for the caregiver to receive a larger inheritance.” It will all depend on what works best for your family.

If you’re the one receiving the care, compensation agreements can benefit you as well. Paying a family caregiver can help you deplete your savings and qualify for Medi-Cal,  which might then help if you later need a nursing home subsidy.  Doing so can also help you reduce your taxable estate, as well as give a gift of sorts to younger family members who may be in need. Remember the Medi-Cal rules are tricky, so best to enlist the help of an Elder Law attorney before creating any care contracts.

However you may decide to structure your compensation agreement, disclosure can be of the utmost importance. Make other family members aware of the agreement up front to avoid suspicion or hurt feelings later on.

Talking to Siblings About Caring for Mom and Dad

December 13, 2010

Many modern families have members living all over the country—and all over the world.  Which means that the holiday season provides one of the only times to all get together in person, celebrate, catch up… and talk about caregiving strategies for aging parents. Unfortunately, this kind of conversation can be a difficult one, especially if not all siblings agree about mom or dad’s needs, or if one sibling feels that he or she shoulders an unfair amount of responsibility. In spite of the difficulty, having the conversation can be of the utmost importance.

In this article in Time Magazine author Francine Russo describes the consequences that can follow when lines of communication break down. “It wasn’t until my mom’s funeral, watching my dad and sister cling to each other and weep, that I got a hint of their long ordeal — and how badly I’d screwed up.”

Russo makes the point in her article that much of the tension and disagreement among siblings can come from inaccurate or conflicting information. “Friction often stems from parents giving their children different information about how they’re doing. Mom may put on a good show for the out-of-towner, who then discounts what the local sibling says.” This is all the more reason for siblings to communicate with each other, not just through mom or dad.

If you aren’t sure how to get the conversation started, Paula Spencer, senior editor for Caring.com wrote this article for Third Age which gives some helpful strategies on how to ease into the difficult topic of caring for aging parents this holiday season.

Help for Alzheimer’s Patients AND Their Caregivers

September 25, 2010

Shakespeare said that old age is a return to childhood; without teeth, without voice… and in the case of Alzheimer’s patients, without memories.  But if the elderly have to endure the drawbacks of childhood, shouldn’t they get some of the benefits too?

The Family Caregiver Alliance must have thought so too, because a few times a year they sponsor a weekend sleepover in Alamo, California called Camps for Caring. The program provides campers with an experience “of shared meals and stories, of activities creative and expressive, of exercise in the outdoors and of new friends and memories made over the weekend.” But the significance of the experience can go far beyond that.

According to a recent story about Camps for Caring on NPR Radio, although “campers typically don’t remember details of the retreat… the experience significantly lifts their mood.”  In fact, “Post-camp surveys of family caregivers indicate that the ‘good feeling’ lingers, and it even can improve daily functioning.”

Beyond being a beneficial experience for the elderly attendees, Camps for Caring provides a much-needed break for overworked caregivers, who often attend to their elderly loved one around the clock, and can quickly find themselves dangerously close to the burnout breaking point.

Out of state residents may find it difficult to take advantage of the Camps for Caring program, but that doesn’t mean that caregivers or their elderly charges must leave themselves at the mercy of the effects of Alzheimer’s.  In addition to information about Camps for Caring itself, the NPR article includes some tips from experts that can make dealing with Alzheimer’s easier on everyone. Or you can go to the Family Caregiver Alliance’s Family Care Navigator to find organizations and resources in your area.

How to Help Your Elderly Parents When You Live Far Away

September 10, 2010

We’ve written often on this blog about the concerns that caregiver children have for their elderly parents, but that’s only one side of the story. Many families also have an adult child living far from home, and though the concerns of the long-distance child may be different from the one who lives down the street, they’re no less important.  Here are some of the more common concerns we hear about in our office, and some suggestions for addressing them:

I worry that when I talk to my parents on the phone I’m not getting the whole truth about their health or situation. This is one of the most common concerns of long-distance children. The best thing to do is be up front with your parents.  Tell them that you want—and need—to know the truth, even if they think it will worry you.  If you still don’t think they’re being completely honest, enlist the help of a sibling or nearby friend or neighbor who can be your eyes and ears.  You can also ask your parents to sign a waiver with their doctor giving him or her permission to share their medical details with you.

I’m afraid that my mom is losing the ability to manage her money and could end up broke. Seniors are the most common victims of financial fraud, and it’s hard to keep tabs on mom or dad if you live far away.  The best way to prevent financial fraud is to talk about money with your parents early and often.  It may go against the grain, but discuss your own finances with them if it will help them open up about theirs.  Visit as often as you can and watch their mail for letters from promotion companies or shady looking “charities”; and put your parent’s phone number on the National Do Not Call registry (1.888.382.1222 or www.donotcall.gov)

I feel guilty that my sister (who lives in the same town as my parents) is shouldering the bulk of the burden. The sibling who lives closest does often end up being the physical caretaker of elderly parents, but that doesn’t mean those who live far away can’t help.  The most common contribution from long-distance children is financial support—and that’s no small thing!  Offer to pay for a housekeeper, in-home care assistant, taxi service, etc.  And don’t forget to talk to your sister about what she needs.  Helping your caregiver sibling is another way of helping your parents.

I love my parents; I want to do more to help than just give them money. A common complaint of seniors is loneliness and fear of being forgotten. One way to help your parent and help calm your own fears is to simply keep in touch.  Make a point of calling your parent on a weekly or bi-weekly basis. Send frequent cards or e-mails. Plan a family vacation that your elderly parent can be a part of.  You can help your parents with your expertise as well; try to be involved in “the big stuff” such as meetings with estate planners, financial planners, nursing staff, or geriatric care managers. And most importantly, work regular trips to visit your mom or dad into the budget.  There’s really no substitute for face-to-face communication.

I think that my siblings close to mom and dad are making the wrong decisions for them, or are pressuring them to make decisions they don’t really want to make. Undue influence is a serious accusation, and if you truly think your siblings may be threatening or manipulating your parent you should seek the help of a professional.  Before you take irreversible action you need to have a private conversation with your parent; ask if they are being coerced and try to determine if fear is a factor. If you still think your parent is being manipulated against their will contact an elder law attorney immediately.

I don’t want to miss out on what could be my last moments with my parent. There’s just no way around it, your parents won’t be here forever, and nobody wants to feel that there were things left unsaid.  If you truly worry that your parent is facing his or her last days the best advice we can give is to go visit if at all possible, and make your visit matter. Look through old photos, talk about your memories, and say the things that need to be said. If you can’t visit in person make phone calls or send letters.  Don’t save your best sentiments for the eulogy—tell your parents how important they are to you today.

Caregiver Compensation Agreements Benefit Elders AND Caregivers

September 1, 2010

Caring for an aging relative is hard work. Many of the people who serve as caregivers admit that they often feel as if they have two jobs—their day job, and the part-to-full-time job of caregiver. If you consider that in our fast-paced society time is money, then most of these caregivers are not only giving up their time, but also their potential income. Caregivers need to know that it doesn’t have to be this way; caregivers can be compensated according to mutually agreed upon terms of a Caregiver Agreement, or Personal-Care Contract.

Elder law attorneys have known about Caregiver Agreements for a long time, but a recent article in the Wall Street Journal will hopefully raise caregiver awareness of this useful contract; especially, as the article mentions, given the “still-fragile” state of the economy. A Caregiver (or Employment) Agreement “should document a caregiver’s responsibilities and hours and set a rate of pay that’s in line with local practices. Both the caregiver and care recipient should sign the contract and disclose it to the rest of the family.”

An agreement of this sort can be useful not only for the care-giver and the cared-for; it also comes in handy if you think you may need to rely on Medi-Cal (known as Medicaid in other states) to cover nursing home costs sometime in the near future.

According to the article, “Before Medicaid will pick up the tab for nursing-home costs, it requires applicants to recoup certain payments made to relatives over the previous five years — and use the money to pay the nursing home… But if payments to relatives are made under the terms of a written employment agreement, often called a personal-care contract, the law allows it.” While the recoupmement term is different in California, the point is well-taken.

But remember, “to pass muster with Medicaid, it’s important to have such a contract in place before the services are rendered.”

This is why it is extremely important to talk to an attorney who is well-versed in elder law and Caregiver Agreements before any contracts are signed or money changes hands.

Falling Through the Cracks

July 23, 2010

Our country may be facing a simultaneous growth and recession… unfortunately, according to journalist John Leland, the two seem to be at odds. What we are referring to is the growth of the elderly population and the recession of funds available to help this aging community pay for the care they need.

The economic downturn of the past few years has hit the elderly with a double-whammy. Many of them lost close to all of their savings when the stock market bottomed out, and now budget cuts to state-funded home-care services threaten to force many of them out of their homes and into hospitals or nursing facilities.

“’I’m not getting a cost-of-living adjustment, and now I’m not getting food,’ said Joyce Plennert, 83, who is on a waiting list for Meals on Wheels in Palatine, Ill. ‘Now I’m worried my home services will be cut. Without that, I’d be in a nursing home, if I could find one with room.’”

According to the above-mentioned NY Times article, a number of states have already made cuts to home-care services, including Alabama, Arizona, California, Colorado, Florida, Kansas, Mississippi, Missouri, Nevada, New Jersey, New York and Texas. “The situation is grim, and it’s safe to say that present trends are expected to continue,”

These budget cuts impact more than just senior citizens—they affect the professional caregivers and home aides who lose their jobs when state programs are cancelled, as well as the families of the elderly. When these seniors lose their ability to live at home it’s their families who will have to pick up the slack either by contributing to the costs of care or more often by becoming the caregivers themselves.

If you or a loved one is facing a loss of benefits due to budget cuts don’t be afraid to explore your options. Geriatric care managers can help families through confusing times, and other advisors such as elder lawyers, estate planners, financial planners and others can offer valuable advice when creating your plan for the future.

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