The numbers don’t lie: at some point, nearly all of your clients will either need long term care or will become caregivers themselves. Because caregiving will more than likely affect all your clients, it’s important you have the knowledge and tools to guide them along the way.
Since the last census in 2010, the oldest Baby Boomer hadn’t even turned 65. Since then, about 10,000 a day have crossed that age threshold, and by 2030, all Boomers will be at least age 65.4 Add that to a rise in the incidence of chronic conditions, and retirees and their families will likely face increasing demands when it comes to evaluating housing options, managing finances and health, understanding legal issues, and creating contingency plans for unanticipated events. Making informed decisions can take time as clients learn the options available to them.
Navigating the Journey
Retirees could hire a Geriatric Care Manager (GCM) to help navigate the complex caregiver journey. Based on 2017 survey, at $300 or more for the initial assessment, and $100-200 per hour after that,5 many may find this option to be financially out of reach. Especially since the cost is entirely out of pocket because Medicare, Medicaid, and most private insurance plans don’t cover it.
PACE (Programs for All-Inclusive Care for the Elderly) is a less costly alternative offered by Medicare and Medicaid, and it may be partially or fully covered for some individuals.
Whether your clients seek help from agencies or choose to handle it themselves, there are several factors you should both be aware of as they explore the possibilities.
Long Term Care
The modern landscape of long term care planning is much different than it used to be, with many options available to meet individual needs. Providers generally fall into one of two categories: informal or formal care.
Informal care typically consists of family or friends who provide assistance with basic everyday tasks like eating, bathing, and dressing (also known as activities of daily living, or ADLs). Formal care involves a facility or provider being compensated for a specific level of care.
The Financial Costs of Care
Finding ways to fund future healthcare costs is one of the most important parts of retirement planning. Many individuals cover expenses with the help of insurance, some pay out of pocket, and others may be eligible for government assistance. While it’s tough to say exactly how much retirees will need, it’s helpful to consider the median costs for three common types of care.
The Other Costs of Caregiving
While family and friends undoubtedly want to help their loved ones, they may not be fully aware of caregiving’s inherent costs beyond finances. For example, in most cases, caregivers are sacrificing their own family and work responsibilities. Ultimately, the financial and emotional toll can be overwhelming, with researchers finding that if the stress of caregiving is left unchecked, it can take a toll on health, relationships, and state of mind — eventually leading to burnout, a state of emotional, mental, and physical exhaustion.6
Quality of Life
While caregiving has its challenges, it can also be fulfilling, and there are several ways caregivers can get the help they need. Technology-based caregiver support, education, and skills training can be an effective and efficient way to enhance caregiver knowledge and skills. Support groups, self-care, relaxation training, and respite programs can also improve the quality of life for caregivers — and their patients.6
Other questions to consider regarding the retiree’s quality of life include:
- Is the individual safe with his or her current level of care? For example, a certain level of independence can be maintained with the addition of a service that provides alerts for emergency medical help.
- Are there opportunities for the retiree to have regular social interaction? Isolation can lead to overall decline.
- Can the individual take care of his or her basic needs? Determine what level of care is needed ― light housework, medication management, meal preparation, basic ADLs ― to begin the search for an appropriate provider.
Every situation is unique, and every choice is an individual one. The key is for clients to be open to a range of possibilities and for them to maintain an ongoing dialogue with family, friends, and caregivers. Encourage your clients to speak up and make their personal preferences known.
As a level of care is determined, work with clients to determine how best to fund their healthcare needs. Be proactive with clients who are still preparing for retirement, and help them plan ahead for potential caregiving needs. By creating a financial strategy that includes Wealth + Health SM, you can help them be ready for whatever comes their way.
In the first phase of senior caregiving, seniors are primarily still living independently but may need a little extra help with a few things. Those needs are likely to evolve over time, creating a spectrum of care that’s required for this phase of caregiving.
One of the biggest decisions your clients will face in this stage is the same as in life before caregiving: choosing where to live based on personal preferences and needs. Options can range from seniors staying in their current homes to finding housing that caters specifically to adults 55 and over.
Clients should consider five basic criteria when determining their required level of care, and subsequently, the best place to live:
- Home Care – What is the desired level of maintenance responsibilities, such as the difference between having a home and an apartment (e.g., lawn care, housekeeping, having to make or schedule repairs)?
- Personal Care – Do they need help with meals? What about personal hygiene (e.g., bathing, dressing, laundry)?
- Health Care – Is immediate access to healthcare services a requirement? For example, is medication management or health monitoring needed?
- Finances – What are the associated housing costs? For example, homes come with property taxes, maintenance costs, and possibly HOA fees. What will insurance cover (e.g., Medicare, Medigap, long term care insurance) for any eligible expenses?
- Safety – Is transportation needed? Does the place of residence provide a safe environment (e.g., grab bars in the bathroom/shower/tub, wheelchair accessibility, no fall hazards like rugs)? Is there a way to get help in the event of a fall, such as an emergency call service?
Once they’ve determined their necessary level of care, they’ll have a better idea of the options available to meet those needs. It’s important to note that many of the care needs previously mentioned can likely be met in the home through various service providers and/or home modifications. However, seniors may desire the amenities, activities, and social access that senior communities provide. Some retirement communities even offer a continuum of care in different areas of one location, such as independent living, assisted living, and memory care.
As clients move forward in their search, suggest resources like Seniors Blue Book — a source for finding and comparing senior housing, health, and home care that may be found in many local grocery stores and online.
So, what is the ideal scenario for today’s typical senior? The answer continues to evolve along with our longevity, and it largely depends on the individual.
Some may want to and be able to remain in their homes. Others may need a higher level of care or not want to deal with the demands of home ownership.
For seniors living with chronic health conditions, it can also be challenging for family members to take on the role of a full-time caregiver. And according to the U.S. Department of Health and Human Services, about 70% of people turning 65 will have a long term care need. 7
One solution for those needing extra help or seeking maintenance-free living is to transition to the formal care provided by assisted living. As the name implies, it refers to communities that serve seniors who need assistance with activities of daily living (ADLs) — things like dressing, bathing, and grooming.
You may have clients who are either considering this next step, or have parents exploring the transition.
Things to Consider:
- Encourage clients to be actively involved in any transition decisions.
- Provide clients with a wide range of resources to help ensure they’re getting the care they need.
- Work closely with your clients to be sure future healthcare costs are part of their overall financial strategy.
1 “What Is Long Term Care?” The Federal Long Term Care Insurance Program, accessed online January 2019
2 “Caregiver Statistics: Demographics,” Caregiving.org, April 2019
3 “Adult Caregiving Often Seen As Very Meaningful By Those Who Do It,” Pew Research Center, November 2018
4 “2020 Census Will Help Policymakers Prepare for the Incoming Wave of Aging Boomers,” U.S. Census Bureau, December 2019
5 “Geriatric Care Managers Advocate for Seniors – and Their Caregivers,” AARP.com, May 2020
6 ”Caregiver Stress and Burnout,” Helpguide.org, October 2019
7 “ How Much Care Will You Need?” LongTermCare.gov, accessed June 2020