This was a newspaper column on aging information sharing and focused on considerations for keeping aging and older family members in their own home environments as long as feasible. It attempted to provide information and suggestions on what the family should consider in making the choices for care giving. It was written for the Bluegrass Women's News. Additional articles featured short informational columns on aging and disabilities.
The great majority of caregivers for elderly families are women (75 percent)--a quarter of whom care for both older parents and children, and some may care for aging siblings when necessary. Caregivers--whether they are full or part-time--need respite and support; otherwise the demands and constraints of care giving can become overwhelming. If you decide to seek outside assistance, you will need to determine how much help your aging/older relative needs and what type of home care worker. The following defines home care personnel:
1. A Housekeeper or Chore Worker performs basic household tasks and light cleaning.
2. A Homemaker or Personal Care Worker provides personal care, meal planning, household management, and medication reminders.
3. A Companion or live-in provides personal care, light housework, exercise, companionship, and medication reminders.
4. A Home Health Aide, Certified Nurse Assistant, or Nurses Aide is supervised by an agency's registered nurse and provides personal care, help with transfers, walking, and exercise; household services that are essential to health care; assistance with medications, and completes appropriate records.
Nonprofit and for profit home care agencies recruit, train, and pay the workers, you pay the agency. When calling an agency be sure to ask:
The first part of this article provided information on contracting with professional agencies to provide in-home assistance to aging and older family members who need assistance to remain in their homes. While home care may not necessarily be less expensive than nursing home care or assisted living, it offers older people and their families the opportunity to remain at home and together. Home care provides flexibility and choice for the at-risk elderly that few other living arrangements can offer. What then should a family consider if they decide to coordinate and / or supervise care providers on an independent basis?
If you advertise for help, it will be necessary to screen applicants and request copies of the necessary qualifications and training certificates, request photo identification, and check references. As an employer, you will need to:
(1) check your insurance coverage for a full-time home care worker (liability, auto, etc.),
(2) withhold and match social security taxes,
(3) pay unemployment insurance, and
(4) workman's compensation.
If you do not want to deal withholdings from the employee's salary, accountants or companies that specialize in doing payrolls can assist with employee's check for the necessary withholdings and tax reports. Be certain to discuss the subject of vacations, holidays, absences and lateness as well as the amount of time each of you should give if the employment is terminated. Ask for the names, addresses, and phone numbers of people who were previous employers and contact them. Explain what you want done and how you would like it done, keeping in mind that the home care worker is there to care for the older person and not the rest of the family. Family members should participate in the interviews with the prospective home care workers and discuss the needs and limitations and their experience in care giving, and expectations of the job.
If you work and are heavily dependent on the home care worker, emphasize the importance of being informed as soon as possible so that you can make alternative arrangements, if the home care worker is going to be late or absent. There should be an alternative or backup provider which could include a list of home care agencies, neighbors, or family members who can help out in emergencies.
Assisting in the care of people who have declining health and are aging is both time demanding and may be a financial drain. Not all families are financially independent and not all may qualify for financial assistance. Recent news stories have painted the baby boomers as victims of their own spendthrift habits and unique demography. Financially strained by the demands of college-bound kids and aging parents, boomers have surprisingly scant savings. Employers are cutting back on pension contributions. Social Security has an uncertain future. However, for the "boomers" with parents who are older homeowners, there may be help under their own roofs! The Reverse Equity Conversion Mortgage program provides the opportunity for any homeowner over the age of sixty-two (62) to use the cash equity on their home for any purpose they feel is necessary and continue to own their home, live there, and make no repayments in their lifetimes. This may be money for repairs or replacement, monthly income to supplement a fixed retirement income, or purchasing support/assistance to remain in their home.
The mortgage is due when one of the following events occur:
(1) at the death of the homeowner,
(2) a permanent move out from the residence, and
(3) if they decide to sell the home.
The plan uses up the home equity and reduces the estate of the individuals. The loan advances (monthly payments or lump-sum payment) are not taxable and do not affect Social Security or Medicare benefits. There are three types of reverse equity mortgages available:
(1) Federal Housing Administration (FHA) Insured Reverse mortgages,
(2) reverse annuity mortgages; and
(3) uninsured reverse mortgages.
Trained HUD counselors are available to assist older homeowners to understand these options and determine if they are suitable. Additional information is available from AARP's Home Equity Information Center in Washington, DC, or the National Center for Home Equity Conversion (612) 933-4474. These funds may be the quickest way to have a source of money to cover the expenses of keeping relatives at home and having others take some of the care giving load. There are some cautions and the up-front costs may be high if the loan is terminated within the first five years.
Return to the Main Menu