In his final couple of years, my uncle often said to me:  “These golden years are not so golden”.  While I think he was referring to the ailments that his early 80s wrought on him – two knee replacements, triple bypass surgery, post-surgical rehab stays, etc. – he could also have been referring to watching his wife of 54 years slip away ever so slowly in a nursing facility.  He may also have been referring to the withering away of their hard-earned (and frugally saved) nest egg to pay for her care and residence.

My aunt required more constant care than my uncle could provide at home.  No one anticipated that she would “live” for 7 years in her condition.  But she did.  After one-half of their joint assets (except their house) were “spent down”, we could enroll my aunt in Medicaid to cover the costs of her care.  This happens more often than most people realize and I suspect few people think about this until they are faced with placing a loved one in a facility.

There are service agencies in communities willing to provide care in private homes.  Most of them do not accept insurance (because they can’t, not because they don’t want to).  This means that families need to figure out if they can pay privately for additional helping hands to keep their ailing loved one at home.  Most often, the kinds of assistance families need help with include bathing, feeding, and positioning (moving from bed to commode, walking to the kitchen table for meals, etc.).  Sometimes they also need help with things like running errands, grocery shopping, or routine housekeeping. Since most non-medical “helping hands” agencies charge between $15-30 per hour, the financial costs can quickly add up to an unsustainable amount for a family (or an elderly spouse).

Home care agencies certainly provide assistance covered by insurance to help with bathing and dressing, and sometimes feeding, but on a limited basis (a few hours a week).  But, depending on the type of insurance involved, once the skilled nursing need is met, all services are discharged.  Again, families (or an elderly spouse) must pay privately for additional care.

As more and more Baby Boomers join the ranks of “elderly,” there will be increasing demands on existing agencies and skilled facilities.  There have been several articles in the media recently that predict a caregiver shortage (family and otherwise).  In order for people to remain in their homes through illness and eventually end of life, financial planning for care will need to become a vital part of family conversations.  Knowing what one can afford will help determine whether one can really remain at home with agency and private pay services or if placement in a facility will be required.

Working on these kinds of plans before the ravages of old age and/or illness strike may help retain some of the hue in the golden years. Although recent changes may provide health care for hundreds of thousands of formerly uninsured individuals, no increases in the already overstretched volume of available health care workers and private duty caregivers are on hand. This could result in making it even more likely that the burden of care will fall to family and friends of those in need. Planning and preparation for one’s future care is becoming more critical than ever before as the number of those in need grows larger than the number of professional and private agencies providing assistance.

Caring Choices offers to help families learn about private services and skilled care in their areas to help make informed planning decisions.

(c) 2013 Caring Choices