For many of us, the pandemic has laid bare the fragility of our work/life balance. For those who are caring for children or an elderly loved one, the line has surely been blurred even further. If you are working and are the fulltime caregiver for someone, it probably feels like you have not had a break in an eternity. It is easy to lose sight of yourself when taking care of someone and although there are more seniors now than ever before, it is still a struggle to provide the proper tools to allow caregivers to maintain their best life while caring for their loved ones. Although you may feel alone, there are programs available to assist caregivers. Caregiving can be extremely rewarding, but only when caregivers remember to think about their own needs as well.
1) Learn about what Benefits might be Available to your Loved One:
Although funding and ease of access to benefits should be increased, there are still benefits available at the state level. All states have unique long-term care Medicaid programs that use federally allocated Medicaid money, but are administered by each state. To learn about your state’s program specifically, click this Medicaid link to view your state’s rules and eligibility requirements. These programs can go by different names so it’ll take a little bit of research, but keep an eye out for names like consumer-directed, cash and counseling, Medicaid Voucher Program, or participant directed. This type of benefit essentially allows a person to hire a caregiver using state money to pay for the care. If you are the primary caregiver for someone, this would allow you many hours of free time each month. Alternatively, many states allow you to be paid as a caregiver if you do not want to hire someone. Some states simply require that you become certified while others require you to meet with social workers or registered nurses to oversee care. Depending on level of care, some states will also allow you to use their benefit to pay for respite care alongside a caregiver.
2) Lean about Respite Care near you:
Respite care can come in many forms, but essentially what it means is that it is providing you (the primary caregiver) a break while your loved one still received the necessary care. The most common form of respite care is adult day care. As implied by the name, adult day care is generally during the day and are designed to help if the primary caregiver has other obligations. Adult day care centers provide varying levels of care, from simple supervision all the way to assisting a person with their activities of daily living.
As a primary caregiver, you shouldn’t need an excuse to take a break, so don’t feel bad if you need to devote time to private issues, work, or honestly just need a disruption in your daily routine. Whatever the reason, adult day care can help. The average senior utilizing adult day care lives with an adult child or spouse and day care is usually paid for privately. As mentioned above, some benefits will help pay for this type of respite care but it varies state by state.
There are three main types: social, health care, and memory specific day care. Social day care provides meals, recreation, social interactions, and limited health-related services. This is for seniors who can not necessarily be left alone due to physical or mental limitations, but do not need substantial care. If your loved one needs more substantial care, then adult day health care can provide the necessary care. Elderly folks in adult day health centers usually need a level of care that would be found at the nursing home level. The third type, memory day care, is devoted to those with dementia, Alzheimer’s or other forms of memory impairment like stroke.
Even though seniors pay on a per diem basis, the cost of care is far less expensive than if your loved one was to move into an assisted living or similar long term care community. If the day care is specifically a medical or Alzheimer’s facility and the care recipient meets certain financial and medical qualifications, Medicaid may pay for part of the bill. Also, if your loved one has long-term care insurance, check their policy since some policies pay for day care in specific circumstances.
For overnight respite care, many assisted living facilities offer care on a per-day respite care cost. In a residential facility, your loved one can remain safely cared for if you need to go out of town or if you would like a more extended/overnight break. Many family caregivers only use overnight respite care if there’s a personal emergency, which makes sense, but then they are often left in a lurch because they did not research their options. To avoid making a decision during a crisis, it’s better to try out care providers when it isn’t a necessity so you know you will have a go-to option if ever the need arises.
3) Learn about your Rights as an Employee:
Although caregiving is a full-time job by itself, some caregivers still have external jobs outside of caring for their loved one. If this is you, then it pays to learn about your rights as an employee and a caregiver. Many people are afraid to tell their employer that they also have caregiving duties because they fear they will be let go, but this just causes unnecessary stress. In the U.S., employers cannot discriminate against you for being the caregiver of a family member as noted by the Equal Employment Opportunity Commission (EEOC). Unlike childcare, your responsibilities will increase as your loved one gets older or their health worsens. Due to this, caring for an elderly person can be unpredictable with unplanned events popping up at the last moment. Since this can create conflicts at work, transparency is a must.
If a health crisis necessitates time off, the Family and Medical Leave Act (FMLA) states that eligible employees of covered employers are able to take unpaid, job-guaranteed leave for various family or medical reasons. Even though you will be taking unpaid leave, your health insurance benefits should remain intact if you receive benefits through an employer. Specifically, the FMLA says that employees may use twelve workweeks of leave in a 365 day period to take care of a spouse, child, or parent with a serious health condition.
I know I’ve mentioned this multiple times, but talking with your employer is key to maintaining the balance between work and caregiving. Although it may seem scary at first, you will be relieved. To help your employer understand, you may need to explain your loved one’s current debilitations, how your schedule might be affected, and how you would like to come up with a plan if you have to leave work in response to a crisis. Ask your employer how you should discuss this issue with your fellow coworkers. Coworkers may be able to assist you with work responsibilities when you are responding to an emergency.
4) Learn How to get Paid as a Caregiver for Your Loved One:
If caregiving has forced you to quit your job, then getting paid as a caregiver can at least help shoulder some financial burden. If you’re the caregiver for a loved one, then you undoubtedly know how much time and energy are required of you. Oftentimes, family caregivers are forced to choose between a career and caregiving, and while caregiving is rewarding unto itself, it doesn’t pay the bills. The Congressional Budget Office estimated the value of “informal” care to be worth $234 billion in 2011 (the most recent year calculated). While this number has surely gone up since then, it seems only logical that family caregivers can find a way to get paid for their services. Although the path to payment isn’t exactly straightforward, I’ll describe a few ways that caregivers can get paid for their time and effort.
- State and Federal Benefits:
As mentioned above, some state benefit programs will pay you to be your loved one’s caregiver. Contingent on income level, medical neediness, and your home state, there may be programs available to help you get paid for caregiving. This benefit exists because in the long run, paying you to be a caregiver saves the state on costs associated with placing someone in a long term care facility, which is the alternative.
If your loved one was a veteran during wartime, they may be eligible for a benefit called Aid & Attendance. Similar to long-term care Medicaid, Aid & Attendance is the Veteran Administration’s answer to providing long term care for servicemembers. The Aid & Attendance benefit is based on income, savings, and medical need, but if eligible, it is a cash award that can be used to pay you as a caregiver for your loved one.
- Spending Down Assets:
If your loved one has some money saved up and does not qualify for Medicaid or the VA Aid & Attendance benefit, they may have to spend down. Many people are over the asset limit for the benefit programs, but don’t have quite enough to pay for an extended period of care, then spending down money and applying for Medicaid may be a good option. Medicaid doesn’t allow applicants to give assets away, but they do allow people to spend down their assets as long as the money is going towards care. If you are a family caregiver, that money can go to you as long as you’re being paid at the market rate. If this option fits your situation, make sure to write up a contract, keep track of formal invoices, pay taxes on the income, and stay within the market rate of pay. This is a great way to keep money in the family without breaking any Medicaid rules.
- Long-term Care Insurance:
If the person you are caring for has long-term care insurance, check their policy because some include what is called in-home coverage. In some cases, in-home coverage can be used to pay a caregiver of their choosing, including you. Again, just as with spending down assets, be sure to write up a contract, keep track of formal invoices, pay taxes on the income, and stay within the market rate of pay. If you’re not sure whether their policy includes this option, call the insurance company and ask to speak to an agent about the policy specifics.
If none of these options apply to you, perhaps you can work out a contract with your loved one and have them pay you as if they were paying a professional caregiver. This can at least alleviate some of the financial burden placed on you as a caregiver.
Beyond adult day care, respite care, and in-home support, there are also many support groups either in-person or online. Although it may not seem like much, talking to others who are experiencing the same thing as you can be immensely valuable. To see what other benefits might be available, visit the National Council on Aging’s benefit check up site.
Max Gottlieb is the content manager for Senior Planning. Senior Planning offers free help organizing and finding care for seniors and people with disabilities.
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