Women as Care Givers

Many of you may already know that the majority of the care givers in this country are women.  Everything from informal care to hands on provider, companion, medical decision maker and personal assistant.  According to the United States Department of Health and Human Services on Women’s Health, about 75% of women in this country are care givers (http://www.4woman.gov/faq/caregivers.htm).

When talking about women and care givers, many of us have heard the term “sandwich generation”.  These were women caring for both young children and elderly parents.  Since women are having children later in life and their parents are living longer, the term sandwich generation is going to well into womens 50′s and 60′s.  When we think of the woman as a care giver, we need to expand the definition of those who are receiving care.  In some situations, a woman may be caring for her elderly mother, her elderly grandmother and more recently for their own grandchildren.  With the increased cost of assisted living, nursing home care and child care costs, many families find that a willing mother as the care giver is a less expensive alternative.  In fact, the average cost of a private health care aid for 8 hours a day can average over $70,000 per year, assisted living arrangements can average approximately $35,000 a year, a private room in a nursing home can be as much as $75,000 a year and child care for the next 7 to 10 years…who knows.  Many individuals have saved and budgeted for retirement, but they have not saved and budgeted any of these additional expenses.

While a mother may solve another family members financial problems related to in-home aid, assisted living or even day care, that same mother may put aside her focus on her own future financial needs.  Care givers take the time to provide assistance for other loved ones and put their own jobs or ability to earn a livelihood on the back burner.  Many times a woman is faced with reducing her work time, dropping out of the work force or even using vacation and family leave options to provide the necessary care for others.  In fact, one study found that 49% of baby boomer care giver’s suffered a future “financial hardship” as a result of the care giving they provided to others (When the Care Giver Needs Care, American Journal of Public Health, 2002).

Although the natural response for many is that the care giver will be able to rely on the pension and Social Security of their spouse, it is important to note that by the age of 65, women are three times more likely than men to be widowed (U.S. Census Bureau 2003). In many situations the widowed care giver is facing a reduced pension and reduced Social Security.  If today’s baby boomers and depression era generation are feeling the financial pinch, one can only imagine what the future holds.  It is anticipated that the health care aid costs, assisted living costs and private room nursing home costs will double every fifteen years.  The question for many of us is how are we going to deal with the issues of living longer, changes in the economy, and increased care giving costs.  The first and most simple answer is that we need to arm ourselves with as much information as possible.  As a family, we need to start educating ourselves now and not wait for our family members to get older and/or for a crisis to exist.  Here are some basic tips to plan ahead:

            1. Begin the process early.  Have a conversation with your parents or loved ones when there is no pressure to make decisions.  You need to be prepared to talk about complicated and delicate matters, including your families budget, their estate plan and funeral burial wishes.

            2.  Where do you hide things from yourself?  You need to learn where important financial documents are located and it may be important to review these documents now so that you are familiar with any day to day responsibilities that you or any other family members may have to take over.

            3.  Create a care network.  It is important that you involve as many family members that are willing to get involved, including other siblings, adult grandchildren, cousins or other close friends.  Do not anticipate that you have to assume the role of sole primary care giver.  Determine how other family members can get involved or how they can relieve you of your responsibility periodically.  It is important that when you discuss care giving services that you also address the issue of compensation.  Does the care giver need to be compensated as a result of quitting a job or cutting back part-time?  Will there be additional costs or expenses that the care giver will face and how will these be reimbursed? 

            4.  Identify local support groups.  It is important that you check with any State, County, or local support groups.  If you are not able to locate any local sites go to www.geocities.com/~elderly-place/support.html to find local information.

            5. Be as informed as possible.  With all the information on the internet, there are many ways to identify what are the best care giving options for you and your family.  The internet may also provide you information on other in-home and community based services, meal programs, senior centers, respite care centers/adult day care facilities, local transportation and even services pertaining to house cleaning and yard work.  As the care giver you need to understand that you are not expected to do it all.  Just because you are caring for a family member does not mean that you have to clean their house and shovel the drive way and maintain a certain level of care. 

            6.  Understand a family members health insurance coverage.  In some situations, a family member may be covered by a health care plan and benefits and coverage can be discussed with their employer or human resource department.  Keep in mind that the company or human resource contact may require that you have a HIPAA release that allows you to discuss the health insurance program that is being provided.  If the individual is receiving Medicare, you may need to locate an senior organization that can assist you with understanding not only the Medicare system, but all of the various Medicare options that can be purchased for additional coverage.  In many situations, the person that you are caring for may not be well versed in their own health care coverage and they may not be able to explain their own coverage.  If you are fortunate enough to establish that the  individual you are providing care for has worked with a local insurance agent, then you will want to arrange a time to meet with that agent early on and establish the medical insurance, prescription coverage and possibly long term care benefits. 

            7.  Establish the financial resources and budget.  It is important, as mentioned above, that you establish where important legal documents are kept. But it is also important that you establish what financial resources a family member has available.  Is a family member relying on a retirement plan, a pension plan, Social Security or other non-retirement investments?  It is also important that you review any outstanding debts or liabilities and determine if these debts need to be paid off or if they can merely be paid down.  In many situations, the person you are caring for may have  worked with local bankers, CPA’s, accountants, financial advisors and/or brokers.  It is important that you establish who these individuals are while the person you are caring for is still competent.  In fact, it may be important for a meeting to be scheduled between you, the family member being cared for and the advisor.

            8.  Don’t forget yourself.  Too often women care givers spend all of their time, energy and resources caring for another person.  The emotional, physical and sometimes financial strain can be overwhelming.  Just remember, if you “the care giver” becomes ill, you have now put yourself at risk and you have placed the person you are caring for in a difficult position.  Obviously, there are situations where the care giver cannot avoid an illness or an injury, but it is all too common for obvious signs of illness or stress of the care giver to be ignored.  This is where the support system comes into play.  Be prepared and be willing to listen to your family members around you if they are telling you that you appear to be exhausted, stressed out or even ill.  Remember, you have found the necessary family network and support groups for the person you have been caring for, but have you identified these same resources for yourself.  Do you have the necessary resources to give yourself the break you need so that you can continue to serve as that care giver for years to come.

For more information, please feel free to contact our office to discuss not only these issues, but such issues as the importance of a Durable Power of Attorney, a Medical Power of Attorney, a Last Will and Testament and a Living Trust.  The Durable Power of Attorney for financial and health care allows you to designate someone to make medical decisions and financial decisions if you are physically or mentally unable to make these decisions for yourself.  The Last Will and Testament and/or Trust allow you to identify who is to receive your assets  at the time of your death.  It is also important that if you have executed these documents, that they are periodically reviewed to ensure that the person that you have designated as your care giver is in fact willing to serve.  It may also be important for you to determine whether additional compensation or a gift should be made in your Will or Trust to provide for a care giver at the time of your death.