Caregiving Affects Marriages

In previous years, family caregiving responsibilities outweighed worries about job security and savings. However, with the economy in recession, job security and finances are now equally, if not more important.

In a recent survey, one-third of caregivers who work outside the home believe that caregiving responsibilities have affected their job performance, and 30 percent of those who are married report that their responsibilities have strained their marriage. The survey found that caregivers spend an average of 10 hours a week coordinating or actively providing care. Despite their sacrifices, 48 percent of the caregivers surveyed lack confidence in the quality of their caregiving arrangements.

Most caregivers are time-starved and overwhelmed by the complexity of their caregiving responsibilities.

80 percent of the survey respondents work full-time outside the home and are juggling caregiving, childcare and job responsibilities. At the same time, many are caring for patients with increasingly serious physical and cognitive impairments – conditions such as Alzheimer’s disease and debilitating arthritis, which are on the rise due to longer life expectancies.

While care recipients in the study receive, on average, 16 to 20 hours of care from all caregivers combined – paid and unpaid – half of the surveyed believe that there are additional hours of care that are required but not provided.
Perhaps as a result of this shortfall, half of the survey respondents report that care recipients have missed meals or suffered from poor nutritional intake, while an additional one-third have visited an emergency room or sustained injuries from an accident. Another 22 percent have been alone at home when an emergency occurred.
As the time demands and costs associated with caregiving escalate, many caregivers feel they have no choice but cut back on care and supervision.

The result, unfortunately, is a sharp increase in nutritional problems, injuries and drug noncompliance. All too often, there is no care coordinator in place who is responsible for ensuring a comprehensive and consistent level of caregiving.
Among the survey’s other key findings, caregivers overestimate the percentage of caregiving costs covered by Medicare. While only 3 percent of the survey respondents expect Medicare to cover all of current and future caregiving costs, 26 percent expect to be reimbursed for most of their care-related expenses and half expect half or more of costs to be covered. In reality, Medicare will typically cover only a portion of the cost of caregiving.

Nearly half of caregivers surveyed report that they worry six or more times per week about the well-being of the person for whom they care.


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Senior Life Care Planning, LLC
1560 Oppossumtown Pike, Suite A-12
Frederick, MD 21702
301.663.9230
www.seniorlcp.com

NINE SIGNS OF FAMILY DISTRESS

If you observe anyone talking about any of the following issues, we can help:

1. Caregiver burnout, frustration or guilt
2. Disabled elderly with children who are out of state, out of town or out of touch
3. Elderly adults or couples who are afraid that the nursing home will be their only long-term care option
4.Children who voice concerns about a parent’s diagnosis that marks the beginning of physical or mental decline even though it could be years before long-term care outside the home is needed
5. Caregivers or family members who seem uncertain about care options, what to do next, or where to get help
6. An elder who has been hospitalized and the family has been told that he or she can no longer live independently
7. An elder who has recently experience a catastrophic event such as a fall, medication mishap, fire, accident in the home, or car accident
8. Children who are voicing concerns about an elderly loved one who is wandering, malnourished, dehydrated or unable to care for him/herself; or a medical event such as a stroke, heart attach or aneurism`
9. A spouse living in the community at risk of being impoverished by long-term care bills

Call us now for assistance

We can help you!

At Senior Life Care Planning, LLC we are dedicated to giving our clients the power to be informed individuals and to give peace of mind. We provide honest ways to protect your home, loved ones and independence in times of great need. We understand the emotional burden, confusion, anger, hopelessness, sense of injustice, fear and loneliness that come with long-term disability and end-of-life issues.
Every day we help and support families and individuals who are in crisis. We work with our clients to provide peace of mind and quality of life.

Senior Life Care Planning, LLC
One Research Court, Suite 450
Rockville, MD 20850
240.453.0070
www.seniorlcp.com

CAREGIVING AFFECTS WORK AND FINANCES

Although caregiving has a big impact on work and life, most caregivers are also feeling financially burdened. Almost one-quarter of households in the United States contain a caregiver, and most of those households provide care for someone who is age 50 or older.

Most caregivers are financially burdened by their caregiving duties. Caregivers with more caregiving responsibilities and those who did not feel they had a choice in becoming a caregiver reported greater financial hardship.

While caregiving creates a financial burden, caregiving has a big impact on work and life. Caregivers provide care an average of 21 hours per week. A majority of caregivers say they are working, either full or part-time, or have worked at some point while caregiving. More than 60 percent of working caregivers have made adjustments to their work schedule, such as leaving early, arriving late, or taking time off. With the current financial situation, can you afford to loose your job because you are worried about your loved one? Not surprisingly, the jobs of caregivers with the most caregiving responsibilities are the most affected; one-third of caregivers who had to provide constant care had quit their job to perform their caregiving duties and 12 percent had retired.

Caregivers also report they have less time for family or friends, have given up vacations or hobbies, and have less time to exercise. Caregivers said they need more help finding time for themselves, balancing work and family responsibilities, and managing stress.

Continuing Care Retirement Communities (CCRCs)

Continuing Care Retirement Communities (CCRCs)

Introduction

CCRCs offer the entire residential continuum—from independent housing to assisted living to round-the-clock nursing services—under one "roof". Residents pay an entry fee and an adjustable monthly rent in return for the guarantee of care for the rest of their life. Because CCRCs maintain an assortment of on-site medical and social services and facilities, residents can enter the community while still relatively healthy and then move on to more intensive care as it becomes necessary. Nursing care is often located within the CCRC or at a related facility nearby. In addition to health care services, CCRCs also typically provide meals, housekeeping, maintenance, transportation, social activities, and security.

CCRCs are diverse in their offerings and personality. The CCRCs run the gamut from urban high-rises to garden apartments, cottages cluster homes, or single-family homes. Some CCRCs provide units that are designed for people with special medical needs, such as Alzheimer's disease.

Most importantly, CCRCs guarantee a life-long place to live. Assisted living and even skilled nursing facilities make no such guarantees, and in fact they may ask you to leave if they believe they cannot provide the care you require. However, bear in mind that virtually no CCRC will guarantee an individual entry into the skilled nursing facility that is a part of the CCRC. If all the nursing units are filled (by either other residents or non-residents), the CCRC may place the ailing resident in another nursing home in the community. This can come as a rude shock to most elders, who believe precisely the opposite.

The downside of CCRCs is the cost, which can be more than those with low or moderate income and assets can afford. Prices depend on the amount of care provided, the type of contract, and the unit’s size and geographic location. Entry fees can be more than $500,000, with monthly charges in excess of $3,000.
Generally a refund will no longer be available after a specified period of residency. Some refundable fees revert to your estate when your unit is sold, while others do not. Therefore, before you expend a large some of money immediately and commit future monies, you need an assurance that the CCRC will be able to provide the promised services for the period of time stated in the contract. Consequently, review the annual CCRC disclosure statement.

CCRC fee arrangements

Although the entry and monthly fee arrangement is the most common, some CCRCs offer rental or equity arrangements. Under a rental arrangement, residents pay only a monthly fee, which typically covers housing and designated services (sometimes including health care services). Under equity arrangements, residents purchase their residence in the same way they would a cooperative apartment or condominium, although the resale of the unit is usually limited to those who meet the community's eligibility criteria. Residents then may purchase service and health care packages for an additional fee.

CCRCs often allow you to choose from three different fee schedules:
• Extensive contracts, which include unlimited long-term nursing care at little or no increase in the monthly fee. This arrangement requires residents to pay a higher fee initially;
• Modified contracts, which include a specified duration of long-term nursing care, beyond which fees rise as care increases; and
• Fee-for-service contracts, in which residents pay a reduced monthly fee but pay full daily rates for long-term nursing care.

The Maryland Department of Aging ("MDA") issues certificates to CCRC's. However, this certification is not an endorsement or guarantee of the community. Also, the MDA maintains financial and other records on all CCRC,s, which are accessible to the public. Consumer packets may be obtained by calling 1-800-AGELINE.

CCRC entry requirements

Most CCRCs require that a resident be in good health, be able to live independently when entering the facility, and be within minimum and maximum age limits. As a prerequisite to admission, facilities may also require both Medicare Part A and Part B, and perhaps Medigap coverage as well. A few are now even requiring long-term care coverage as a way of keeping fees down. Some CCRCs are affiliated with a specific religious, ethnic or fraternal order and membership in these groups may be a requirement. Of course, applicants will have to demonstrate that they have the means to meet the required fees. Also, you may be placed on a waiting list, since CCRCs are often sought after.

Many CCRC residents usually fund their care out of their own pockets. However, Medicare, and at times Medicaid, can be used to pay for certain services, and most CCRCs accept either Medicare or Medicaid. Although Medicare does not generally cover long-term nursing care, it often covers specific services that a CCRC resident might receive, such as physician services and hospitalization. Because the financial requirements for residence are fairly strict and the costs are relatively high, very few CCRC residents are eligible for Medicaid.

How to evaluate a facility and contract

Deciding on a CCRC is a once-in-a-lifetime choice, and it is a decision that should be made carefully. Many communities allow prospective residents to experience life at the facility. Each community has an agreement or contract that lays out the services provided. You should make sure you understand the contract before signing, and you would be well advised to seek legal or financial counsel before entering into any agreement.

Twenty Questions for a Continuing Care Residential Facility

1. What is the CCRC's background and experience?
2. Review the facility's financial, actuarial, and operating statements. Does it have sufficient financial resources?
3. What levels of care are provided? Licensed or certified by the State of Maryland?
4. How much is the entrance fee, monthly fee, processing fee, and other fees?
5. Can you get a refund of all or part of it?
6. What is the monthly fee?
7. Can the monthly be increased?
8. What happens if you cannot afford the monthly fees?
9. Do the fees change when your level-of-care needs change?
10. What happens if your marital status changes? Will your payments change, or will you be asked to move?
10. What if spouses require different levels of care?
11. What services are included in my regular fees?
• Meal services?
• Special diets/tray service?
• Utilities?
• Cable television?
• Furnishings?
• Unit maintenance?
• Linens/personal laundry?
• Housekeeping?
• Recreational/cultural activities?
• Transportation?
12. What kind of assessment is done to determine your needs? Is a plan prepared for meeting those needs? How is it reviewed?
• Physician services?
• Medications?
• On site nursing care facility services: Are they on-site? Who pays?
• Nursing services outside a nursing unit?
• Private duty nursing?
• Dental and eye care?
• Personal care services?
• Homemaker/companion services?
• Drugs, medication and medical equipment/supplies?
• Emergency call system?
13. What happens if a nursing bed is not available when you need it?
14. Can the facility ask you to move if you become too sick or impaired to be cared for by the facility?
15. Can you receive Medicare and Medicaid coverage in the facility? Do you need to buy private insurance or participate in a special group insurance program?
16. Who is involved in making the change of level of care decisions?
17. What are the staffing levels and professional qualifications of the staff?
18. Is there a resident council? How are complaints and disputes handled?
19. What are the grounds for eviction? What happens if you break a rule? What conditions can the CRCC terminate the contract?
20. What happens if you are injured? Does the contract release the facility from liability for injury resulting from negligence? What are you rights under the law?