Family caregivers in the United States assist millions of seniors with their activities of daily living. Together with caregivers who assist disabled relatives, an estimated 65.7 million Americans serve as family caregivers, representing 29% of the adult population.
Most family caregivers have jobs outside the home. Family members sometimes work different shifts so that someone will always be available to help a relative as needed. Others have opted to work from home, foregoing the insurance benefits that often accompany outside employment so they can respond to a relative’s needs.
Burdens of Family Caregiving
Love and respect motivate family members to take care of aging relatives. Caregiving can be its own reward. Many caregivers find that spending quality time with aging relatives enriches their lives. Providing caregiving services can nevertheless be a second fulltime job for which no compensation is paid.
Caregivers often confront financial and emotional burdens. Caregivers face extra stress when a relative suffers from dementia or health conditions that cause personality changes. The help that caregivers need to cope with their caregiving role can be difficult to find.
Community resources can provide vital assistance to family caregivers. Day centers allow families to drop off a senior for part of the day. Respite care allows caregivers to take a much-needed break to attend to their own needs. Community volunteers may be able to help with shopping, meal preparation, and financial planning.
Still, affordable services and volunteers are not always available. Nor do volunteer services typically ease the financial burden imposed by uninsured healthcare expenses. Some seniors would be better served in an assisted living facility but many families lack the means to pay for the care their relatives need.
While long-term care facilities are the best option for many seniors, they are beyond the financial reach of some families. Even the expense of a home-care worker can exceed the means of families that are living within a tight budget.
Medicare does not pay for long-term eldercare, although it may cover the cost of short-term skilled care, either at home or in a nursing home, under limited circumstances. Medicaid might cover nursing home care, but beneficiaries must typically “spend down” their own financial resources as a condition of accepting assistance. Before relying on Medicaid, it is wise to get professional advice about how assets might be protected.
Medicaid in many states will pay for some form of home care for seniors who satisfy functionality and financial eligibility standards. Available services and eligibility standards vary from state to state. Even if a senior is eligible, however, many states have lengthy waiting lists for those benefits. Seniors might wait years to obtain all the services for which they are eligible.
Expanding Assistance for Senior Care
Although caregiving options are limited for many families, President-elect Biden has proposed a plan to help family caregivers. The plan calls for increased funding for Medicaid to eliminate the waiting lists for caregiver services.
Biden’s proposal would also fund respite care and day services, create a $5,000 tax credit for family caregivers, and increase tax subsidies for long-term care insurance. Uncompensated home care work would qualify for credit toward Social Security benefits.
While long-term care was a priority in Biden’s campaign, what a newly elected president hopes to do is not always the same as what the president is able to do. The president can only propose legislation. It is up to the House and Senate to craft the legislation, if any, that Biden will sign into law.
The pandemic will likely be Biden’s first priority. A coherent COVID-19 policy will likely have an impact on seniors, including the distribution of vaccines to seniors and “a national strategy to reopen facilities to family members who have been unable to visit loved ones for eight months.”
Long-term care may be high on the list of Biden’s post-pandemic priorities, but success will depend on the willingness of the legislature to work with the new president to help seniors and their caregivers. A proposal to require paid family leave for caregivers who need time off from work to assist aging family members has a measure of bipartisan support, although one Republican version of the proposal would “allow workers to receive Social Security benefits early to offset time away from work.”
Other aspects of Biden’s long-term care plan may depend on the willingness of both political parties to engage in serious negotiation and compromise — words that seem to have been lost from the legislative vocabulary in recent years. Senior caregivers may not know in the near future whether the incoming administration will succeed in giving caregivers the assistance they need.