Caregiving IS in Your Future: Family and Financial Challenges Jean F. Austin FCS Educator, Maryland Cooperative Extension 2007 ESP Annual Conference It.

Caregiving IS in Your Future: Caregiving IS in Your Future: Family and Financial ChallengesFamily and Financial Challenges

Jean F. AustinJean F. AustinFCS Educator, Maryland Cooperative ExtensionFCS Educator, Maryland Cooperative Extension

2007 ESP Annual Conference 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

September 2007 J.Austin, ESP National Conference 3

Caregiving: Family and Financial ChallengesCaregiving: Family and Financial Challenges

There are only 4 kinds of people in There are only 4 kinds of people in the world:the world: Those who Those who have beenhave been caregivers caregivers Those who Those who areare caregivers caregivers Those who Those who will bewill be caregivers caregivers Those who Those who will needwill need caregivers caregivers

September 2007 J.Austin, ESP National Conference 4

Caregiving: Family and Financial ChallengesCaregiving: Family and Financial Challenges

What do we know about caregiving in What do we know about caregiving in the US?the US?

Who are the caregivers?Who are the caregivers? What is the cost of caregiving?What is the cost of caregiving? What is the value to society of family What is the value to society of family

caregiving?caregiving? Where do caregivers need community Where do caregivers need community

and public policy support?and public policy support? How can families and individual How can families and individual

caregivers better prepare?caregivers better prepare?

September 2007 J.Austin, ESP National Conference 5

Caregiving: A Brief HistoryCaregiving: A Brief History

Families are the most common social Families are the most common social structure for providing carestructure for providing care

1818thth century -- later life or long term century -- later life or long term care (LTC) meant having wealth and care (LTC) meant having wealth and childrenchildren

1919thth century -- poor houses and old age century -- poor houses and old age homes serve indigent elderly in citieshomes serve indigent elderly in cities

2020thth century – many changes in century – many changes in approach, the depression, post WWII, approach, the depression, post WWII, Medicare and Medicaid in the 1960’sMedicare and Medicaid in the 1960’s

September 2007 J.Austin, ESP National Conference 6

Caregiving TodayCaregiving Today Increase in life expectancyIncrease in life expectancy Lower population growth Lower population growth

in USin US More older persons More older persons

survive to a point of survive to a point of needing careneeding care

22.4 million households 22.4 million households (nearly 1 in 4) include at (nearly 1 in 4) include at least one caregiver for least one caregiver for someone >50yrs oldsomeone >50yrs old

September 2007 J.Austin, ESP National Conference 7

Caregiving StatisticsCaregiving Statistics

Most women will spend Most women will spend 17 years caring for 17 years caring for children and 18 years children and 18 years helping an elderly helping an elderly parentparent

American businesses American businesses loose between $11 -- loose between $11 -- $29 billion each year $29 billion each year due to employees’ need due to employees’ need to care for loved ones to care for loved ones >50yrs >50yrs

September 2007 J.Austin, ESP National Conference 8

Caregiving: Financial BasisCaregiving: Financial Basis

0

50

100

150

200

250

300

Annually

PaidHomeCare

NursingHome

FamilyCaregiving

Family caregivers Family caregivers provide 80% of the provide 80% of the dollar cost of all dollar cost of all home care serviceshome care services

Only 20% comes Only 20% comes from Medicare and from Medicare and MedicaidMedicaid

September 2007 J.Austin, ESP National Conference 9

Estimated Caregivers by StateEstimated Caregivers by State

September 2007 J.Austin, ESP National Conference 10

Caregiving StatisticsCaregiving Statistics

Women caregivers are 2.5 times more likely Women caregivers are 2.5 times more likely to live in poverty than non-caregiversto live in poverty than non-caregivers

Women average 13 years of zero earnings Women average 13 years of zero earnings due to caregivingdue to caregiving

Women are more likely to take a part time Women are more likely to take a part time job to accommodate caregivingjob to accommodate caregiving

The pool of family caregivers is dwindling. In The pool of family caregivers is dwindling. In 1990 there were 11 potential caregivers for 1990 there were 11 potential caregivers for each person. In 2050 the estimate is 4:1.each person. In 2050 the estimate is 4:1.

September 2007 J.Austin, ESP National Conference 11

Children as CaregiversChildren as Caregivers

2002 3rd International Family Care 2002 3rd International Family Care Conference cited the need to better Conference cited the need to better understand the role of child caregivers as understand the role of child caregivers as a key prioritya key priority

September 2007 J.Austin, ESP National Conference 12

Children as CaregiversChildren as Caregivers

Estimated 1.4 million children between 8 and Estimated 1.4 million children between 8 and 18 years old provide care for an older adult18 years old provide care for an older adult

Seven in ten child caregivers are caring for a Seven in ten child caregivers are caring for a parent or grandparent. One in ten is helping parent or grandparent. One in ten is helping a sibling.a sibling.

Over half (58%) of child caregivers help with Over half (58%) of child caregivers help with at least one ADLat least one ADL

One third help with medicationsOne third help with medications Child caregivers have more behavior Child caregivers have more behavior

problems and schoolwork issues than their problems and schoolwork issues than their peerspeers

September 2007 J.Austin, ESP National Conference 13

Caregiving RelationshipsCaregiving 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

September 2007 J.Austin, ESP National Conference 14

““Stages” in a Caregiving CareerStages” in a Caregiving Career

1 – Performing 1 – Performing caregiving taskscaregiving tasks

2 – Self–2 – Self–identification as a identification as a caregivercaregiver

3– Performing 3– Performing personal carepersonal care

4 – Seeking 4 – Seeking assistance and using assistance and using formal servicesformal services

September 2007 J.Austin, ESP National Conference 15

““Stages” in a Caregiving CareerStages” in a Caregiving Career

5 – Considering 5 – Considering nursing home nursing home placementplacement

6 – 6 – InstitutionalizationInstitutionalization

7 – Termination of 7 – Termination of the caregiving rolethe caregiving role

September 2007 J.Austin, ESP National Conference 16

Caregiving Supports and ResourcesCaregiving Supports and Resources

Children & other Children & other family membersfamily members

Senior centers, Senior centers, adult day careadult day care

Paid services Paid services Employer benefitsEmployer benefits Public benefitsPublic benefits Disease specific Disease specific

support support organizationsorganizations

September 2007 J.Austin, ESP National Conference 17

Financial ChallengesFinancial Challenges

Have a financial planHave a financial plan Calculate Net worthCalculate Net worth Manage credit and debtManage credit and debt

Organize records andOrganize records and

personal paperspersonal papers Avoid scams and fraudAvoid scams and fraud Negotiate the cost of paid Negotiate the cost of paid

servicesservices

FINANCIALGOALS

M

R

T

pecificeasurable

chievable

esults-oriented

rackable

A

S

September 2007 J.Austin, ESP National Conference 18

Financial ChallengesFinancial Challenges

Review insuranceReview insurance MedicareMedicare MedicaidMedicaid Long term careLong term care End of life planningEnd of life planning

September 2007 J.Austin, ESP National Conference 19

Financial ChallengesFinancial Challenges

Will, trustWill, trust Durable medical power of attorneyDurable medical power of attorney Durable financial power of attorneyDurable financial power of attorney Advance directivesAdvance directives Letter of last instructionsLetter of last instructions Preplan funeralPreplan funeral Legal adviceLegal advice

September 2007 J.Austin, ESP National Conference 20

Caregiving Case StudiesCaregiving Case Studies

Johnson FamilyJohnson Family Paul and Marie Paul and Marie

EvansEvans Waxman FamilyWaxman Family Randy HillRandy Hill Smith FamilySmith Family