Top 4 Myths of Caregiver Costs: Understanding the Reality of Caregiving and Planning for Success
According to the National Alliance for Caregiving and AARP (2015), roughly 34.2 million caregivers provide unpaid care to an adult age 50 or older in the last 12 months. Caregiving is a challenging, demanding and often rewarding experience for millions of Americans. The costs are substantial, but many caregivers find their role uplifting and purpose driven. Understanding and meeting the costs of caregiving is an important aspect to successfully navigating this part of life.
These are the Top 4 Myths of Caregiver Costs we see regularly, which limit the guidance, support and needs of caregivers all over the country. In debunking these myths, we explain the truth behind the cost of caregiving and offer tips for caregiving with success.
Myth #1 – All medical expenses will be covered by insurance.
Many medical expenses are not covered by insurance. For example, Medicare Part A & B do not cover eye exams related to prescribing glasses, most dental work, hearing aids and exams for fitting them, routine foot care, acupuncture or cosmetic procedures. Other procedures are covered but, under some circumstances, coverage is incomplete. For example, Medicare Part B covers a screening mammogram every 12 months for women 40 years and older and diagnostic mammograms if medically necessary. However, the patient must pay 20% of the diagnostic mammogram, and the Part B deductible applies. Each insurance company has specific coverage rules and applications, but rarely are all expenses covered entirely.
Add to this the cost of transportation for medical appointments, the cost of time to get to and from appointments and the cost of non-prescription medications and supplies (bandages, supplements, etc.), and unforeseen costs can quickly add up.
Planning for additional medical expenses is an important part of caregiving. Speaking with a financial planner to set aside income for unexpected medical expenses is a wise choice for many. Other tips for saving on and planning for extra expense include:
- Getting prescriptions/medication from big-box retailers like Sam’s Club, Costco or mail-order pharmacies. Some large chain retailers offer discounts on medications (even without health insurance) – for example, $4 for a 30-day supply or $10 for a 90-day supply of some generic drugs. Check with your local pharmacy, grocery store or retailer for discounts, coupons or savings programs. Sometimes these offers are less than what is offered even by insurance co-pays.
- If medical appointments are far away, schedule them for the same day, making the hour-long trip once a week rather than twice. This saves on gas, money spent eating out and time off work.
- Create payment plans for extra co-pays (like the mammogram example). Doctor’s offices will often negotiate with patients and may even offer discounts.
- Establish a Health Savings Account, particularly if your loved one has a high deductible. The money contributed to these plans is tax deductible, grows tax-free and can be withdrawn. without tax penalty as long as it is used for qualified medical expenses. Speak with an expert for more information on how to make the most of saving for these extra expenses.
Myth #2 – Caregiving won’t impact the caregiver’s employment.
The time and energy of caregiving, particularly intensive caregiving related to impaired older adults, can impact a caregiver’s primary employment in challenging ways. According to researchers, “Today’s caregivers of older adults are much more likely to be employed than in the past. The NSOC found that approximately half of all caregivers of older adults were employed either part- or full-time. Depending on the care needs and the intensity of the caregiving role, a caregiver may have to make accommodations in order to manage their caregiving responsibilities and their job.” Without such changes at work, or if adjustments are impossible, some caretakers risk job security, income, personal retirement savings and investments/benefits and future career opportunities.
Certain adjustments or workplace accommodations can help caregivers balance the demands of employment and caregiving including:
- flexible work hours
- taking time off to manage specific situations (or to take much-needed vacation)
- reducing work hours and/or level of responsibility
- taking a sabbatical or leave of absence
Having or hiring help during working hours is also beneficial, allowing the caregiver to serve as the primary caregiver but also have support when he or she cannot be in the home.
Myth #3 – All in-home assistance costs will be covered by insurance.
Caregivers are often thrown into the caregiving role with very little training or preparation. Loved ones can fall ill suddenly or need intensive care after sudden life events (loss of insurance, loss of income, being removed from a facility or worsening of a chronic health condition). Understanding insurance policies, billing statements and the other intricacies of caregiving is challenging.
Many new caregivers mistakenly believe all in-home care needs of a loved one will be covered by insurance. This is simply not the case and understanding what is and is not covered will be key for a caregiver to understand. Knowing what is and isn’t covered helps a caregiver provide the best care possible for a loved one as well as take care of him or herself.
Insurance (even long-term care insurance) primarily covers specific skilled nursing costs related to a specific diagnosis for a short-term period. For example, if your father falls and breaks his hip, upon his return home, he will need help bathing. This may qualify as a skilled-nursing need and be covered under Medicare for the duration of his recovery from surgery. However, this service will not be offered on a long-term basis, and while this service is provided, other services cannot be ‘tacked on’ – such as having the nurse assist with medication management or run errands.
Tips to better understand and prepare for caregiving-related costs and insurance coverage include:
- Speak with a professional for an explanation of insurance benefits, costs and coverage.
- Have a care manager assess your loved one’s needs and provide an accurate assessment of how they may change in the future and how you may begin preparing today.
- Find out more about home care options in your area including part-time help and adult day care, and be sure to ask about the cost of services. It may be less than you anticipate and may bridge the gap between what insurance does and does not cover.
Myth #4 – The cost of caregiving is only financial.
Caregivers share much more than the financial cost of caring for a loved one. Caregiving takes time which might otherwise be spent at work, with other family, on self-care or on leisure activities. Emotional support and energy provided by the caregiver is not infinite. The emotional toll of caregiving is well-known, and many caregivers suffer ‘burnout’ and emotional fatigue from offering ongoing, long term support for loved ones. According to research in the American Journal of Nursing (2008), “Caregiving has all the features of a chronic stress experience: It creates physical and psychological strain over extended periods of time, is accompanied by high levels of unpredictability and uncontrollability, has the capacity to create secondary stress in multiple domains such as work and family relationships, and frequently requires high levels of vigilance.” Researchers also note depressions is one of the most common negative effects of caregiving, and caring for persons with dementia is particularly challenging.
However, the research isn’t all bad. In the same study, researchers found caregiving can also be beneficial, “enabling caregivers to feel good about themselves, learn new skills, and strengthen family relationships.”
A few tips for keeping healthy while caregiving are key:
- Make time for yourself and your own care. You can’t pour from an empty cup.
- Take breaks and ask for help. People are there to support you as well.
- Join a support group for caregivers who can offer comfort, advice and emotional support.
- Learn new ways to better care for your loved one. Seek out community resources and see if new treatments, ideas or resources are available. Sometimes, a small change can have an enormous impact in day-to-day caregiving.
With planning and accurate information, the cost of caregiving can be better understood. This helps families make the best, most sustainable plans in caring for loved ones.
Speaking with a professionally trained Aging Life Care ™ Manager can help you explore options, understand realities and make important decisions regarding caregiving.