How to financially cope when caring for family

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How to financially cope when caring for family


One in five American households -- 52 million people -- are involved in caring for an adult who isn't self-sufficient, and this number is only poised to grow. Long-term care cost Americans about $220 billion in 2014 -- over 9 percent of all U.S. health care spending that year.

And many of those in the "sandwich generation" are stretched even further, as they support both their children and their aging parents at the same time.

Caring for someone else is never easy, especially when it's unexpected. Here are some tips on how to deal.

1. Gather your information.

"The more information a caregiver can get, the better," says Christina Irving, a family consultant for the Family Caregiver Alliance. Will this likely be a short-term crisis or a long-term situation? The social worker on your loved one's case may be able to provide more details.

Throughout, be your own advocate. For example, hospitals have a responsibility to provide a safe discharge for their patients, so if you refuse to have the patient discharged to your home because you're uncomfortable or don't think it'd be safe, the hospital is supposed to find other options.

In addition, know when the follow-up appointments are, and "make sure there's a very clear discharge plan," Irving says.

If you're not getting the help you need, look for a patients' rights advocate within the hospital or an outside advocacy organization.

2. Empower yourself.

If you're trying to help someone who's of sound mind and body, consider getting power of attorney or another legal document that could allow you to make decisions or take actions on behalf of that person, suggests Marguerita Cheng, Certified Financial Planner™ and CEO of investment advisory Blue Ocean Global Wealth. "This does more than just let you decide major things. You might need it to renew a prescription on someone's behalf."

Research what else you need to be an effective caregiver, and consult an attorney if you have questions. Do you need the patient to sign something so medical professionals can speak to you directly about her care or so you're authorized to schedule appointments and pick up prescriptions on her behalf?

3. Know what you can afford.

There's no "right" amount to chip in when someone you love is in need. But here are some steps for figuring out how much you can handle.

Step 1: Calculate your discretionary income.

Some of your expenses, such as rent, utilities and student loan payments are probably non-negotiable, while others are more discretionary, such as cable or dining out. Subtract all your "non-negotiable" expenses from your income, and see what's left over. How much are you willing to dedicate to this new care-giving responsibility?

Step 2: Think about your emergency fund.

A family crisis might be an emergency worth dipping into a rainy-day fund for, but you don't want to be unprotected against other emergencies, like if you have your own unexpected medical costs.

"Don't bring your emergency fund down to zero -- you need at least some for yourself. If you have three months' of savings, I'd say don't take out more than one," Cheng says.

Step 3: Stop before committing to less-desirable options.

In extreme cases, you might contemplate more drastic ways to access cash - but you should think carefully before taking these measures.

Cheng recommends against using money earmarked for another goal, such as a down payment on a house, unless you're comfortable delaying that goal. She's also against using retirement funds to support a family member, because you could incur penalties and it could leave you financially vulnerable.

Similarly, she says, try to avoid racking up credit card debt or failing to make minimum payments on any of your current loans.

4. Get other people involved.

Even if other family members aren't willing to contribute to the patient's care, Cheng recommends getting them on board with decision-making.

However, your family members have the right to say no to helping out. By the same token, there may come a time when you have to say no, too -- especially if care-giving is such a financial or emotional strain that you can't take care of yourself.

It might help to invite a social worker or therapist to facilitate a family meeting if he can provide necessary information and keep the conversation moving forward, Irving says.

5. Keep track of everything.

"If possible, open a separate checking account to help you track what you're spending on care-giving," Cheng says. It's also a good idea to write down your agreements with other caretakers so you have a record of the conversation later.

Clarify expectations with the person you'll be caring for as well. These expectations may include:

  • If you provide financial support, will you be reimbursed?
  • If someone moves in with you, is there a set time limit?

Putting all of these expectations in writing can help make everything clear.

6. Make a care plan.

Some care-giving services can be covered in part or in full by Medicare, Medicaid or veteran benefits. If the person you're caring for has long-term care insurance, that could help you pay for at least some of these costs.

Major care-giving options include:

  • Home health aides: The cost varies from place to place, but generally ranges from about $19 to $21 an hour. The average cost for a full-time home health aide was just under $46,000 in 2015.
  • Visiting nurses: It often costs around $25 to $60 per hour for a nurse to make a home visit.
  • Day health care: This is a daytime solution for adults who need some supervision but not round-the-clock care. This can cost roughly $70 a day.
  • Assisted living: Some patients may qualify for financial assistance, like for subsidized senior housing. The average cost for a nonsubsidized assisted living facility is about $43,000 a year.
  • Nursing homes: The average cost of a semiprivate room in a nursing home is about $80,000 per year; the average cost for a fully private room is over $90,000.
  • Hospice nursing: You might be able to find hospice services for free, as many are nonprofits.
  • Respite care: Respite care providers are pinch-hitters who can take care of your loved one if you're on vacation or if you simply need a little time away. Costs vary widely, but in-patient respite care ranged from about $75 to $200 a day in 2012.

7. Tap available resources.

Reach out for help as early as possible. "It's better to tap into supports early on, before you're burnt out," Irving says. Remember: If one organization can't help you, request a referral to another that can.

Our experts recommend these resources as a place to start:

8. Take care of yourself.

Your health and financial security are just as important as that of the person you're caring for, Irving says. (Her organization publishes a document called the caregiver's bill of rights.)

She suggests seeking as much support as possible, such as joining a support group, going to individual counseling or working with a disease-specific advocacy organization.

Bottom line

The steps above may help you manage the burden of caring for a loved one.

This experience could also inspire you to get your own affairs in order. "Think about who could make financial decisions if you were incapacitated," Irving says. Long-term care insurance doesn't make sense for everyone, but think about whether it might be a good option for you.

And don't forget to tell trusted friends or family members where you store your documents. "It does no good to name a power of attorney if that person doesn't know it's been done or where the documents are," Irving says.

No matter how old you are, now's the time to take action, Irving says.

About the Author: Allison Kade is a freelance writer whose work has appeared in publications including Bloomberg, Travel + Leisure, Forbes, Real Simple, Business Insider, TheStreet, BoingBoing, Fox Business News and more. When she isn't writing about personal finance, she's probably still writing fiction. Or traveling. Or solving -- or creating -- puzzles. Follow her on Twitter.

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