NEW SURVEY: ECONOMIC CONDITIONS TAKING TOLL ON FAMILY CAREGIVERS AND THEIR ABILITY TO PROVIDE CARE

[MI Family Caregivers]

The Evercare®/National Alliance for Caregiving Survey of The Economic
Downturn and Its Impact on Family Caregiving, found that during the
past 12 months, almost 20 percent of caregivers report a decline in
the quality of care their loved ones receive as a direct result of the
recession, and 14 percent say the amount of care they have been able
to provide for others during this time period has decreased. The
survey is published by Evercare, UnitedHealthcare and the National
Alliance on Caregiving.
Read the final report www.caregiving.org/data
Next: What to do if your parents are less independent -- and how to
pay for it
If your parents are mobile but show mild signs of dementia or
forgetfulness, you may want to investigate out-of-home adult day
services or day health-service programs. Supervised adult day services
let the elderly socialize with other seniors, and day health services
may have nurses who can give out shots and medications. These services
often have their own facilities or may be part of a local community
center. In addition to asking the Area Agency on Aging for names of
reputable, convenient programs, you can consult the staffs of nearby
senior centers, churches, and synagogues.
If your parents are less independent -- say, if your mom is having a
hard time getting in and out of bed or sometimes forgets she turned on
the stove or bath -- she'll need in-home care. "It took three
different people and about three months to find a perfect match for my
mother," says Helen Nazar Bishop, whose mom has Alzheimer's. "And we
are always communicating with the home-care worker." As a first step
in finding a reliable caregiver, start at the Website of the Family
Caregiver Alliance (caregiver.org), which has put together the first
comprehensive, 50-state online directory of caregiver support
programs.
For a personalized, overall-care plan, hire a geriatric-care manager,
usually a nurse or social worker trained in helping the elderly.
You'll typically pay $300 to $800, depending on where your parents
live, to have this person visit them in their home, assess how they're
doing, and recommend cost-efficient things they might need to stay
independent. "Geriatric-care managers have their fingers on the pulse
of services available locally," says Elinor Ginzler, senior vice
president of livable communities for AARP. For an additional fee, the
geriatric-care manager can also make all the arrangements. Expect to
pay roughly $80 to $200 an hour for this service, depending on how
much attention your parents need and where they live; the cost isn't
covered by health insurance, Medicare, or Medicaid. You can find
Professional Geriatric Care Managers (PGCMs), who are trained,
experienced professionals, by visiting caremanager.org.
How to Save Money
Hiring help doesn't have to mean draining your parents' bank account
-- or yours. Adult day services, which average $64 a day, are far less
expensive than in-home daytime help. And in-home, nonmedical daytime
assistance (about $18 an hour) will probably be a bit less costly than
an in-home health aide (about $20 an hour), if your parents won't need
medical supervision. The federal government might shoulder some
expenses, too. Medicare usually pays for some short-term, in-home
medical help prescribed by a doctor for people 65 and older. But it
won't pay for long-term custodial care. If your parent does qualify
for that, check medicare.gov to find local Medicare-certified in-home
health-care agencies.
Medicaid rules vary by state. The program may cover home care or day
services if your 65-plus parent is nursing-home -- eligible and meets
low-income requirements. So you'll likely have to exhaust your
parents' resources before turning to this type of help. If your dad
needs constant surveillance, Medicaid would likely require him to go
to a nursing home or similar facility (check govbenefits.gov for
details).
Since this is difficult terrain, consider consulting an elder-care
attorney to help navigate regulations and discuss asset-management
planning, which will be important if your parents' health declines.
Find a specialist at the National Academy of Elder Law Attorneys'
site: naela.com.
Look into lowering expenses through local senior programs. For
example, utility companies may offer a break on energy bills -- just
give them a call and ask. Church or synagogue volunteer programs might
provide a companion to keep your mom company periodically. Some areas
have transportation services that can save the cost of using taxis or
part-time drivers. In the Boston area, disabled or impaired seniors
can use The Ride, which provides a door-to-door wheelchair-access van
or sedan for $2. "I had a 90-something client who took it to work
every day," says Suzanne Modigliani, a geriatric-care manager in
Brookline, MA.
With some delicate conversations and aid from the right places, you
can help your parents stay in their homes for as long as possible.
"It's hard, make no mistake," Ginzler says. "But respect the fact that
Mom and Dad want to control their lives as much as they can. Being
compassionate will lead you to the right decisions."
Next: How to deal with Alzheimer's or Dementia
Dealing with Alzheimer's or Dementia
Memory loss goes hand in hand with getting older. It's completely
normal for an older person to walk into the kitchen and occasionally
wonder, "Now, why was I coming in here again?" But if your mother is,
say, coming home from the supermarket empty-handed because she
couldn't "find anything" on her grocery list, or if she keeps her
cleaning supplies in the fridge, pay attention. These may be signs of
dementia or Alzheimer's (see 10signs.org for more info). Talk to your
parent's doctor to determine if Alzheimer's may be involved.
If the diagnosis is made, visit the Alzheimer's Association for
information and access to support groups. A doctor who specializes in
dementia care can prescribe medications that can delay the onset of
symptoms, among other options. As the disease progresses, check out
the MedicAlert + Safe Return program. For $50 up front and a $25
annual fee, your parent will get a bracelet or pendant identifying her
as someone with dementia. If she is found wandering, responders can
contact her caregiver or family and EMTs will be able to get her
medical records.
After a diagnosis, your parent may be angry or in denial. Rather than
dictating what should be done, involve her in the conversation.
"Coming up with options and talking through them helps a parent feel a
sense of control over her experience," says Peter Reed, Ph.D., senior
director of programs for the Alzheimer's Association.
Next: Find out the financial documents and medication information you
need from your parents
Paperwork Prep
Learn where your parents keep their financial documents and medical
information. This can avoid costly mistakes and let you know the
extent of their resources. Here are some of the biggies (for a
detailed list, check out the financial-planning area at mymoney.gov,
and print one out for your folks).
• Wills
• Durable power of attorney (so someone can legally act on their
behalf) and medical power of attorney
• Advance directive, like a living will, which states wishes for end-
of-life care
• Life insurance policies
• Long-term-care policies
• Bank and brokerage accounts
• Social Security cards
• Medicare and health insurance cards
• Doctors' names and numbers
• List of medications
• Lawyer and accountant contact information