A recent report from the Alzheimer’s Association states that one in nine Americans age 65 or older currently have Alzheimer’s. Caring for someone with dementia is more expensive—and care is often needed longer—than for someone who does not have dementia. Because the cost of care in a facility is out of reach for many families, caregivers are often family members who risk their own financial security and health to care for a loved one.

In this issue of O’Connor Elder Law Reporter, we will continue to explore these issues and steps families can take to alleviate some of these burdens.

Cost of Care for the Patient with Dementia—And How to Pay for It

As the disease progresses, so does the level of care the person requires—and so do the costs of that care. In a 2016 study by Genworth, options range from in-home care (starting at $46,332 per year) to adult daycare (starting at $17,676 per year) to assisted living facilities ($43,536 per year) to nursing homes ($82,128 per year for a semi-private room). Needless to say the costs of this care have only increased in the past seven years.

There are few outside resources to help pay for this kind of care. Health insurance does not cover assisted living or nursing home facilities, or help with activities of daily living, which include eating, bathing and dressing. Medicare covers a limited number of days of skilled nursing home care, but only after a medical incident such as a fall.  Medicare does not cover long-term care. Medicaid, which does cover long-term care, was designed for the indigent.  A person’s assets must be spent down or lawfully sheltered to almost nothing to qualify. VA benefits for Aid & Attendance will help pay for some care, including assisted living and nursing home facilities, for wartime veterans and their spouses who qualify.

Financial Costs for the Family

Women are more likely to be caregivers for family members, this having a financial impact on them. Over 60% of surveyed women by Genworth pay for care using savings and retirement funds, overing household expenses, personal items, transportation, informal caregivers, and long-term care facilities. Almost half report reducing their quality of living to cover these expenses.

In addition, absences, reduced hours and chronic tardiness can mean a significant reduction in a caregiver’s pay. In a worst-case scenario, many women had to leave their job as the result of a long-term care situation. Losing income also affects retirement benefits, social security benefits, and family members’ standard of living and savings.

Emotional and Physical Costs to Caregivers

In addition to the financial costs, caregivers face increased stress, anxiety, and depression. Despite positive feelings about providing care for a loved one, this also can  negatively affect their personal health, well-being, and relationships with their family or spouse.

People with dementia may wander, become aggressive, and lose recognition of family members, even those caring for them. Caregivers may become exhausted, leading to feelings of failure and guilt. They may also have high blood pressure, increased risk of hypertension, less preventative care, and higher risk of coronary heart disease.

What can be done?

• Planning is important. Caregivers face emotional, financial, and job-related stress when providing care for a loved one. To alleviate these challenges, consider options like additional caregivers, alternate funding sources, and respite care. Legal options can protect assets and access funds for long-term care. However, most people fail to plan ahead, leading to confusion about care needs, options, and resources. Discussing dementia and incapacity early on in a diagnosis can help prepare families for potential challenges.
• Watch for early signs of dementia. The Alzheimer’s Association (www.alz.org) has prepared a list of signs and symptoms that can help individuals and family members recognize the beginnings of dementia. Early diagnosis is crucial for treatment, support, and future planning.
• Take good care of the caregiver. Caregivers require support and time off to maintain their stamina, energy, and positive outlook. Joining a caregiver support group can help share questions and learn from others. Regular exercise, outings, and breaks can help maintain stamina. If the main caregiver works outside the home, inquire about available resources and consider compensation from family members.
• Seek assistance. A local Elder Law attorney can prepare necessary legal documents, help maximize income, retirement savings and long-time care insurance, and  apply for VA or Medicaid benefits. 

Conclusion

Caring for a dementia-related loved one is more demanding and expensive than caring for a non-dementia person. Families must discuss options and create asset protection plans for long-term care.

We help families who may need long term care by creating an asset protection plan that will provide peace of mind to all. If we can be of assistance, please don’t hesitate to call.