by Vicki Rackner MD
You may be one of the 30 million Baby Boomers who provides countless hours of assistance to elderly parents at no charge. It is estimated that, using average hourly wages, the total amount of this uncompensated care is comparable to the entire Medicare budget. For the estimated 7 million Boomers who provide long distance care, actual out of pocket expenses amount to almost $5,000 per year. For caregivers who have, or are considering leaving the workforce to care for an ailing parent, the costs are even greater – over $650,000 in forfeited salaries, benefits and pensions.
This stark economic reality shows only one dimension of the price caregivers pay for this act of love.
Caregivers pay with losses that extend well beyond their bank accounts. They often forego the activities that bring joy and richness to their lives, like meeting friends for dinner, or going out to the movies or taking family vacations. They pay with their time, the loss of professional opportunities and the erosion of personal relationships that result in isolation.
Sometimes otherwise healthy loved ones need a short dose of care as they recover from an acute medical episode like a broken leg. Usually loved ones are on a path of steady decline with cascading assistance needs. Some caregivers sacrifice large chunks of their own lives as they help their parents and other family members and friends peacefully make their transitions. Caregivers can pay with their health and well-being. In fact, we have evidence that some caregivers pay for their acts of care with their very lives.
You can decrease the personal and economic costs of caregiving. This means proactive planning rather than reactive responding. Planning saves money. You know this as you reflect upon your experience of going to the grocery store with and without a shopping list. Planning also minimizes personal wear and tear and decreases stress. Think about how much better you feel when you know your options and develop back-up plans before you jump into a challenging project.
Here are some tips to decrease the cost of careing for your parents.
Begin the conversation today. We have tremendous cultural resistance to the recognition of aging, disability and death. Just as the first few steps up hill are the hardest, so, too, you may meet the greatest resistance simply starting the conversation about their possible need for care. Say today, “Mom and Dad, it would be great if you lived forever, but the discovery of the fountain of youth is nowhere on the horizon. What thoughts and plans do you have about enjoying your golden years?”
Create a plan. Talk with your parents about their ideal plan if they are no longer able to care for themselves. Then start to work toward that proactively. Investigate long-term care insurance. Draw up the appropriate legal documents. Find out who would make medical choices if they are not able to make them on their own, along with some guiding principles for the choices. You can anticipate and limit parental resistance by saying, “Mom and Dad, I just got back from the lawyer's office signing my will and durable medical power of attorney. I've asked Mitch to make my medical choices if I cannot make them myself. Just so you know, if I were in vegetative state, I wouldn't want to be maintained on a machine. You probably already planned ahead too, right?”
Use personal and community resources. Make caregiving a family job to which each member contributes. Even children can make grandma's life special with drawings and phone calls. Identify services that make your job as a caregiver easier. If you and your parents live in the same community, check with friends and neighbors and local organizations to learn about services and resources that make your job easier. You say, “Mom has just moved in with us, and she wants to 'find a card game with the girls.' Do you know of any senior centers that have social events? How about transportation?”
We're a mobile society and millions of caregivers live more than an hour away from their parents. Executive William Gillis learned from his own personal experience how challenging it is to identify community resources from afar. As he was carving the path that ultimately led to the on-line portfolio management you may now use, he became the caregiver for his father. Mr. Gillis said, “Talk about mixed emotions! Professionally, I was introducing a service that let millions manage their investments with one click of a computer mouse. Personally, I was investing untold hours just to find one bit of information to help my dad.”
As with so many innovators, he used his personal and professional experience to launch Parent Care (www.parents-care.com), a service that he wished would have made his life as a caregiver-at-a-distance easier.
Gather cost-savings tips. This might mean something as simple as ordering generic medication or regularly inquiring about senior discounts. But, most cost savings opportunities aren't as obvious. Mr. Gillis found, for example, that some states will pay for phones for hearing, visually or mobility limited seniors or fund home safety improvements. He said, “We've invested heavily to locate time and money saving resources that most would have difficulty finding. I made it a personal mission to help other caregivers avoid some of the costs and frustration I encountered.” You don't have to re-invent the wheel. Tap into the resources others have collected.
Take care of yourself. You will give the best as a caregiver when you're at your best. Get good nutrition, enough sleep and regular exercise. Manage your stress and do a little something every day to nurture your soul. Understand that you are at increased risk for anxiety, depression, and weakening your immune system. Talk to your doctor if you see worrisome signs such as problems sleeping, changes in appetite or loss of interest in activities you enjoy.
Despite the costs, most caregivers say that they received much more than they gave. Most say they would do it again, and many do.
Sometimes the question is not the personal cost of caregiving; it's the value that you bring to the lives of others that matters in the end. What personal cost are you willing to pay for the privilege of helping those who welcomed you into the world to enjoy their golden years and traverse the road of illness with love and dignity?
Copyright © Vicki Rackner MD, 2006