Valuing the Invaluable: A New Look at the Economic Value of Family Caregiving
Access this June 2007 report on the financial impact of caregiving on caregivers, as well as the economic value of their contributions.
Services That Help You Provide Care at Home
Lauren's mother, Frances, declared, "I want to stay right here as long as I'm able." In many ways this is an optimal situation, despite Frances's increasing difficulty in walking. Her studio apartment is on a single level in an elevator building with a front desk and a 24-hour attendant. "I called my mother the other day to see if she needed anything from the grocery store," says Lauren. "We've been making a weekly grocery run for my husband's father for about a year now, and just recently the logistics changed so that I pass by mom's apartment on the way to pick up my husband. I was pleasantly surprised to learn she's had a long-standing arrangement with someone who works in her apartment building. 'Antonio does my shopping every week,' she said. 'So thanks for thinking of me, but I'm fine.'"
Adapted from Caring for Your Parents
Many older people prefer to stay at home despite declining health. As a result, their families take on care responsibilities, manage high-tech medical treatments, assist with daily activities, and ultimately confront end-of-life issues.
Too often, adult children feel that with a little extra effort they can take care of everything themselves—a point of view some parents may encourage. However, caregivers who get help are less likely to burn out and are better able to provide long-term support for their parents.
If you don’t know what your options are or how to find information and resources, you’re not alone. This article is designed to help you. It presents an overview of the varied community services available to help older people remain at home and suggests ways to find and use these services, as Frances did, to their best advantage.
A Community Ready to Help Many community-based services for older parents are considered long-term care solutions. They include help with household chores, round-the-clock care, and everything in between. A nurse, trained aide, or volunteer might be able to assist. The following are some of the most common types of help:
Day to Day Companionship services. These include companionship, home supervision, telephone reassurance, and friendly visits in person. These visits and phone calls cost little or nothing if provided by the local agency on aging.
- Help around the house Homemakers and home-care aides take care of such things as laundry, cooking, errands, and shopping, and also provide some help with bathing and dressing. Home repair services perform minor maintenance and repairs. These providers generally charge an hourly rate. Check with your parents' local aging office for services in their area.
- Meal programs Meals can be delivered to the home or eaten in group settings at, for instance, a senior center. Again, check with your parents' local aging office for programs near them.
- In-home nurses and therapists Registered nurses (RNs) and licensed practical nurses (LPNs) provide skilled care prescribed by physicians such as monitoring medications and teaching patients and their families about special procedures. Professional therapists provide respiratory, physical, speech, and occupational therapies in the home. The costs may be covered by Medicare, Medicaid, or other insurance policies.
- Home health aides These workers assist with personal care such as bathing, dressing, eating and exercising. These too may be covered by Medicare, Medicaid, or other insurance policies.
- Hospice care Hospice care involves professionally coordinated support, including pain and symptom management, social services, and emotional and spiritual support for the terminally ill and their families. The care is provided at home or in other settings. Medicare, Medicaid, or other insurance policies may pay for hospice care.
- Adult day services Local centers provide structured, comprehensive programs including a variety of health, social, and related support services during the day, but for less than 24 hours. Costs vary according to needs.
Relief for Caregivers
- Caregiver support groups Here you’ll find emotional support and information from other cargivers and can gain a boost from those in similar situations.
- Geriatric care managers These professionals assess a person’s mental, physical, environmental, and financial conditions to create a care plan to assist in arranging housing, medical, social, and other services.
- Respite care These services provide temporary relief to regular caregivers and can last from a few hours for one day to several weeks. The care can take place in an adult day center, a nursing home, in the home (usually for short stints), or elsewhere. Some programs are subsidized, and some use volunteers. Most provide companionship or supervision when care is needed for only a few hours at a time.
Linking with Community Services Community services can make a big difference, but it takes work to find the most effective ones for your situation. Here are some tips to get you started:
- Identify needs. You can do this on your own, or you may want to have a geriatric care manager conduct a formal assessment, which will identify both needs and sources of assistance.
- Do your research. Find out what community services are available where your parents live. Or you may want to get help from a geriatric care manager, social worker, or hospital discharge planner. In addition, some community agencies provide relevant information and referral services.
- Compare costs. What will insurance cover? While you may be able to find free or subsidized services, some may be short-term only. If Medicare, Medicaid, or other insurance policies provide coverage, be sure to find out the limits. Check with your area agency on aging, organizations offering community or faith-based services, and your local department of social services.
- Check for the quality of services. Currently, there is limited government oversight of long-term care services, so it’s important for you to analyze their quality.
- Get referrals. Start with friends and family. Interview providers and involve your parents if feasible. Find out about worker education, training, and experience, and get at least two references. Ask if the agency screens and bonds employees and provides training. Visit facilities. How clean are they? What kinds of activities are going on? Who participates—those with physical disabilities? Speech problems? Alzheimer’s?
- Be organized. Specialists on aging will tell you to organize a filing system for all the agencies you research. This information may be useful later.
- Be sensitive to your parents’ reactions. Although your parents may prefer that you or other family members provide all their care, you have the right to get help. Work through your parents’ concerns, and if needed seek help from a geriatric care manager.
Some of this material appears in slightly different form in Caring For Your Parents: The Complete AARP Guide.
© 2003, 2004, 2007 AARP. Reprinting by permission only.