Caring for a loved one can be more complicated and costly than you think

Often Overlooked Costs Associated With Caregiving

by Paige Estigarribia


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Organizing the caregiving process can take time and patience. There are many different considerations, especially regarding the costs. We wanted to find out a little more about the often overlooked costs associated with caregiving, so we reached out to Ashley Huntsberry-Lett, editor-in-chief at AgingCare.com. She gave us some valuable tips and insight on costs that are often overlooked when planning for the care of a loved one. Here are her tips:

Q: What are some important, but often overlooked, costs associated with home caregiving?

Ms. Huntsberry-Lett: For many family caregivers, an aging parent has not lived with them throughout their adult life. They come to realize, whether it is during a holiday visit or news of developing health issues, that their parent is no longer able to live alone safely. A number of the members on AgingCare.com's Support Groups have made the choice to move their parent(s) into their own home in order to provide care and supervision rather than opting for an apartment in assisted living or another long term care facility (which can be extremely pricey).

These family members have not lived together in decades, and this new arrangement can be extremely trying for everyone involved. However, the costs of this decision, initially made to save money on care and housing expenses, can actually add up very quickly. Depending on the layout of the home and the aging parent's health and mobility level, equipment may have to be installed to make the home senior-friendly. Strength, balance, and mobility issues may not yet be an issue for Mom and Dad when they move in, but things can change very quickly.

Stairs can be one of the most dangerous aspects of getting around the house for seniors, but installing a stair lift is far less expensive and less stressful than moving or dealing with a serious fall. Bathrooms are also notoriously hazardous for aging loved ones who may be prone to falling. A walk-in shower or tub as well as grab bars or handrails installed in precarious spots are great additions for seniors who are unsteady on their feet. Other adaptive measures a caregiver may have to take include adding non-slip strips to certain areas of the house, ramps, raised toilet seats, purchasing a medical alert device, and changing out light switches and/or doorknobs with ones that are easier for a loved one to grasp and use. Some of these items may be expensive, but when used correctly, each one can provide added peace of mind, which is priceless to a family caregiver.

Furthermore, any time you add another person (or two) to your household, costs will go up. This affects everyday expenses, such as grocery budgets, water, electricity, heat, transportation, etc. In some cases, an aging loved one may be able to pay for their own costs of daily living, but many family caregivers end up taking on at least some portion of these costs themselves.

Lastly, transportation costs can definitely sneak up on a caregiver. Even a meticulous budgeter may overlook the "few miles here and there" that they drive Mom or Dad to various doctor's appointments, bingo nights, church functions, etc. However, the cost of gas and the wear and tear on a vehicle can add up very quickly.

Q: Are there ways, when planning for caregiving, to be sure you have thought through all parts of the caregiving budget?

Ms. Huntsberry-Lett: The best way to begin or reassess a caregiving budget is to start with a comprehensive care plan for the care recipient. A proper care plan requires a detailed assessment of a loved one's home, health, daily care, recreational/social activities, and finances. Some of these important questions include:

- Is their living environment safe? Can any changes be made to increase the safety of their bedroom, bathroom, kitchen, etc.?

- What health issues are they currently facing? What medications are they taking (reason, dosage, frequency, prescribing doctor)? Do they use any durable medical equipment? Are they enrolled in Medicare? Do they have any private health insurance?

- What daily care activities do they need help with? (These include bathing, dressing, eating, transferring/walking, continence, toileting, managing medications, housekeeping, preparing meals, managing finances, and shopping.)

- What types of social, recreational, or spiritual activities do they engage in on a regular basis? Are they intent on continuing to partake in these? What, if any, assistance will they need (a ride, companionship, materials, etc.)?

- What is their financial situation like? What sources of income do they have (social security, pension, 401k, investments, etc.)? Do they have any outstanding debt? Do they have insurance policies (private health, life, long-term care)? What are their expenses (taxes, insurance payments, pet care, etc.)?

After having assessed all of these areas (and any others that apply to your loved one's situation), you can determine the costs that will be required to meet all of these needs and where they will come from. One very simple example is that Dad enjoys going to brunch every Sunday morning after church, or Mom needs plenty of yarn to do her knitting each week. These are regular expenses that should be factored into the budget to keep them active and happy. Funds for these activities might come from Mom or Dad's monthly social security check, or the caregiver can agree that a sibling will be responsible for this weekly transportation and/or expense.

Another more complex example would be if a loved one has continence issues or needs assistance going to the restroom. There are plenty of items that their caregiver may need to factor into their budget. Adult briefs, catheters, booster pads, wipes, gloves, and/or a bed-side commode may all be necessary at some point during their care. Disposable incontinence supplies are an ongoing expense for many caregivers, and unfortunately, Medicare only covers related durable medical equipment, such as commode chairs and ostomy and urological supplies (like bags and catheters).

The expense of this common age-related condition can add up very quickly, and this is a prime example of how caregivers must be proactive researchers when it comes to finding out how to get coverage, reimbursement, or deductions for certain supplies and tests.

Q: Are there any costs that you can't plan for, but should think about preparing for?

Ms. Huntsberry-Lett: It is nearly impossible to sit down and create a comprehensive long-term budget for a child from birth through adulthood. There are countless speedbumps, accidents, and surprises that we can't account for. Many of the same challenges are presented when creating a budget for the care of an aging loved one, but there is no milestone age at which they become self-sufficient. In fact, it is quite the opposite as a loved one's needs typically increase as they age.

You cannot predict the future of a loved one's health, but it is crucial for all seniors to position their own affairs in such a way that they can provide for themselves for as long as possible. If a loved one has a family history of Alzheimer's disease, there is no telling whether they will eventually develop this condition or need memory care. However, it is definitely something that they should think about preparing for. Financial planning and preparation are all about setting goals and constructing realistic and flexible plans for the future.

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Q: How can the costs change? And can that also pose issues when planning a caregiving budget?

Ms. Huntsberry-Lett: Costs of caregiving can change instantly, which makes budgeting a real challenge. Saving enough money for retirement is difficult enough, but as we live longer, being able to pay for long-term care is now an added concern. According to the U.S. Department of Health and Human Services Administration for Community Living, approximately 69% of Americans will require some long-term care during their lifetime.

As we age, our immune systems become less effective and we become more susceptible to countless health issues. Even a perfectly healthy and active senior can experience a sudden downward spiral after a simple fall or bout of the flu. Progressive diseases such as Alzheimer's and other forms of dementia are the bane of all planning efforts.

While aging is a natural process that should not be regarded with fear, it is wise to plan for the worst and hope for the best. Ideally, a loved one will have saved throughout the course of their life and have funds to pay for incidents like those mentioned above. However, as health care costs rise, family members often feel obligated to help finance their aging parents' care.

It is a difficult decision to enforce, but it is crucial for a caregiver to set a limit to the contributions they will make to a parent's care. Contributing too much could undermine the caregiver's own savings and plans for retirement and long-term care. This can cause a domino effect of family members who feel obligated to fund an aging loved one's care. It is wise to look in to local, state, and federal programs that may be able to assist in paying for their care without leaving the caregiver financially insecure.

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Q: Are there costs (and/or budgeting issues) that come up that most people forget to consider?

Ms. Huntsberry-Lett: Caregivers are often so focused on nurturing and supporting their loved ones that they forget to factor their own needs into their budgets for money and time. If a caregiver has little to no help, they can be extremely susceptible to stress and burnout.

Over time, these things can wreak mental and physical havoc on a family caregiver. It is crucial for family members to recognize their own limits and either call in a favor from a friend or other family to help, or pay for professional support like in-home care or adult day care. "Saving money" on care by providing it yourself at the expense of your own health is a bad move even just in financial terms. Hospitalization and/or treatment for a heart attack, stroke, anxiety, depression, and other common stress-related conditions will likely cost more than a few hours or days of respite care each week.

Ultimately, the golden rule is for caregivers to make sure their own needs are balanced with their loved one's needs, financially and across the board. Operating on a deficit is not sustainable long term, and if something happens to the caregiver, who will care for the care recipient?


Ashley Huntsberry-Lett is the editor-in-chief at AgingCare.com. Visit today!

Paige Estigarribia is a writer for The Dollar Stretcher who enjoys writing about food, frugal living, and money-saving tips. Visit Paige on Google+.

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