Helping Caregivers Prepare
By Allan S. Vann, EdD, MS
My wife, Clare, has Alzheimer’s disease and recently was placed in the dementia unit of an assisted living facility. However, when she was at home and I was her 24/7 caregiver, I had thought about what I would have done if an emergency had prevented me from caring for Clare. This was an even more heightened concern once I learned that I would soon need hip replacement surgery. If Clare were at home with me when I had the surgery, I would have had to make arrangements for her 24/7 care for the period of my hospitalization and subsequent physical therapy in a rehabilitation facility.
Fortunately, by the time I needed surgery, I already had placed Clare in the assisted living facility, so she was well cared for during my hospitalization and rehabilitation. But what if I needed this surgery earlier, while Clare was still living with me at home? What would I have done?
This is a frequent concern among 24/7 spouse or partner caregivers, especially those with no adult children or other close relatives living nearby. Social workers can provide guidance to caregivers for advance planning should an emergency cause a sole caregiver to be unable to provide 24/7 care for a loved one.
There basically are three options available if an emergency prevents caregivers from tending to their loved one: rely on family and/or friends, hire assistance from public or private agencies, or place a loved one in a respite or residential elder care facility either on a temporary or permanent basis.
Family and/or Friends
If the caregiver is fortunate enough to have family and/or friends who can come to the house to help in an emergency, this may be an ideal solution. There are no costs involved, and the person needing care will be in a familiar environment with familiar faces.
However, family members and friends who suddenly find themselves in the role of a 24/7 caregiver may be easily overwhelmed when discovering all that caregiving involves. Also, family and friends may be available for only short periods of time. But if enough family members and friends are available, perhaps a rotating schedule can be prepared. Each day would be covered for 24 hours, with different friends and relatives each providing several hours of care.
If no family members or friends can provide emergency coverage, then the caregiver must consider alternative solutions.
Public or Private Agencies
Hourly home companions, health aides, nurses, and live-in assistance are available for hire. Support can be for personal care, general supervision, engaging loved ones in hobbies and activities of interest, shopping, housekeeping, meal preparation, and various other household tasks. Caregivers should be urged to contact local, county, or state government health or elder care agencies as well as local branches of the Alzheimer’s Foundation of America or the Alzheimer’s Association to learn about services available in their areas. Local nursing homes, assisted living facilities, and elder care centers may sponsor daytime programs, provide home care services, or even provide respite programs lasting days or weeks that can be part of a caregiving solution.
However, caregivers must be aware that 24/7 home health care can be very expensive, depending on location. In the Long Island, NY area where I live, the customary rate is approximately $20 per hour, meaning that costs for 24/7 care can add up quickly: $480 per day or $3,360 per week. Unless someone has a long-term health care policy that covers a large part or all of these costs, the loved one or caregiver can quickly accrue debt.
Some 24/7 caregivers may assume they are covered because they have long-term health care insurance. However, some policies provide coverage only in assisted living facilities or nursing homes, so caregivers must check their policies carefully to see whether home health care costs will be covered in part or whole.
Placement in a Facility
If a caregiver already has been considering placing a loved one in an assisted living facility or nursing home and knows which would be chosen when the time comes, this becomes another option. If a bed is available for a loved one, a sooner-than-planned placement would provide the 24/7 care necessary if a caregiver emergency arises. Similarly, if an anticipated hospitalization or other event will prevent caregivers from providing that needed 24/7 care, then caregivers may want to consider an immediate placement of their loved ones.
Just as with home health care, assisted living and nursing home placements are costly. Where I live, the cost in a typical assisted living facility (ALF) usually is around $200 per day or $6,000 per month. Nursing home placements easily can be 50% more than ALF placements
If caregivers have long-term health care policies, they must check the criteria for coverage. If their loved one will be covered, caregivers must verify the costs for which they may be responsible. For example, Clare’s policy had a 100-day deductible period, and we were responsible for paying all costs during that time.
How Social Workers Can Help
Caregivers must be advised to prepare for emergencies. They never know when an emergency or unanticipated event may make caring for a loved one more difficult, if not impossible. The time to make such plans is before any emergency arises.
Caregivers should be advised to speak with family members and friends, investigate sources of public or private agency assistance, and explore temporary and long-term residential placement options in case an emergency should arise. Caregivers who do so will be better prepared to act if they ever need to implement emergency procedures to care for their loved one.
— Allan S. Vann, EdD, MS, is a retired public school principal writing to advocate for increased awareness of Alzheimer’s disease and to stimulate greater research funding, improve diagnosis and treatment for people with Alzheimer’s, and enhance the lives of fellow caregivers.