2. Caregiving IS in Your Future: Family and Financial Challenges Jean F. Austin FCS Educator, Maryland Cooperative Extension 2007 ESP Annual Conference It is the policy of the University of Maryland, Agricultural Experiment Station and Maryland Cooperative Extension, that no person shall be subjected to discrimination on the grounds of race, color, gender, religion, national origin, sexual orientation, age, marital or parental status or disability. Equal Opportunity Employers ~ Equal Access Programs

3. September 2007J.Austin, ESP National Conference3 Caregiving: Family and Financial Challenges There are only 4 kinds of people in the world: There are only 4 kinds of people in the world: Those who have been caregivers Those who have been caregivers Those who are caregivers Those who are caregivers Those who will be caregivers Those who will be caregivers Those who will need caregivers Those who will need caregivers

4. September 2007J.Austin, ESP National Conference4 Caregiving: Family and Financial Challenges What do we know about caregiving in the US? What do we know about caregiving in the US? Who are the caregivers? Who are the caregivers? What is the cost of caregiving? What is the cost of caregiving? What is the value to society of family caregiving? What is the value to society of family caregiving? Where do caregivers need community and public policy support? Where do caregivers need community and public policy support? How can families and individual caregivers better prepare? How can families and individual caregivers better prepare?

5. September 2007J.Austin, ESP National Conference5 Caregiving: A Brief History Families are the most common social structure for providing care Families are the most common social structure for providing care 18 th century -- later life or long term care (LTC) meant having wealth and children 18 th century -- later life or long term care (LTC) meant having wealth and children 19 th century -- poor houses and old age homes serve indigent elderly in cities 19 th century -- poor houses and old age homes serve indigent elderly in cities 20 th century – many changes in approach, the depression, post WWII, Medicare and Medicaid in the 1960’s 20 th century – many changes in approach, the depression, post WWII, Medicare and Medicaid in the 1960’s

6. September 2007J.Austin, ESP National Conference6 Caregiving Today Increase in life expectancy Lower population growth in US More older persons survive to a point of needing care 22.4 million households (nearly 1 in 4) include at least one caregiver for someone >50yrs old

7. September 2007J.Austin, ESP National Conference7 Caregiving Statistics Most women will spend 17 years caring for children and 18 years helping an elderly parent American businesses loose between $11 -- $29 billion each year due to employees’ need to care for loved ones >50yrs

8. September 2007J.Austin, ESP National Conference8 Caregiving: Financial Basis Family caregivers provide 80% of the dollar cost of all home care services Only 20% comes from Medicare and Medicaid

9. September 2007J.Austin, ESP National Conference9 Estimated Caregivers by State

10. September 2007J.Austin, ESP National Conference10 Caregiving Statistics Women caregivers are 2.5 times more likely to live in poverty than non-caregivers Women caregivers are 2.5 times more likely to live in poverty than non-caregivers Women average 13 years of zero earnings due to caregiving Women average 13 years of zero earnings due to caregiving Women are more likely to take a part time job to accommodate caregiving Women are more likely to take a part time job to accommodate caregiving The pool of family caregivers is dwindling. In 1990 there were 11 potential caregivers for each person. In 2050 the estimate is 4:1. The pool of family caregivers is dwindling. In 1990 there were 11 potential caregivers for each person. In 2050 the estimate is 4:1.

11. September 2007J.Austin, ESP National Conference11 Children as Caregivers 2002 3rd International Family Care Conference cited the need to better understand the role of child caregivers as a key priority

12. September 2007J.Austin, ESP National Conference12 Children as Caregivers Estimated 1.4 million children between 8 and 18 years old provide care for an older adult Estimated 1.4 million children between 8 and 18 years old provide care for an older adult Seven in ten child caregivers are caring for a parent or grandparent. One in ten is helping a sibling. Seven in ten child caregivers are caring for a parent or grandparent. One in ten is helping a sibling. Over half (58%) of child caregivers help with at least one ADL Over half (58%) of child caregivers help with at least one ADL One third help with medications One third help with medications Child caregivers have more behavior problems and schoolwork issues than their peers Child caregivers have more behavior problems and schoolwork issues than their peers

13. September 2007J.Austin, ESP National Conference13 Caregiving Relationships A child being raised by a grandparent A husband who has had a stroke A wife with Parkinson’s disease A mother-in-law with cancer, a grandfather with Alzheimer’s A son with traumatic brain injury from an auto accident A friend with HIV/AIDS

14. September 2007J.Austin, ESP National Conference14 “Stages” in a Caregiving Career 1 – Performing caregiving tasks 2 – Self–identification as a caregiver 3– Performing personal care 4 – Seeking assistance and using formal services

15. September 2007J.Austin, ESP National Conference15 “Stages” in a Caregiving Career 5 – Considering nursing home placement 5 – Considering nursing home placement 6 – Institutionalization 6 – Institutionalization 7 – Termination of the caregiving role 7 – Termination of the caregiving role

16. September 2007J.Austin, ESP National Conference16 Caregiving Supports and Resources Children & other family members Children & other family members Senior centers, adult day care Senior centers, adult day care Paid services Paid services Employer benefits Employer benefits Public benefits Public benefits Disease specific support organizations Disease specific support organizations

17. September 2007J.Austin, ESP National Conference17 Financial Challenges Have a financial plan Have a financial plan Calculate Net worth Calculate Net worth Manage credit and debt Manage credit and debt Organize records and Organize records and personal papers personal papers Avoid scams and fraud Avoid scams and fraud Negotiate the cost of paid Negotiate the cost of paid services services FINANCIAL GOALS M R T pecific easurable chievable esults-oriented rackable A S

18. September 2007J.Austin, ESP National Conference18 Financial Challenges Review insurance Medicare Medicaid Long term care End of life planning

19. September 2007J.Austin, ESP National Conference19 Financial Challenges Will, trust Will, trust Durable medical power of attorney Durable medical power of attorney Durable financial power of attorney Durable financial power of attorney Advance directives Advance directives Letter of last instructions Letter of last instructions Preplan funeral Preplan funeral Legal advice Legal advice

20. September 2007J.Austin, ESP National Conference20 Caregiving Case Studies Johnson Family Johnson Family Paul and Marie Evans Paul and Marie Evans Waxman Family Waxman Family Randy Hill Randy Hill Smith Family Smith Family

22. September 2007J.Austin, ESP National Conference22 Caregiving Evaluation 1. Was your interest in this program personal, professional or both? 2. How well did the program meet your expectations? A little A little Some Some A lot A lot 3. What suggestions do you have to improve the program?

23. Caregiving IS in Your Future: Family and Financial Challenges Jean F. Austin FCS Educator, Maryland Cooperative Extension AAFCS 2006 Annual Conference It is the policy of the University of Maryland, Agricultural Experiment Station and Maryland Cooperative Extension, that no person shall be subjected to discrimination on the grounds of race, color, gender, religion, national origin, sexual orientation, age, marital or parental status or disability. Equal Opportunity Employers ~ Equal Access Programs