“Taking Care of the Caregiver” – The Need for Respite
In 2005, according to Family Caregiver Alliance (FCA) statistics, the majority of caregivers in the United States (83%) are family members. The typical caregiver is a 46 year old female with some college experience who provides more than 20 hours of care each week to a loved one. In addition, she may be also working full-time and/or taking care of young children. Another large population of caregivers is spouses. Half (53%) of all caregivers reported that their health had gotten worse due to caregiving and said that the decline in their health affected their ability to provide care (National Alliance for Caregiving, 2004). Additionally the National Alliance for Caregiving (NAC) reported caregivers do not go to the doctor because they put their family’s needs first (67%), or they put the care recipient’s needs over their own (57%). More than half (51%) said they do not have time to take care of themselves and almost half (49%) said they are too tired to do so (2004).
In light of the above statistics, it is easy to see how caregiver burn out occurs and more important – to realize the need for respite for caregivers of any age. What resources are available to help “take care of the caregiver?” There are several that provide reliable options: In-home Home Care, Adult Day Centers (ADC), and facility-based respite stays.
In-home Home Care provides for caregivers to come into the home (private residence, Independent Living, Assisted Living) on a scheduled or as-needed basis. Some Home Care Agencies or Personal Service Agencies that offer these services have background checked, drug tested, insured, trained employees (Certified Nursing Assistants, Home Health Aides or the like) who come into the home to provide assistance with Activities of Daily Living (ADLs) such as bathing, dressing, transferring, toileting, meal prep, medication reminders, as well as companionship and light housekeeping. They are also able to take the individual to the doctor and on errands or outings. This gives the caregiver an opportunity to leave the home or to continue to work outside the home without worrying about their loved one. The cost of these services usually ranges from approximately $20-25/hour. Mileage may be additional if the caregiver uses his or her car to transport the client. The cost of these services may be covered by long-term care insurance (LTC) and the VA Aide and Attendance benefit. This coverage will vary from policy to policy under LTC and will be based on financial qualification for the VA benefit.
Adult Day Centers are another viable option if the cared for individual is easily transported. These centers are community-based group programs designed to meet the needs of seniors and other adults who require supervised care. They help the participants to continue live in the community, relieve stress on caregivers, and reduce the cost of care by preventing or delaying nursing home placement. ADC usually have half- or full-day enrollment options and open early and close late to allow caregivers who work the opportunity to drop off before and pick-up after work. Some centers have transportation for an additional charge. Adult day services provide a variety of health, social, recreational and therapeutic activities. While the services offered by ADC vary from location to location, they may include AM/PM snacks, lunch, activities, outings, current events, exercises, medication administration and some even offer bathing (usually at an additional charge). Depending upon the program, the cost of ADC can range from $45 – $65/day along with a one-time enrollment fee ($50-$75). This cost is approximately one-fourth the cost of nursing home care.
Respite Stays are utilized by caregivers who need an extended length of time away from their loved one for whatever reason (vacation, illness, work, etc.). These stays are offered by senior living communities and provide the senior room and board, medication reminders/administration, involvement in facility activities, transportation, assistance with ADLs, and whatever else may be needed. The cost varies widely from facility to facility and is not covered by Medicare. There are some senior communities who require a minimum stay of two weeks, while others have reduced the length of stay to only one week or perhaps just a weekend. Not all senior living communities offer this service, so it is recommended to check with each one individually. It is always advisable to visit a facility before making a decision for your loved one. Due to the increasing popularity of respite stays, advance planning will allow for a better selection.
Regardless of which option a caregiver selects, the need for respite from caregiving cannot be overstated. What would happen to your loved one if suddenly you, the caregiver, were taken ill and could no longer provide care? What would your loved one do or where would your loved one go? The answer is unpleasant and most likely not an option you would have chosen with the luxury of time on your side.
By Nancy Hanley, RN
Geriatric Care Manager