Deciding when or whether to give up doing tasks on your own or hiring someone or an agency employing someone to do it for you is one of the most unrecognized stressful activities that we are called upon to accomplish on a regular basis. This becomes especially relevant when considering whether to hire caregivers for parents or your spouse or even yourself or to try to plow through on your own.
When Mom or Dad or your husband or wife needs assistance it is tough to tell when and how much and whether things are getting better with our help and we do not want to concede that it is beyond our abilities. This is especially true when the tasks seem like something we should be able to do on a day to day basis.
We can console ourselves with the idea that a crisis is a one time event or that if we just hang in there we will get used to it. Sometimes conditions do improve and it is a one time or infrequent event and we can settle back into daily living but sometimes we have to have a conversation with ourselves recognizing when things are too much. This self-conversation is complicated by a number of factors including, not the least, the following.
Money. Cost of outside providers could cause you to hesitate. This is not unreasonable but should not necessarily end the conversation. Just as you may not know all the answers on the best techniques for caregiving, you might not have considered all the possibilities for help either. One of the factors that our office considers is what help is available – either through government sources or by pooling family resources – to provide that help. Another factor we consider is how realistic are the plans both for outside caregiving and for home care by family also taking family finances into account.
Guilt. You should be able to do it yourself, right? You always have. Even though you, your parents or your family may have the money to provide outside care where you have been the caregiver, guilt can play a major role against deciding to allow someone else to come in. You might even have family that assumes you should be the one.
Inertia. Once you begin down a road it may be difficult both for you and your family to reverse gears and try something different. They may think it always worked. Maybe it seemed to from outsiders but you would be able to decide yourself whether the burden it too great.
Caregiving Preferences. Spouses might only want their spouse to care for them .Parents might only want their daughter, son or daughter in law. The person needing care might simply say he or she does not want a stranger in their house.
Uncertainty. If you chose a cheap but unreliable agency or person be prepared if they do not show or cause other problems.
On the positive side, consider this.
Money. In looking at the money equation, you need also to consider the personal cost to yourself if you become a full time caregiver. If you give up your own employment and with it your Social Security credits and contributions to retirement or 401(k) to stay at home as a caregiver, you need to balance this out against the cost of bringing someone in even to do jobs you could handle yourself such as taking Mom to the doctor’s or simple meal preparation.
Capacity. Twenty years ago the dividing line between staying at home and moving to skilled nursing was often whether a person suffered from dementia with relatively little help at home. Now, more often, the distinction is whether it takes more than one person to lift or attend to the person who needs care. There can come a time when you need to decide either on extensive at home help or move to skilled nursing or assisted living with backup.
Your Own Health. One in three caregivers dies before the person needing care. If caregiving is destroying your own health and wellbeing, consider how far you can go both for yourself and your family member.
Caution. Finally, payment “under the table” can present dangers both for tax purposes and whether the payment is later considered a “gift” disqualifying for benefits purposes. Seek help if you need it.
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.