Care Receiving or Caregiving in Your Future?

There are more and more older people in the United States every day. I did a search on Gemini AI for this post. Here’s what I found:

  • In 2022, there were 58 million people aged 65 and older.
  • It increased to 62 million in 2024.
  • In 2030 there will be 74 million. 1 in 5 people will be 65 or older.

Why Are These Numbers Exploding?

There are 2 reasons:

  • The number of people in the Baby Boomer generation, and
  • With the advances in medicine and medical care, people are living longer.

One Drawback of Getting Older

Unfortunately, there are drawbacks for many of us as we grow older. We will develop medical conditions which won’t resolve. Some of these will require us to get ongoing care.

This is not new. The only thing that has happened is advancing medical care has enabled us to live longer. We may not need this care until we’re older. We also may need it for longer and longer periods of time.

Here are some statistics on this:

  • 65% of older people needing care are female. Their average age is 69.4.
  • 33% of men are 50 and older.
  • 48% of people needing care reside in their own home. 57% of these need less ongoing care versus 28% who need more care.
  • 40% of those receiving care need a lot of care. 92% of their caregivers spend an average of 21 hours a week providing the care they need.

The average amount of time an older person needs care is 4 years. 30% require it for less than 1 year.  24% require care for more than 5 years and 15% require care for 10 years or more.

Initially, a person may only need a limited amount of care, maybe several hours a week. As time goes by, they need more and more.

Who Provides This Care?

The Family Caregiving Alliance reports:

  • “Upwards of 75% of all caregivers are female. They may spend as much as 50% more time providing care than males. [Institute on Aging. (2016).”
  • “Male caregivers are less likely to provide personal care, but 24% help a loved one get dressed compared to 28% of female caregivers. 16% of male caregivers help with bathing versus 30% of females. 40% of male caregivers use paid assistance for a loved one’s personal care. About 14.5 million caregivers are males out of the 43.4% who care for an older family member. [National Alliance for Caregiving and AARP. (2009). Caregiving in the U.S.]”

In some instances, caregivers are hired to provide the care necessary.  Along with everything else, that has become more and more expensive. Not that many people can afford to pay for caregivers other than for a short period of time.

Most of the time, members of the family or relatives have to provide the care needed.

  • When a husband or wife needs care, typically the spouse will provide the care as long as they can
  • When a mother or dad needs care and there is no spouse or the spouse is dead, the adult children typically provide the care
  • At times, it’s another relative

How Much Time Do People Spend Providing Care?

Family caregivers spend an average of 24.4 hours per week providing care.

  • Nearly 1 in 4 caregivers spends 41 hours or more per week providing care. [National Alliance for Caregiving and AARP. (2015) Caregiving in the U.S.]
  • For people with Alzheimer’s or other forms of Dementia, a caregiver may spend as many as 9 hours a day caring for them.

The Type of Care a Person Needs Varies by Their Condition.

Family members often:

  • Cook meals and do housekeeping tasks.
  • Manage the person’s finances.
  • Help with bathing and personal care
  • Give them their medicines and take them to medical appointments.
  • Deal with their doctors, nurses and other medical professionals
  • Handle their insurance matters
  • Provide emotional support to them
  • Prevent them from wandering, deal with aggressive behavior and be there for them when they hallucinate.
  • Keep other family members updated on the person and their condition. At times thy have to confront unhelpful family members.

Prior to becoming a caregiver . . .

. . . Most People Have No Idea of the Amount of Work That Has to Be Done

They don’t think they will have any problems providing care for a spouse or loved one They suddenly find how difficult it is and how their own lives suddenly are turned upside down.

Here are some of the realities for caregivers:

  • 80% say there is more stress than they imagined
  • Most become depressed. For 50%, this is significant
  • They have more anxiety than those who don’t provide care
  • They themselves are more prone to new health problems
  • The strain on a caregiving spouse increases their own risk of dying prematurely
  • Their own immune systems are compromised and their own wounds heal more slowly
  • They also have more colds and other viral illnesses

Many also experience a strain on their own finances. They suddenly have to pay for things their care receivers need that they didn’t expect. Those caregivers who are still working might have to pass up promotions or reduce the time they work to provide the care required.

There can be significant changes in marital relationships when a spouse is providing care. They may have to take over some things their spouse did. That may require them to learn new things and they don’t have the time or energy to do so. This can be overwhelming or frustrating.  The time caregiving requires may prevent them from spending much time with their friends.

Challenges for a Family Caregiver

While caring for an older person in the family, a caregiver frequently has challenges they would not have had in the past. They might:

  • miss their own medical appointments
  • ignore their own health problems
  • not be eating properly
  • overuse tobacco or alcohol at times of stress
  • stop exercising because of a lack of time
  • not sleep properly
  • not be able to spend time with friends
  • find themselves getting angry at their care receivers, other family members or friends

Training for Family Caregivers

Until recently, most family caregivers did not have any training in what they may be required to do. Their training was on the job. They learned as things came up.

Starting in 2025, Medicare will cover the cost of a caregiver learning and developing the skills required to care for a care receiver, such as giving medications, personalized care and more as part of the care receiver’s treatment plan. The care receiver’s physician or health care provider has to say this training is appropriate for the care receiver’s treatment plan.

The caregiver can get this training in an individual or in group training sessions from the provider. Medicare will pay 80% of the cost of this training up to the Medicare approved amount under the care receiver’s plan after the Part B deductible has been paid.

Other Resources for Family Caregivers

Under the Family and Medical Leave Act (FMLA}, family members can take up to 12 weeks off from their work in a 12 month period to care for an aging loved one. They are not paid during this time.

Many employers offer some form of a Flexible Spending Account which can be used to cover long term caregiving costs. Employees can put pre-tax money into these accounts and use it to cover these charges. Sadly, many people are not aware of this and fail to take advantage of it.

Older people who are on Tenncare may qualify for the TennCare CHOICES in Long-Term Services and Supports Program (Choices). Some of the eligible services under this program are adult day care, home delivered meals, attendant care, homemaker services, home modifications, and respite care. These are provided to delay a person’s admission to a nursing home.

To speak with a Choices Intake Specialist, call 866-836-6678. Choose option 1. They will ask for the social security number of the care receiver, their date of birth and annual income.

Those not on TennCare may qualify for help under the Tennessee Options for Community Living program (Options). To be eligible, there needs to be at least 3 daily activities the care receiver can’t do themself. These are things such as physically being unable to do housekeeping, shopping, bathing, walking or other activities without assistance.

The care receiver’s income does not exclude them from this program. If their monthly income is over the monthly amount in the Federal Poverty Guidelines, they will have to pay a portion or all of the cost of the services they receive.

Under this program self-directed care is allowed. Friends and family members (but not spouses) can be paid to provide the care.

For information on this, call the Area Agency on Aging and Disability at 866-836-6678.

Benefits for Family Caregivers of Veterans

 Family caregivers 18 years of age or older may get certain benefits from the Veterans’ Administration if they live with the veteran full-time or are willing to live with the veteran full-time and are designated as their family caregiver.

The veteran themself must have a VA disability rating of 79% or higher, require at least 6 months of continuous in-person personal care and be enrolled in VA health care.

The caregiver must be providing services to support the veteran’s:

  • Health and well-being
  • Everyday personal needs (like feeding, bathing, and dressing)
  • Safety, protection, or instruction in their daily living environment

The veteran can appoint one primary family caregiver and 2 secondary family caregivers to support the primary caregiver when necessary.

Eligible Primary and Secondary Family Caregivers can receive:

  • Caregiver education and training
  • Mental health counseling
  • Travel, lodging, and financial assistance when traveling with the Veteran to receive care

Primary Family Caregivers may also receive:

  • A monthly payment for the care they provide, and
  • health care coverage through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) if they don’t already have their own health insurance.

As we age, none of us look forward to having someone care for us especially our spouse, a son or daughter. Unfortunately, we may need them it.

Thankfully, the Federal and state governments are providing more assistance to caregivers. That assistance will probably expand as the specific needs become better known.

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If you have any comments on what you have read in this post, I would love to know them. Please email them to me. Also – if you have any ideas about subjects you would like to see discussed in future posts, please send me an email and let me know. My email address is bob.ooablog@gmail.com.