In-home care for elderly adults is a convenient way for many seniors to stay in their own homes for long-term care. However, providing home care for the elderly is expensive and stressful. Learning and planning more about home care financing options is a good way to ease the stress of paying for long-term care.
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Using Medicaid and Medicare for Long Term Care
Older adults with limited funds usually receive help with some or all of their home care expenses via Medicaid. All of the states except Arizona have some form of home and community-based Medicaid waiver that promotes in-home care for seniors. Elderly adults that meet the requirements for nursing home services and have a limited income may be eligible for the Medicaid home and community waiver in their state.
Medicare is available to all adults 65 and older. However, Medicare is meant for acute health episodes, and not long-term care. Although Medicare will not pay the majority of home care costs, older adults who are homebound, need skilled services and require intermittent help may be able to receive some home health care services under Medicare funding.
Consider Long-Term Health Care Insurance
Many seniors do not purchase long-term care insurance. Large premiums and a fear of aging make it impossible or improbable that some will even think about a long-term care insurance policy. However, those who have investments totaling over $500,000 may want to consider purchasing a long-term care policy. Each policy is different, with some covering only nursing home costs while others cover much more. Do appropriate research and read the fine print before agreeing to a long-term care insurance policy.
State Programs and Out of Pocket Costs
Finding state programs that provide in-home care funding for an elderly relative can be difficult. This is because each state has its own policies and regulations. However, older adults that do not qualify for larger government programs like Medicaid can qualify for more local state programs. Because states have greater freedom in establishing requirements for their programs, some seniors may qualify for programs at the state level.
Many caregivers and families of elderly adults choose to perform many of the home care services for an older relative themselves. On the other hand, some seniors require skilled services. For families that do not meet eligibility requirements of certain programs, out of pocket funding may be unavoidable. However, there are many other non-profit organizations, volunteer groups, or faith-based organizations that can help. Check a local area agency on aging for more information.
Other Areas of Planning
Since planning is essential for effective caregiving, every decision made now is one less stressful concern for the caregiver when the elder is no longer able to communicate or make decisions. A caregiver should plan to:
- Thoroughly think through the caregiver position and realize what a caregiver may have to sacrifice for months or years in order to carry out caregiving duties.
- Find the right doctor(s). Caregivers have to work closely with doctors in caring for the patient with Alzheimer’s disease or dementia. A good relationship established in the early stage of eldercare reduces a lot of stress for both client and caregiver.
- Research the condition. Whether it’s an ailment caused by old age, a broken hip, or a debilitating disease like Alzheimer’s, find out everything possible in the way of treatment, therapies, and medications.
- Get family members involved early in the program. Communicate through a monthly newsletter or by some method that lets everyone know what’s going on. A primary caregiver should not hesitate to ask for assistance or let his or her needs be known.
- Find a support group or educational workshop. Knowledge is a powerful tool and what better place to find answers than from people who are living the same experience. Group leaders will have information on resources and be able to answer many concerns and questions.
- Let the elderly loved one be involved as much as possible in making life care decisions. Include the elder in family activities. Get out into the community and do things for as long as possible.
- Check out assisted living and nursing home facilities. Deciding on advanced care before a crisis situation gives both the caregiver and client a chance to sort through options and make sound unhurried decisions.
- Strongly encourage the elderly person to make a will or update a current will. The caregiver should become familiar with elder care legal terms. Discuss power-of-attorney and durable power-of-attorney with the competent elder and with the legal representative.
- Have the elderly person draw up a living will if possible.
- Research caregiver agencies and volunteer groups that may be able to provide secondary caregivers for respite purposes or to help with the constant care when the elderly person’s condition worsens. Family members may not always be able or willing to assist with caregiving.
- Plan to take the time to indulge in a few favorite activities. A caregiver is less apt to burn out or become ill if he or she takes a break.
What Home Caregivers Learn on the Job
There are lessons to be learned from being a caregiver, especially if an adult child becomes a primary caregiver for an aging parent with Alzheimer’s. Prepare for future long-term care because no one can determine when a tragic accident or lengthy illness will strike. Planning now will save the next adult generation – or a spouse – from having to make so many frustrating and emotional decisions when the time comes. What can a younger parent or individual do to organize his affairs for the future?
- Keep insurance policies updated as needed. Know what is covered and what is not. Inform an adult child or trusted relative where agent information and policies can be found.
- Make a will and a living will (or advanced directive) and keep it updated. Let someone responsible know where the paperwork can be found.
- Set up power-of-attorney and durable power-of-attorney so final wishes can be met.
- Complete funeral pre-planning and let an adult child or other responsible adult know the details, including the decision to be cremated.
- In the event a child with a disability lives in the home, arrangements for care should be discussed and planned, especially if there is currently only one guardian or parent with custody.
A spouse or adult child assumes a heavy burden when an elderly loved one is diagnosed with Alzheimer’s disease or sustains a disabling injury. Even when the elder is placed in an assisted living facility or nursing home, a relative acting as caregiver must see to hundreds of details ranging from personal care to advocating for legal and medical assistance. The best course a caregiver can take is to learn as much as possible. Prepare mentally and emotionally for the challenges ahead and decide in advance who to call for help when the primary caregiver role becomes too demanding.
Organization of Vital Information
Having a quick detailed reference guide of important information is a must for excellent home caregiver organization.
Invest in one or two notebooks with dividers, or purchase a spiral pad that has at least three dividers (five is even better). In the first section make an outline of what needs to be accomplished over the next year, starting with the most important details. For example, if the elderly person’s will needs updating, or delegating power of attorney needs to be settled, then list those matters ahead of all others.
Hopefully, the elderly parent or loved one will be able to help with the organized plan of action. Jot down any matters of estate or other elder care legal affairs that require attention. Write down where important papers can be found in the home for reference in a hurry.
An Efficient Caregiver Covers all Areas of Care
In the next section of the caregiver’s notebook, write down the names of the elderly person’s physicians, therapists, pharmacy, medications, insurance information, notes on hospital stays and anything that might be important. Include phone numbers, addresses, and emergency weekend numbers. Also, record the number/extension for medical records. Write down the directions to any doctor’s or business offices for easy reference.
The third section of the notebook can be used for the support network. List family members, friends, groups and agencies (and phone numbers) that might be able to offer assistance. List transportation services, church volunteers, and respite workers. Don’t forget to include equipment vendors (mobility, oxygen, etc.) in this section, if desired.
A Structured Routine Reduces Stress
The caregiver may want to list in the notebook all the assisted living homes or nursing facilities one has checked out. Include any details, questions and answers, dislikes, features or anything else that might prove helpful. Record the contact person and the number of the home for easy access.
What other information should be written down? The caregiver might use one section of the notebook for ideas and events for the upcoming year:
- January might be a good time to try out a Nintendo Wii fitness program.
- Plan to attend the annual Valentine’s Day dance in February or attend some other community event.
- Spring is a good time for starting a gardening project – an especially good idea for someone with Alzheimer’s disease.
- Pick a month and join a music therapy program.
- If the elderly person drives suggest a senior’s driving program to brush up on skills.
- Check out what other seniors in town are doing for the summer or take a leisurely vacation.
- Go bowling, swim, or learn to play golf to avoid caregiver burnout.
- Try a volunteer project in the fall, or visit a museum.
- Learn to play bridge or attend a political debate.
- Fill the calendar with fun ideas and events that will get both the caregiver and the elderly person out of the house.
Create a Caregiving Strategy That Works
There are many topics under which a caregiver might record information. One might record nutritional information, recipes, and dietary restrictions in one section. Another person might record the elderly person’s daily routine. The caregiver might even use a notebook section to keep a daily journal, noting any significant changes that might help the medical team to better understand the elderly person’s condition.
Logging routines, specific needs, and recreational activities give family members an idea of what needs to be done to help out. If a friend should ask what he or she can do to help, the caregiver will have a definite answer to a plan of action on hand.
Caregivers who come up with an efficient system – be it a notebook or even a file cabinet filled with organized information – are less likely to burn out compared to those who have no plan. Start the New Year, a new season, or even a new month with a positive goal in mind and get caregiver duties properly organized. When outlining the month’s or year’s strategy, don’t forget to include respite time for the caregiver.
