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The Hidden Costs of Caregiving


Mike Clement and his wife Kaki thought their days of caregiving were coming to an end when their teenage son headed to college. But then Clement’s mother suffered a fall and had to be rescued by the local fire department. Within weeks, the Clements moved the 76-year-old woman into their Charlotte, N.C. home. As her health declined, taking care of her “involved a 24/7 focus from the family, friends and a hired caregiver,” says Clement, now 51.

The demand for informal caregivers–like family members, friends or neighbors–is expected to increase by more than 20% in the next 15 years–and by 85% in the next 40 years–as baby boomers age, data from the Dept. Health and Human Services show. Nearly 62 million Americans already care for another adult at least part-time, an expensive and time-consuming undertaking.

Many people first spot a need to take on a bigger role in a parent or older relative’s life at big family gatherings where mom suddenly seems to be wobbly on the stairs. Even caregivers who hire paid help can expect to spend an average of 24 hours each week on actual care, according to a 2007 study by the National Alliance for Caregiving and Evercare. And 56% of caretakers who live with their charge spend more than $4,500 per year on directly-related out-of-pocket expenses such as food, transportation, and medication.

But there are other difficult-to-detect costs that come along with the role of caregiver. Among white-collar workers, for example, 11% of caretakers say they “almost always” feel stressed at home compared to 7% of non-caregivers, according to a 2010 study of employees by the National Alliance for Caregiving and the MetLife Mature Market Institute. “The impacts can have a cascade effect” on a caregiver, says Marc Agronin, a geriatric psychiatrist and the author of “How We Age.” The stress and physical demands can bring about higher medical expenses and career roadblocks for anyone tending to another person, he adds.

A look at some of those hidden costs — and some ways to combat them:

Caregiving can make you sick

Caregivers of all ages have a heightened risk for chronic health problems. Among working women 50 and older, 20% of caregivers report just fair or poor health — more than double the number of non-caregivers, the MetLife/NAC study found. And nearly 26% of adult men under the age of 39 say the same, more than three times the rate of non-caregivers in that group. Among the most common chronic health conditions reported at higher rates: diabetes, hypertension, and high cholesterol. Those — and other related illnesses — can be expensive to treat and because many caregivers are strapped for time, they skip or delay medical care they need, Agronin says. That’s particularly true for full-time or nearly-full-time caregivers.

How to combat it: To carve out time for your health needs, consider using an adult day care — they charge about $75 per day — or hire a temporary home health aide once or twice a week. You can usually find a list of such services, as well as other resources, at Caregiver.org and Eldercare.gov. Agronin suggests attending a free or low-cost support group for caregivers to help ward off stress — which exacerbates illness. Find one through the Alzheimer’s Association or Caregiving.org.

Your career may hit a dead end

Nearly half of caregivers report that they’ve lost a job, had to change shifts or have missed out on career opportunities as a result of their responsibilities, a 2010 study by Genworth Financial and Age Wave found. Those lost wages, promotions and other benefits really add up over a lifetime, especially if you — like 37% of caregivers — quit your job or cut back on hours. Leaving a $60,000 a year job means foregoing $240,000 worth of paychecks over four years, the average duration of caregiving, and can mean the loss of employer benefits like insurance and sick pay. And the fact that even those who keep their jobs may be overlooked for promotions and raises because of the time they’re forced to spend away from the office is “a common and serious problem,” says Joseph Matthews, an attorney and senior editor at Caring.com.

How to combat it: Make your work schedule work for you — and the company. If you’ve established yourself as a strong performer, you can try to negotiate a flex-time or partial work-from-home arrangement with your employer. Newer companies in creative and high-tech fields often are most amenable to such arrangements, says Charles Purdy, senior editor of Monster + HotJobs. If ever you can’t meet a deadline, talk to your boss and offer alternatives. “If he wants [something] Friday afternoon and you can’t do that, offer up Saturday by noon,” Purdy suggests.

You may have to delay retirement

A full 57% of caregivers tapped their retirement savings to care for a loved one at some point during the past year, according to the Genworth Financial/Age Wave study. Add to that the fact that 63% of caretakers suffer a reduction in or loss of income because of their responsibilities. That double whammy makes it difficult to save enough to retire at a reasonable age. Cutting contributions to retirement accounts or even borrowing from them could cause you to lose critical savings, says Ted Sarenski, CPA, president of Blue Ocean Strategic Capital. For example, if you have $50,000 saved and contribute $5,000 per year less beginning at age 50, you’ll have nearly $30,000 less at age 55 than you would otherwise (assuming a modest 5% annual return).

How to combat it: Shore up your finances by taking advantage of assistance programs. In 15 states, caregivers — even family — can get paid for their services through Cash and Counseling programs which dole out payments to Medicaid recipients who can then use the money to pay their caregiver. Some long-term care insurance policies may allow for compensation to a family member for providing in-home care, though pay rates vary widely depending on the policy and some require caregivers to complete a training session to qualify. Make sure to maximize available caregiving tax deductions, including a deduction of up to $3,650 for taking care of a qualifying relative.

Enter the family lawsuit

Fights between siblings over money used to care for mom or dad are common and can lead to legal wrangling, Matthews says. Issues like who pays for care, the level of input each sibling has in caregiving preferences, and how much time each sibling spends on care also top the list of hot button issues. And “medical end-of-life issues flip out families and can cause lasting damage” Matthews adds. A legal fight with your siblings over the estate, end-of-life care or that small stipend you get for caring for mom can cost tens of thousands of dollars. Even mediation is pricey; sessions cost anywhere from $2,000 to $10,000 depending on the weightiness of the issues.

How to combat it: With the entire family present, talk over — and put into writing — health and end-of-life care preferences, as well as estate issues, says Robert Leamer, SVP and general counsel, Metropolitan Jewish Health System. All siblings and immediate relatives should sign a caregiving agreement (ElderLawAnswers.com offers an outline of this document), which lays out the financial and time responsibilities that each person will assume. If the family fighting becomes problematic, consider hiring a care manager to oversee and organize what needs to be done for a parent — and who does it, says Sarenski. Find one through the Association of Professional Geriatric Care Managers.

Read more: 4 Hidden Costs of Caregiving – https://www.marketwatch.com/story/caregiving-for-parents-what-it-can-cost-2013-02-12