Growing number of seniors caring for other seniors

Growing number of seniors caring for other seniors

January 6, 2014 3:59 AM ET
By MATT SEDENSKY from The Associated Press

NOBLESVILLE, Ind. (AP) - Paul Gregoline lies in bed, awaiting the helper who will get him up, bathed and groomed. He is 92 years old, has Alzheimer's disease and needs a hand with nearly every task the day brings. When the aide arrives, though, he doesn't look so different from the client himself - bald and bespectacled.

"Just a couple of old geezers," jokes Warren Manchess, the 74-year-old caregiver.

As demand for senior services provided by nurses' aides, home health aides and other such workers grows with the aging of baby boomers, so are those professions' employment of other seniors. The new face of America's network of caregivers is increasingly wrinkled.

Among the overall population of direct-care workers, 29 percent are projected to be 55 or older by 2018, up from 22 percent a decade earlier, according to an analysis by the Paraprofessional Healthcare Institute, or PHI, a New York-based nonprofit advocating for workers caring for the country's elderly and disabled. In some segments of the workforce, including personal and home care aides, those 55 and older are the largest single age demographic.

"I think people are surprised that this workforce is as old as it is," said Abby Marquand, a researcher at PHI. "There's often people who have chronic disease themselves who have to muster up the energy to perform these really physically taxing caregiving needs."

Manchess came out of retirement to work for Home Instead Senior Care after caring for his mother-in-law, who, too, had Alzheimer's and whom he regarded as his hero. The experience, though taxing, inspired his new career.

Three days a week, he arrives at Gregoline's house, giving the retired electrician's wife a needed break. He carefully shaves and dresses his client, prepares breakfast and lunch, cleans the house and quickly remedies any accidents. He does the laundry and swaddles Gregoline in a warm towel from the dryer, reads him the sports page to keep him updated on his beloved Bears and sometimes pulls out dominoes or puzzles to pass the time.

Gregoline is rather sedate this afternoon, relaxing in his favorite chair while occasionally offering glimpses of his trademark wit. Asked if he remembered anything about the Army, he says: "It was a bitch!" Offered the chance to go outside, he responds: "No! I'll freeze my ass off out there!" Describing an abrasive personality of long ago, he offers: "He followed me around like a bad conscience."

Manchess has worked for Gregoline for about a year, and the men are at ease around each other. Past aides to Gregoline have been in their 20s, but Manchess says he thinks his age is an asset.

"Age can be an advantage," he said, pointing to the common conversation points and life experience, including his own health troubles and aches and pains that can come with age. "We hit it off pretty well. Maybe I didn't seem to be too much out of the ordinary."

Around the country, senior service agencies are seeing a burgeoning share of older workers. About one-third of Home Instead's 65,000 caregivers are over 60.

Like most occupations, some of the growth in older caregivers is driven by the overall aging of the population and the trend of people working later in life. But with incredibly high rates of turnover and a constant need for more workers, home care agencies have also shown a willingness to hire older people new to the field who have found a tough job market as they try to supplement their retirement income.

The jobs are among the fastest-growing positions in the U.S., but are also notoriously physically demanding, with low pay and high rates of injury. Manchess has had spinal surgery and says he's especially careful when vacuuming. He's not sure how many years he'll be able to continue this work, and he acknowledges it can be tough.

"Halfway through my shift, I'm a little weary myself," he said. "It takes its toll."

Manchess had worked as an Air Force pilot, then in real estate, then as a school bus driver, before becoming a professional caregiver. As Gregoline contentedly nibbles on his ham sandwich, Manchess wraps up his shift, turning reflective when considering his life's careers.

"I think this is about as rewarding, if not more rewarding, than any of them," he said.

Article is C/O:
Associated Press http://www.ap.org/

Matt Sedensky, an AP reporter on leave, is studying aging and workforce issues as part of a one-year fellowship at the AP-NORC Center for Public Affairs Research, which joins NORC's independent research and AP journalism. The fellowship is funded by the Alfred P. Sloan Foundation and supported by APME, an association of AP member newspapers and broadcast stations.
___

Follow Matt Sedensky on Twitter at http://twitter.com/sedensky

Become A Son Again

To us, it’s personal.

Everyone shares similar concerns about care for parents, grandparents, and loved ones reaching retirement age and beyond. Perhaps your mother experiences confusion and can't keep her medical appointments and prescriptions straight. Or perhaps you notice signs of depression in your dad, who no longer enjoys his hobbies. Maybe your grandmother suffering from Alzheimer's needs regular attention while you're at work. In difficult situations like these, Home Instead Senior Care can provide the in-home care that your loved one needs.
Becoming a Son Again

She sang you to sleep, taught you to tie your shoes, made soup when you were sick, and cheered at your games. Knowing she was always there for you gave you confidence and stability.

Now you find yourself tying her shoes, helping her with meals, and cheering for her when she accomplishes small projects. You want to provide that same confidence and stability for her without the uncomfortable feeling that you’ve become the parent in your relationship. The roles begin to feel reversed as you feel the full weight of responsibility for her physical and emotional well-being.

Home Instead understands the difficulty of maintaining healthy relationships as loved ones age, and we invite you to become a son again. With our expertise home care, we can relieve the worry you feel by assisting you in providing compassion and companionship for your loved one, freeing you to enjoy your role as a son without additional pressures.

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Earn Free CEU's: Webinar - Part of the Family Caregiver Support Series, sponsored by Home Instead Senior Care

Earn Free CEU's

10:00 AM Pacific / 11:00 AM Mountain
12:00 PM Central / 1:00 PM Eastern

Part of the Family Caregiver Support Series, sponsored by Home Instead Senior Care


Register Now for May 15


PLEASE NOTE: The webinar content will be the same, but you’ll have a chance to ask your question during the Q&A portion. CEUs will also be offered for each session.

Caregiving can be an emotionally intense experience, and some caregivers experience negative feelings that they feel the need to bury or deny. This can lead to a an emotionally, and sometimes physically, unhealthy state. If you are a caregiver, or work with someone who is, this webinar will help identify the difficult feelings that can arise, and offer solutions to deal with negative emotions.

Participants in this web seminar will be able to:
Describe five negative feelings frequently experienced by caregivers.
Identify four positive ways to cope with your feelings.
List two important benefits of not repressing your emotions.


Presenters:

Dr. Amy D'Aprix is the Executive Director of the DAI Foundation, a nonprofit organization established to meet the needs of caregivers. She is also President of Dr. Amy Inc., a company dedicated to Family Caregiver Wellness by providing access to information and education, services, support with emotional and family issues, and legal and financial support. She holds a PhD and Masters in Social Work, specializing in Gerontology, and earned her CSA (Certified Senior Advisor) - a designation for which she also trains others, as part of their accreditation.

Mary Alexander, Director of Strategic Alliances with Home Instead Senior Care corporation, actively manages strategic partnerships with companies, associations and organizations whose products, services and programs help franchise owners grow their businesses. She and her team’s focus include long-term care insurance companies, hospitals, health care organizations, work/life balance opportunities and senior industry leaders.

Our CAREGiver Meeting

What a great CAREGiver meeting we had last week!  We had a chance to provide our CAREGivers with more information on Alzheimer's, upcoming training classes as well as honoring the many CAREGivers outstanding efforts and compassionate hearts.

Help For Alzheimer's Families

In conjunction with the Alzheimer's training workshops and network-wide emphasis on Alzheimer's disease and other dementia's during Alzheimer's Awareness Month in November, we will hold a series of four Live Chats led by Alzheimer's and caregiving experts to address questions from family caregivers. Registration will start on October 19. Please register at http://helpforalzheimersfamilies.com

Home Instead CAREGivers Receive Alzheimer's Training

In mid 2009, the U.S Census Bureau released a report titled An Aging World: 2008. Highlights included the prediction that by 2040 more than 1.3 billion people around the world will be over the age of 65. In many countries, those over age 80 make up the fastest growing segment of the population, one that's predicted to increase 233% between 2008 and 2040. And it's expected that of those over 85, one of every two people will have Alzheimer's disease.

A Global Crisis

Every year, 4.6 million new cases of dementia are reported worldwide -- one new case every seven seconds. The 2009 World Alzheimer's Report estimates 35 million people around the globe are living with Alzheimer's and other forms of dementia. By 2050, the incidence will quadruple, meaning 115 million, or 1 in 85 persons, worldwide will be living with some form of dementia. The number of people with dementia is anticipated to increase by 40% in Europe and 89% in the developed Asia-Pacific countries.

Individual Needs 

To us, these statistics are not just numbers. They are individuals who require special care. They are families trying their best to care for an aging loved one. We know that the best place for a person with memory loss is in familiar surroundings. The services provided by the Home Instead Senior Care^® network of locally involved franchise offices is a valuable, trusted solution to help those struggling with the challenges of dementia to maintain a regular routine, enhancing quality of life. With more than 900 independently owned and operated offices internationally, Home Instead Senior Care is uniquely positioned to provide reliable, one-on-one senior care through more than 65,000 compassionate CAREGivers^SM. Because we've been caring for seniors with Alzheimer's since 1994, we have the experience and knowledge to help millions of families make what can be a most difficult time much less stressful.

Alzheimer's Training for CAREGivers Worldwide

Home Instead Senior Care's Alzheimer's care training programs are an important part of the training we provide. They give CAREGivers the latest in Alzheimer's education and dementia care techniques, so all franchises in your master territory can offer the care of a trusted professional, skilled in dealing with dementia-related issues.

CAREGivers are trained to:

• Maintain a safe environment
• Manage changing behaviors
• Provide nutritious meals
• Provide mind-stimulating activities
• Create social interaction
• Supervise daily activities
• Provide personal care and continence care

In addition, CAREGivers can provide assistance with enhancing and restoring the simple pleasures of life, such as a walk in the park, a ride in the car to get ice cream or spending time in the garden. These elder care activities are proven to maximize abilities and independence, and they remain one of the best treatments for this disease. Home Instead Senior Care's approach of encouragement and assistance helps family members cope with the challenges of dementia. As a Home Instead Senior Care Master Franchisee, you can offer an effective solution for this ever-growing worldwide need.

Visit the National Alzheimer's Association at alz.org or log onto the Alzheimer's Foundation web site at alzfdn.orgfor more information and resources.

Should You Pay a Relative to Take Care of Mom?

Should You Pay a Relative to Take Care of Mom?

Growing numbers of families are compensating relatives who serve as caregivers to elders. But to avoid exacerbating tensions, it is important to disclose such arrangements to the entire family.

According to a report by the National Alliance for Caregiving and AARP, 43.5 million Americans looked after a friend or relative age 50 or older in 2009, 28% more than in 2004. In a survey conducted for Home Instead Senior Care, a home-care franchiser, nearly 7% of respondents said they receive compensation for providing care to a relative.

Jeffrey Bloom, an elder-law attorney in Boston, says the number of such cases in his practice has quadrupled since before the recession. "I have several clients with adult children who are out of work," he says. "Rather than pay someone else for care, many hire the child."

Feeding the trend: the high unemployment rate, the rising cost of nursing-home care, an aging population and a 2006 change in Medicaid law that makes it harder for people who wish to qualify to give away assets. (Individuals are subject to strict limits, which vary by state, on the value of their assets in order to qualify for Medicaid benefits.)

When caregivers make financial sacrifices, elder-law attorneys say, it is often appropriate to compensate them. Some 37% of caregivers surveyed by the NAC in 2007 said they had quit a job or reduced their hours to accommodate their responsibilities.

There are several ways to compensate a family caregiver. Attorneys say many families pay an hourly wage. As an estate-planning tactic, others opt for annual gifts or a lump-sum payment designed to cover services over an extended period. Some arrange for the caregiver to receive a larger inheritance.

Which option makes the most sense will depend on factors such as the caregiver's desire for income now versus later and the care recipient's estate-planning goals. Families also must consider tax consequences. And if a parent may need to rely on Medicaid to cover future nursing-home costs, it is important to pay the caregiver in a way that is permitted under Medicaid law.

Regardless of the method selected, elder-law attorneys urge clients to disclose these arrangements to the whole family. When revealed after the fact, compensation agreements can create suspicions that result in family conflicts or even estate litigation, says Howard Krooks, an elder-law attorney who practices in Boca Raton, Fla., and Rye Brook, N.Y. (To find an elder-law attorney familiar with your state's rules, go towww.elderlawanswers.com or www.naela.org.)

Under federal law, when annual compensation exceeds $1,700, an employer and employee each owe federal payroll taxes of 6.2% for Social Security and 1.45% for Medicare. The employer must generally also pay 6.2% on the first $7,000 in wages in federal and state unemployment tax, says Melissa Labant, a CPA with the American Institute of Certified Public Accountants. (For more information, see IRS Publication 926, "Household Employer's Tax Guide.")

In many cases, people employing someone 40 hours or more a week also are required to contribute to state workers' compensation insurance pools.

Some families prefer to give caregivers tax-free gifts in lieu of compensation. Current law allows people to give up to $13,000 a year to anyone, which also may reduce the amount of a taxable estate. While each person also is permitted to give away an additional $1 million over his lifetime, such gifts reduce the amount a donor can ultimately shelter from the estate tax.

Particularly in situations where a care recipient may eventually need to rely on Medicaid, attorneys say it is important to draft a written agreement—often called a "personal care contract"—that documents the caregiver's responsibilities and hours and sets a rate of pay in line with that of local service providers.

Under such a contract, Anne Stone, 51, received $420 a week for providing 21 hours of care to her wheelchair-bound father, William Stone, 81, from October 2008 until last February, when he entered a nursing home. Ms. Stone says the payments made up for some of the income she lost when caregiving responsibilities forced her to take time away from the doggie-day-care business she operates in Sudbury, Mass.

"I was taking so much time off from work that we had to turn business away," she says.

The payments had an unanticipated benefit: They also helped Mr. Stone deplete his savings so he could qualify for Medicaid. Without the employment contract, Medicaid would have considered all of the payments to Ms. Stone a gift made to hide assets, subjecting Mr. Stone to delays in coverage, says Mr. Bloom, the Stones' attorney. To pass muster with Medicaid, he says, it is important to have such a contract in place before the services are rendered.

Rather than issue regular paychecks, some families opt to pay caregivers an upfront lump sum, typically calculated by multiplying the caregiver's hourly wage by the number of hours he or she is expected to work over a parent's life expectancy. With such a move, a family can transfer assets to a child that Medicaid might otherwise deem available to pay a nursing home.

Still, in some states, says Mr. Krooks, lump-sum payments can trigger delays in Medicaid coverage.

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