Caregiving IS in Your Future: Family and Financial Challenges

2. Caregiving IS in Your Future: Family and Financial Challenges Jean F. Austin FCS Educator, Maryland Cooperative Extension 2007 ESP Annual Conference It is the policy of the University of Maryland, Agricultural Experiment Station and Maryland Cooperative Extension, that no person shall be subjected to discrimination on the grounds of race, color, gender, religion, national origin, sexual orientation, age, marital or parental status or disability. Equal Opportunity Employers ~ Equal Access Programs

3. Caregiving: Family and Financial Challenges • There are only 4 kinds of people in the world: • Those who have been caregivers • Those who are caregivers • Those who will be caregivers • Those who will need caregivers J.Austin, ESP National Conference

4. Caregiving: Family and Financial Challenges • What do we know about caregiving in the US? • Who are the caregivers? • What is the cost of caregiving? • What is the value to society of family caregiving? • Where do caregivers need community and public policy support? • How can families and individual caregivers better prepare? J.Austin, ESP National Conference

5. Caregiving: A Brief History • Families are the most common social structure for providing care • 18th century -- later life or long term care (LTC) meant having wealth and children • 19th century -- poor houses and old age homes serve indigent elderly in cities • 20th century – many changes in approach, the depression, post WWII, Medicare and Medicaid in the 1960’s J.Austin, ESP National Conference

6. Caregiving Today • Increase in life expectancy • Lower population growth in US • More older persons survive to a point of needing care • 22.4 million households (nearly 1 in 4) include at least one caregiver for someone >50yrs old J.Austin, ESP National Conference

7. Caregiving Statistics • Most women will spend 17 years caring for children and 18 years helping an elderly parent • American businesses loose between $11 -- $29 billion each year due to employees’ need to care for loved ones >50yrs J.Austin, ESP National Conference

8. Caregiving: Financial Basis • Family caregivers provide 80% of the dollar cost of all home care services • Only 20% comes from Medicare and Medicaid J.Austin, ESP National Conference

9. Estimated Caregivers by State J.Austin, ESP National Conference

10. Caregiving Statistics • Women caregivers are 2.5 times more likely to live in poverty than non-caregivers • Women average 13 years of zero earnings due to caregiving • Women are more likely to take a part time job to accommodate caregiving • The pool of family caregivers is dwindling. In 1990 there were 11 potential caregivers for each person. In 2050 the estimate is 4:1. J.Austin, ESP National Conference

11. Children as Caregivers • 2002 3rd International Family Care Conference cited the need to better understand the role of child caregivers as a key priority J.Austin, ESP National Conference

12. Children as Caregivers • Estimated 1.4 million children between 8 and 18 years old provide care for an older adult • Seven in ten child caregivers are caring for a parent or grandparent. One in ten is helping a sibling. • Over half (58%) of child caregivers help with at least one ADL • One third help with medications • Child caregivers have more behavior problems and schoolwork issues than their peers J.Austin, ESP National Conference

13. Caregiving Relationships • A child being raised by a grandparent • A husband who has had a stroke • A wife with Parkinson’s disease • A mother-in-law with cancer, a grandfather with Alzheimer’s • A son with traumatic brain injury from an auto accident • A friend with HIV/AIDS J.Austin, ESP National Conference

14. “Stages” in a Caregiving Career • 1 – Performing caregiving tasks • 2 – Self–identification as a caregiver • 3– Performing personal care • 4 – Seeking assistance and using formal services J.Austin, ESP National Conference

15. “Stages” in a Caregiving Career 5 – Considering nursing home placement 6 – Institutionalization 7 – Termination of the caregiving role J.Austin, ESP National Conference

16. Caregiving Supports and Resources • Children & other family members • Senior centers, adult day care • Paid services • Employer benefits • Public benefits • Disease specific support organizations J.Austin, ESP National Conference

17. FINANCIAL GOALS S pecific easurable M A chievable esults-oriented R T rackable Financial Challenges • Have a financial plan • Calculate Net worth • Manage credit and debt • Organize records and personal papers • Avoid scams and fraud • Negotiate the cost of paid services J.Austin, ESP National Conference

18. Financial Challenges • Review insurance • Medicare • Medicaid • Long term care • End of life planning J.Austin, ESP National Conference

19. Financial Challenges • Will, trust • Durable medical power of attorney • Durable financial power of attorney • Advance directives • Letter of last instructions • Preplan funeral • Legal advice J.Austin, ESP National Conference

20. Caregiving Case Studies • Johnson Family • Paul and Marie Evans • Waxman Family • Randy Hill • Smith Family J.Austin, ESP National Conference