Best Ways to Save: December 2021

Do You Know the Costs of Providing Care at Home?  Here’s a List From Someone Who Knows

Most older adults want to age in place and stay in their own homes as they grow older.  But doing so takes a major commitment on the part of the person who becomes the primary caregiver for a family member with Alzheimer’s or dementia.  Recently, we heard from Cliff R., a resident of South Carolina who is the primary caregiver of his wife who was diagnosed with Alzheimer’s in 2007 — fourteen years ago.

Cliff wrote: “Inflation is rising and that affects many of the basic senior needs; gas, food clothing, medicines and medical devices…One of the needs which has increased substantially is the cost of hiring help to assist the caregiver and their patients in their basic functions...”  In fact, according to the Bureau of Labor Statistics, the cost of providing care in the home rose by almost 10% from July of 2020 to July of 2021 as shortage of good home healthcare aides grew during the pandemic.      

For the first six years after his wife’s diagnosis, Cliff continued to work and care for his wife at home.  But at age 74 he retired allowing him to devote more time to his wife’s growing needs.  Most long-term maintenance care, help with daily living activities that Cliff’s wife needed, is not covered by Medicare.  But four years ago, his wife started hospice services which are covered by Medicare when the patient’s condition is so severe there is no chance of improvement.

Cliff points out the multiple ways that long term care needs escalated spending, and how the annual cost of living adjustment or COLA does not factor in the types of costs.

For those of you considering the needs of family members, here are some of the often unplanned costs, many of which are not covered by Medicare, that Cliff outlined:

  • Wheelchair or folding wheeled transporter —Although covered by Medicare, these are not free.  The patient often has a lease – to - own arrangement over a certain number of months, making payments until it becomes yours.
  • A larger vehicle — Wheelchairs don’t easily fit into a 4-door sedan and you may need something like an SUV instead.
  • Depends and bed pads — The average cost of incontinence products can run well over $200 - $300 per month and are not covered by Medicare, except in authorized hospice settings.  Even then, those bed pads are often minimal protection that requires more frequent changing.
  • Cooking and prepared meals — Caregiving is exhausting.  Augmenting with prepared frozen meals or ordering out helps keep the workload distributed while providing nutritious meals.
  • Ensure and liquid protein enhancement — At a certain point, the doctor may put liquid protein drinks such as Ensure, on the care plan.  A 30-day supply of 8 ounce bottles of Ensure, for example, will cost about $50 from Walmart.
  • Location technology —Alzheimer’s and senile dementia patients are at risk of wandering and getting confused about their location and getting lost.   Project Lifesaver is a tracking and locating program operated through local public safety agencies (such as local sheriff and police departments) that can provide registered electronic locating devices to people at high risk.  The patient wears a transmitter around their wrist, and the local police departments have receiver devices to track down missing individuals.  The cost varies by locality, but the program appears to significantly cut the amount of time a person remains lost.
  • Legal fees – Primary caregivers are likely to need legal advice and documents such as a durable power of attorney and medical directives.  It may be necessary to set up guardianship or trusts to ensure continuity of care.
  • Home health care aides — Nationwide in 2019, the average hourly fee for home health services was $16.00 to $30.00 per hour.  Good in home aides are hard to find, and the cost of services, especially when 24/7 overnight care is provided, can rival the cost of nursing home care.

Our thanks to Cliff R. who shared his remarkable story about caring for his wife.