Posts Tagged "caregiver"

caregiving

Retirees’ Need for Caregivers Varies Widely

Nothing causes dread in a retiree quite like the prospect of having to go into a nursing home someday or becoming dependent on someone who comes into the house to help with routine daily needs.

But media reports or studies with alarming predictions of infirmity in old age are not very useful to retirees or their family members. A new study provides a more nuanced picture of the various scenarios that can play out.

home care tableResearchers at the Center for Retirement Research estimated that roughly one in five 65-year-olds will die without using any care, and another one in five will need only minimal care.

But one in four will have such severe needs that they will require high intensity support for three years or more. The largest group of people – 38 percent – will fall somewhere in the middle: they are likely to need a moderate amount of care for one to three years. A strong indicator of how much assistance someone will require is whether they are healthy in their late 60s.

To determine future need, the researchers combined two dimensions of care: intensity and duration. The intensity of care varies widely. Many retirees can remain largely independent if they hire someone for a couple days a month to clean house or manage their finances, while others will need round-the-clock support.

The duration of care also varies. The researchers divided duration into three categories: less than a year, one to three years, and more than three years. Many retirees need assistance for only a few days or weeks after being released from the hospital. But others, including people who develop severe disabling conditions such as dementia, may need years of care.

The researchers used 20 years of biennial surveys of older Americans and data on caregivers to predict the share of 65-year-olds who will have minimal, moderate, or severe lifetime needs.Learn More

Helping hands

An Appreciation of Professional Caregivers

My 85-year-old mother had been up a few times during a night in early June and still wasn’t feeling well in the morning. I called her doctor, who sent a prescription to her pharmacy, and went about my day’s work. But when I checked in that afternoon, mom was in a full-blown medical crisis that she and her 92-year-old male companion did not think was bad enough to tell me about.

I asked her companion to call the EMTs, who immediately dispatched mom to an emergency room a few miles from her Orlando retirement community. These events marked the start of my maiden voyage as my mother’s caregiver from 1,300 miles away in Boston. It was a high-stress affair that challenged all my organizational skills and stamina – an experience I am, no doubt, destined to repeat.

I’ve heard about the stresses of caring for an elderly parent but had only a vague sense of what that would be like. Nearly a week was consumed with keeping tabs on mom’s medical care at the hospital and what she needed, tracking down busy nurses and doctors – in a pandemic! – for updates on her condition (pneumonia) and treatment. Finally, upon mom’s hospital release on a Sunday, I wanted to make sure nothing else would go wrong at home.

The clouds started to lift when I hired three professional caregivers – Rachel, Nadine, and Rosa – to keep an eye on my mother for the first 24 hours at home. I developed a great appreciation for their kindness and efficiency and the unique talents each one brought to the job.

The hiring process wasn’t seamless, however, due to the COVID. My mother and her partner are fully vaccinated. But Florida has a much lower vaccination rate – 62 percent of adults have at least one dose, compared with 81 percent in Massachusetts – and I quickly learned that 35-year-old Rachel, the first caregiver assigned to mom, was among the unvaccinated.

I was about to cancel the contract with the company employing the caregivers when they offered to give Rachel a rapid COVID test. That worked for me. Having made my intentions crystal clear, the company texted me Nadine’s and Rosa’s vaccine cards for the later shifts. …Learn More

Video: Grandparents as Substitute Parents

In 2015, the journal Pediatrics estimated some 3 million children were living with grandparents – and the number is certainly higher today. Grandparents find themselves in a caregiving role in the aftermath of parents’ myriad personal traumas, including opioid addiction, suicide, incarceration, and now COVID-19.

In this excellent PBS NewsHour video, “Grandfamilies,” grandparents tell journalist Stephanie Sy about the financial and emotional toll of caring for children. Despite the challenges, they wouldn’t have it any other way.

But the financial strain is real. Some of the people Sy interviewed said their childcare duties have forced them to close businesses, and others are earning less due to the pandemic.

Lisa Banks stretches herself thin helping each of her three grandchildren with their remote learning. The new members of her household have also increased the electricity and food bills – her two grandsons are teenagers. “It’s like, I’m hungry, I’m hungry, I’m hungry. You hear it all day,” said Banks, who gets food assistance from a non-profit on Sundays.

COVID-19 adds another layer of worries. Kim Elia, who is standing in for her 11-year-old granddaughter’s parents, is recovering from the disease. “I was truly afraid to die because of what would happen to Brooklyn,” she said.

Raising children is a big job for young adults. A second go-around late in life seems even harder. …Learn More

Diverse Population Uses Nursing Homes Less

Son with father in wheel chair

Since the 1980s, the share of the U.S. population over 65 has grown steadily. At the same time, the share of low-income older people living in nursing homes has declined sharply.

New research by the University of Wisconsin’s Mary Hamman finds that this trend is, to some extent, being driven by an increasingly diverse population of Hispanic, Black, Asian, and Native Americans. They are more likely to live with an adult child or other caregiver than non-Hispanic whites, due, in some cases, to cultural preferences for multigenerational households.

Nursing home residence is also declining among older white Americans. However, in contrast to the Black population, whites are increasingly moving into assisted living facilities. This creates what Hamman calls a “potentially troubling pattern” of differences in living arrangements that might reflect disparities in access to assisted living care or perhaps discriminatory practices. Notably, the researcher finds that the Black-white gap in assisted living use persists even when she limits her analysis to higher-income adults.

Eight states have seen the biggest drops in nursing home use: Florida, Georgia, Louisiana, New Jersey, New Mexico, North Carolina, South Carolina, and Tennessee. Many of these states have experienced fast growth in their minority populations or have more generous state allocations of Medicaid funds for long-term care services delivered in the home.

Growing diversity is actually the second-biggest reason for lower nursing home residence, accounting for one-fifth of the decline, according to the study, which was funded by the U.S. Social Security Administration and is based on U.S. Census data.

As one might expect, the lion’s share of the decline – about two-thirds – is due to policy, specifically changes to Medicaid designed to encourage the home care that surveys show the elderly usually prefer. …Learn More

Caring for a Parent Can Take Financial Toll

Parent and adult child with masks

Last spring, as COVID-19 tore through the nation’s nursing homes, many people agonized over whether to pull their elderly parents out and assume responsibility for the care.

The fall surge in the virus is no doubt causing more handwringing as adult children again weigh the challenges of home care against concerns about their parents’ physical and mental well-being.

One practical consideration is the impact on the work lives of parental caregivers, who are overwhelmingly women. Recent research has found that “there are long-term costs associated with caregiving reflected in [lower] earnings even long after caregiving has taken place.”

The research involved women in their 50s and 60s with at least one living parent or in-law, though they generally provided care to a parent rather than an in-law.

Workers sometimes downshift their careers in the years prior to retiring, but caregiving can affect whether older women work at all, the researchers found. Among the caregivers they followed, the share who were working fell by nearly 2 percentage points, to about 56 percent, after their duties began. And the caregivers who remained employed worked fewer hours after taking on a parent’s care.

Women also earned less over the long-term if they had spent time as a caregiver. They saw about a 15 percent decline in their earnings by the age of 65 – or nearly $1,800 per year, on average – according to an update of a study initially funded by the Social Security Administration with subsequent funding from the Sloan Foundation. …Learn More

A drawing of a hand holding a heart

States Give Financial Help to Caregivers

On Jan. 1, Arizona residents caring for elderly or disabled family members became eligible for up to a $1,000 reimbursement from the state for expenses incurred in their caregiving responsibilities.

This is a trial program and the legislature allocated very little money – $1 million over two years – in a state with an estimated 800,000 residents caring for a disabled adult over 18.

But it’s a start.

Caregivers “aren’t asking for everything. They’re asking for a little bit to make their lives better,” said Elaine Ryan, vice president of government affairs for AARP, which has been on the forefront of advocating for such policies at the state level. “That’s the least we can do.”

Arizona’s program would defray a portion of caregivers’ spending. For older family members, this would cover technologies to aid older family members, such as hearing aids or computer programs, or shower grab bars and wheelchair ramps.

Graphic of caregiver expenses

Like Arizona, state governments around the country, as laboratories for policy experimentation, have passed a hodgepodge of programs to support caregivers. Other bills approved in recent years range from New Jersey’s tax credit for military families caring for wounded veterans to Oregon’s paid family leave program for workers taking care of aging spouses, parents and grandparents.

The programs are a tacit acknowledgment of the enormous financial strain caregivers face – a strain that is only expected to grow and, increasingly, to affect Millennials as their baby boomer parents age.

However, it’s not easy to pass bills that require states to approve financial assistance or tax credits, because the work done quietly by family caregivers is often invisible and under-appreciated by the general public and federal and state legislators. …Learn More

Caregiving Disrupts Work, Finances

What do groceries, GPS trackers, and prescription drug copayments have in common?

They are some of the myriad items caregivers may end up paying for to help out an ailing parent or other family member. And these are just the incidentals.

Graph of what caregivers gave upThree out of four caregivers have made changes to their jobs as a result of their caregiving responsibilities, whether going to flex time, working part-time, quitting altogether, or retiring early, according to a Transamerica Institute survey. To ease the financial toll, some caregivers dip into retirement savings or stop their 401(k) contributions. Not surprisingly, caregiving places the most strain on low-income families.

People choose to be caregivers because they feel it’s critically important to help a loved one, said Catherine Collinson, chief executive of the Transamerica Institute.

But, “There’s a cost associated with that and often people don’t think about it,” she said. “Caregiving is not only a huge commitment of time. It can also be a financial risk to the caregiver.”

The big message from Collinson and the other speakers at an MIT symposium last month was: employers and politicians need to acknowledge caregivers’ challenges and start finding effective ways to address them.

Liz O’Donnell

Liz O’Donnell was the poster child for disrupted work. As her family’s sole breadwinner, she cobbled together vacation days to care for her mother and father after they were diagnosed with terminal illnesses – ovarian cancer and Alzheimer’s disease – on the same day, July 1, 2014.

Her high-level job gave her the flexibility to work outside the office. But work suffered as she ran from place to place dealing with one urgent medical issue after another. She made business calls from the garden at a hospice, worked while she was at the hospital, and learned to tilt the camera for video conferences so coworkers wouldn’t know she was in her car.

“I felt so alone that summer,” said O’Donnell, who wrote a book about her experience. “We’ve got to do better, and I know we can do better.” …Learn More