Caregiving 101 Part 1

If you have taken on the role of a caregiver in the last few years, you have joined on of the biggest and most important working groups in America today.  According to the Family Caregiver Alliance (FCA), an estimated 44 million Americans have taken on this vital job. Caregivers fix meals, make doctor's appointments, do the laundry, and generally make sure their frail or sick relatives or friends can live as well as possible for as long as possible.  The actual list of things a caregiver does would take weeks to compose and pages to print.  Suffice to say, caregiving is a tough job and every caregiver deserves a big round of applause.  Although we know caregiving is done behind the scenes and is often a thankless job.  

Caregivers have every right to feel proud of their role. Without them, untold numbers of people would have to move to nursing homes or other facilities. Of all of the adults who receive long-term care at home, nearly 80 percent depend solely on the help of friends and family members. And without caregivers, the health care system would likely collapse from the financial burden. As reported by the FCA, it would cost over $306 billion each year to pay for the services that family caregivers provide for free.

But caregivers also have every right to feel overwhelmed, worried, and confused. As you continue your on-the-job training, you're bound to face many caregiving dilemmas. You want your relative to get the help she needs, but you don't want to give up your life or drain your finances in the process. Learning the basics about your job and the resources available to you -- a sort of Caregiving 101 -- can help you succeed at your new position.

Step One: Taking stock of the situation

One of your first tasks is to take a complete inventory of your loved ones situation. Do they simply need some help with daily chores? Are they lonely and need some company? Or do they need someone watching over them throughout the day? 

The answers to these questions will shape the big decisions that will undoubtedly emerge in the near future.

One of the biggest decisions is usually housing. If they no longer are able to fully take care of themselves, they may need help from in-home caregivers, who may include family members. But if it's not possible to get in-home help, they may need to move into an assisted living facility or nursing home. Or even, possibly, your house.

As part of this inventory, you'll have to take a close look at their finances. If you are the primary caregiver, talk with your relatives about giving you durable power of attorney. (Above all, don't wait till the last minute to have the conversation about who your relative wants to manage finances if she becomes unable to do it herself.) As their representative, you can gather her bank statements, bills, insurance policies, and other vital documents for review; otherwise you'll need to review them together. You may need to be added to their checking account in order to pay bills or initiate arrangements to have bills automatically paid from their account. If you need to do this, it's a good idea to consult with an attorney or bank official first.

You should also make sure that they are getting all of the benefits they are entitled to, including social security, pensions, Medicare, and veteran's benefits. A financial consultant can also help you investigate reverse mortgages and other possible ways to find extra money to pay for care so that they can remain in their home.  A reverse mortgage or home equity line of credit on their home may also help pay for caregiving if a caregiver moves into their home. In addition, if they have long-term health insurance, read the policy carefully: Some LTC insurance pays relatives for caregiving. (A social worker can be very helpful in these circumstances; the patient's doctor may be able to give valuable advice as well.)

Make sure your loved one has an up-to-date will or living trust. They should also have a "living will," a document that expresses their desire for end-of-life care. If you can foresee a time when they will no longer be able to make their own medical decisions, ask them to give you or another trusted person "durable power of attorney for health care," which give the caregiver the legal authority to choose treatments. (Doing all this might well give you the incentive to get your own affairs in order, too.)

From here on out, you'll have to develop a close relationship with your relative's medical team, including their doctors, nurses, pharmacist, and a representative from their insurance company. Doctors and nurses can provide important instructions on topics ranging from prescription medications and insulin injections to mattress pads and bedpans. A pharmacist can review your loved one's medication list to help avert dangerous interactions between drugs and may be able to find ways to reduce the costs of prescriptions. Going with your loved one to doctor appointments and taking notes is also an important role for caregivers.

Keep in mind that your loved one will be more likely to get the coverage they deserve if you can make contact with the person at the insurance agency who is in charge of their case. Familiarize yourself with the company's guidelines and the fine print of all your relative's policies. If you feel that your relative has been unfairly denied coverage, get on the phone and make your case.

Check back for updates on this article series.