By Jody Gastfriend, LICSW, VP of Senior Care Services, Care.com
Editor’s note: 50plusnorthwest.com is proud to present our comprehensive guide to caregiving services. How to provide home care for a loved one is a major concern for both boomers and seniors. We hope to answer some of your most pressing questions with this ongoing series. Please check back regularly for updates.
Caregiving involves much more than just dealing with medical problems. It can take a major toll on family finances, especially if there is not a plan in place. Without a proper caregiving plan, those family members in need of care end up with the least say in their wishes and priorities for the future. Too often this happens because families don’t ask questions ahead of time. While discussing money can be uncomfortable, it is precisely these important conversations – about savings, net worth, debt, and assets – that enable you as a caregiver to chart a sensible course based on realistic options. There will come a time (now or later) when the caregiving tables will turn and you’ll be the frontrunner in making the tough decisions when it comes to your parent’s care. Either way, you should plan ahead and understand the often confusing landscape of paying for long term care.
Take for instance my friend, Frank, who was ill-prepared when his 76 year old father fractured his hip, and despite many months of rehabilitation, continued to deteriorate. Frank’s mother suffered from chronic obstructive pulmonary disorder, and could not manage her husband’s care. When Frank began to explore nursing homes for his father, he was startled by the price tag: $80,000 year! “I had mistakenly thought Medicare would pay for a nursing home,” he said. “Apparently, Medicare only pays for short term skilled care, and my Dad used up those days. When I tried to gather information about my parent’s finances, it was bleak.” There was little savings, no long term care insurance, and a small mortgage left on the home. They were over-income for Medicaid but did not have enough money to pay the full cost of a nursing home. “I wish I had started the process of planning much sooner,” Frank lamented.
Frank is not alone. Many adult children and seniors wait until there is a crisis and as a result, limit their options and experience increased stress and confusion. Frank hired a financial planner and elder law attorney, and was able to sort out the finances, get his parents on a Medicaid spend down, and use the existing private pay funds for care right away.
While 80% of care in the U.S. is provided by unpaid family and friends, many family caregivers like Frank cannot shoulder the entire burden of care on their own.
Here’s how you can plan ahead:
- Learn the difference between Medicare and Medicaid. Don’t be like Frank who assumed Medicare would pay for long term care in a nursing home. For more information go to www.medicare.gov.
- Don’t wait until the discharge date to learn about your parent’s ability to pay for care. Medicaid eligibility may require years of advanced planning.
- Research funding sources. Is your father a Veteran? Does your mother have long term care insurance? Would a reverse mortgage be an option?
- Consult professionals. Elder law attorneys, financial planners, and geriatric care managers can be very helpful in sorting out options for care and funding.
- Consider indirect expenses such as transportation, missed work, financial and legal assistance, and travel expenses as part of the cost of care.
- Explore benefits through your workplace. More companies are recognizing the need to provide support to caregiving employees and offer resources such as expert consultation, backup care, provider referrals, and geriatric care management.
Whether your parents, family members or you personally can age in place, or eventually require a long term care facility, the good news is there are many excellent options to choose from. Understanding how to plan and pay for long term care can give you peace of mind, prevent a crisis, and ultimately, enable you to make more informed choices when the time comes.
About the Author
Senior Care Expert Jody Gastfriend, VP of Senior Care Services, Care.com, is a licensed clinical social worker with more than 25 years of experience in the field of eldercare.
Jody’s broad range of leadership positions include Director of the Department of Social Services and Case Management at Lawrence Memorial Hospital, Clinical Supervisor within the Social Service Department of Massachusetts General Hospital, Chief Operating Officer of a Medicare-certified visiting nurse association, and Director of Adult Care Services at a national backup care company where she established a successful and expansive eldercare division serving more than 130,000 employees.
Jody shares the personal journey of her clients, having helped manage the care of her own parent with dementia for more than a decade. She has consulted to individuals, professional societies and corporations in the field of eldercare. Additionally, Jody has lectured widely on topics related to aging and work/family balance to audiences that include family caregivers, HR administrators, health care professionals and policymakers. A featured senior care expert on NBC and Fox News, Jody is a regular contributor to The Huffington Post’s Huff/Post50 section, and has published numerous articles on caregiving and aging, including a 5-part series in USA Today.
Jody received her BA, Magna Cum Laude, from Tufts University, and her Masters Degree in Social Work from Simmons College School of Social Work.
