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"The Newsletter that Keeps Geriatric Professionals Up-To-Date on Important Healthcare Topics" 
An American Care Managers, LLC / American Home Care, LLC publication 


Senior Care: “Being an Unpaid Caregiver is Expensive”

To add to the poor economic conditions we are now facing are the costs associated with caring for an elderly loved one.  The cost for an unpaid paid caregiver has been increasing at an alarming rate placing extra financial burdens on these caregivers. The price of food, oil, clothing, medicine is all increasing thereby creating new financial problems for caregivers.  Currently there are more that 34 million unpaid caregivers caring for ill senior citizens in America. As reported by the AARP, these giving caregivers are estimated to be providing unpaid help valued at approximately $375 billion to the elderly each year.  

The typical caregiver is a woman in her 40’s with a husband and children. Given the difficult economic situation in today’s world many elderly have moved in with their children in order to maintain their lifestyle without having to go to an expensive nursing home.  However, this addition to the family creates new pressure, from how to cover the new expense for the ill senior citizen to dealing with how to provide adequate care for the senior loved one. Most American families are trying to figure out how they are going to pay their mortgages, feed their family, and pay their bills.  Now they have the added expense of ensuring the senior loved is able to pay for their medication, isn’t in harms way, and maintains a proper diet.

Further, on average the typically family member dedicates three (3) hours a day to the elder person they are caring for in their home.  This actually represents a revenue loss for the person that could be working to bring in another much-needed paycheck.  Or, this extra three hour time period is also the time that people typically use to wind down, relax and rest after a long day at work.  Consequently, since people are not receiving the rest they need they are now getting sicker quicker and running themselves down leading to more expenses and time away from work.

Similarly the study by AARP found that more than 1/3 of the caregivers had to reduce the hours they are working on their full-time job or quit their jobs completely in order to care for the senior person.  In addition, they also tend to spend upwards of $5,531 of their own money to cover the costs associated with the senior loved one. Hence, the time lost to bring in extra income (3 hours per day) coupled with the spending of their own monies to care for the senior person becomes a very expensive proposition. 

To add insult to injury most townships have begun reducing the support they provide families catering to caregivers by reducing the free transportation to doctors, shopping centers, and senior centers.  In fact, many of the senior centers in each town are reducing the services they offer seniors such as free meals, blood tests, and classes.  

Caregivers need as much extra support as possible.  Unfortunately the economy is not helping to promote new services or to continue existing services for seniors.  We as a community need to work together to ensure caregivers receive the resources they need to provide the care senior people require after all, we could fall into this category in the near future. 

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Senior Retirement: “Navigating New Medicare Choices”

As you may be aware the Medicare eligibility deadline is coming up for the following year.  Decisions need to be made for every person once they turn 65 and qualify for Medicare.  There is only a small period of time given seniors to choose the Medicare plan they would like to participate in.  There are two choices available, though each has numerous variations and knowing how to navigate through them can be likened to climbing Mount Everest.   This is the time period where seniors already in Medicare can add, drop, or change their service plans and prescription coverage.                   

There are typically only two options seniors are able to take when choosing a Medicare plan, a fee for service or a federally subsidized advantage plan.  Most people choosing a traditional Medicare program also tend to purchase a Medigap policy to cover gaps in coverage and separate prescription plans that covers the prescriptions they typically take annually.     

Each of the more than three dozen programs available offers a choice of monthly premiums, fees, co-payments, and deductibles to enable seniors to cover their costs.  As a result it is not easy to figure out what your annual costs will be.  Unfortunately most people get overwhelmed and tend to choose the plan with the lowest deductibles, though this is not always the right choice. 

Statistically, 44 million beneficiaries are enrolled in traditional Medicare and 9.4 million people are enrolled in Medicare Advantage (Medicare options through private companies). Consider and understand the following points when navigating the maze of choices,

Traditional Medicare consists of Part A which has no charge as long as you or a spouse has paid into Medicare via a payroll deduction, for 10 or more years, that covers hospitalization 

Traditional Medicare also has a Part B with premiums for around $96.4 a month which pays for doctor visits and other types of outpatient care

Traditional Medicare doesn't pick up the tab for everything; patients are required to pay a portion of some of their bills, via deductibles and other cost-sharing arrangements.

Seniors can purchase Medigap (officially known as Medicare Supplement Insurance) which will cover the costs that Medicare will not pick up.

Medicap options are offered by private companies and are labeled "A" through "L” offering different basic and extra benefits. The more benefits, the higher the premium.

Medigap does not cover prescription drugs therefore you should look into purchasing Medicare Part D for additional prescription drug coverage.

Medicare Advantage gives seniors the options of receiving Medicare Coverage through private insurers.  These plans typically cover a larger number of benefits such as prescription and dental.  Though the payments for these might be lower premiums, the company that insures them can change fees from year to year, restrict seniors to going to providers in their networks, have larger deductibles, and do not fully protect seniors from high medical bills.

Before choosing a plan, seniors should first ensure their doctors and local hospitals are covered in the plan they are choosing. 

HMO’s severely restrict the care seniors are able to get outside of network

PPOs allow policyholders to more readily visit doctors and receive care outside of their network. 

Make sure any plan a senior joins has a cap for annual expenditures. 

Pick carefully since it can take months to switch a plan during the Nov 15^th to March 31^st enrollment dates. 

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Senior Issues:  “Funding is Drying up for the Elderly”

Unfortunately as industry faces profit windfalls so do the states that collect tax money from these companies.  Most states across America are forecasting a large shortage in the amount of funding they typically receive from taxes and from the national government.  This means that many of the programs states were funding are being reevaluated and are either totally being cut or dramatically reduced.  One of the first programs facing large cuts across the country is support services provided for the Elderly and the disabled.  

Most states are focusing on cutting programs that allowed low income seniors to remain independent and receive in-home care such as home health aids, cooking, cleaning, etc.  Many seniors depend on these services to maintain a very basic quality lifestyle as opposed to moving to a nursing home.  Many of the seniors who will have these services terminated are going to have to quickly revaluate their living situation forcing those seniors without additional finances to leave the independent lifestyle they deserve and have grown accustomed to.   Many of these seniors will, of course, have to dip into their own small savings to pay for these services further straining what money they may have left. 

Currently 41 states are facing cutbacks and budget shortfalls forcing them to act to restrict the funding of non-critical services.  The State short sighted decision-makers do not understand that the people that they are cutting funding from are the most vulnerable.  These seniors are not able to work or take care of themselves, yet try to lead an independent lifestyle.  These cuts are going to force seniors to face the question of funding these services themselves, buy their own expensive prescription drugs, or purchase groceries to eat.  This is not a choice seniors should have to be faced with since most if not all of these services are needed for them to stay alive and lead a low level of quality existence that they have surely earned. 

Typically, when seniors deplete their personal savings they are typically forced to move into a nursing home. Clearly, the majority of senior citizens prefer to avoid a nursing home.  To their credit, the Government, over the past 8 years, has been focused on keeping seniors at home through increased home based care in order to negate the high Medicare cost of providing care for senior citizens in nursing homes.  In 2006 alone the federal/state governments spent upwards of $45 billion on nursing homes and only $15 billion on in-home care and community services.  In anticipation that some day this proportion of spending be reallocated seniors lower class senior citizens may be in for a long haul and a rough time.