In my latest issue of Bifocal, the bi-monthly publication of the American Bar Association’s Commission on Aging, I noticed a helpful new resource entitled Ten Legal Tips for Caregivers. Here’s a link to the document. In case you’re wondering who that “typical” family caregiver is, a recent New York Times article written by a resident physician, identified her as
a 49-year-old woman caring for an older relative — but nearly a quarter of caregivers are now millennials and are equally likely to be male or female. About one-third of caregivers have a full-time job, and 25 percent work part time. A third provide more than 21 hours of care per week. Family caregivers are, of course, generally unpaid, but the economic value of their care is estimated at $470 billion a year — roughly the annual American spending on Medicaid.
The comments section of this NYT article is both telling and heart wrenching, as there are so many stories of people who recount many of the article’s observations that this massive group of volunteer caregivers put themselves at risk in ways from which it may be difficult to recover. There is the great financial risk, cutting back on work in order to care for an elder parent. This financial strain is measurable but probably the more disturbing numbers comes from other studies concerning the lingering health effects (like depression, anxiety and chronic disease) of extended caregiving. A JAMA article from 1999 entitled “Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study” quantify the heightened mortality rates of caregivers.
So, enough of this gloom and doom, eh? Don’t let me get started on how this volunteer army’s numbers will be forced to multiply dramatically in the event the Affordable Care Act, with its Medicaid expansion services which many seniors now enjoy, is repealed. Considerable portions of the Medicaid programs for elders will likely simply disappear under the block grants which could replace the ACA’s funding of these programs, which has taken several years to put in place. Changes to Medicare from the proposed legislation known as the AHCA could compromise Medicare’s viability in a shorter time frame. That’s another blog post!
Olay, so what steps can a caregiver take to protect themselves legally? The tip sheet identifies ten different steps or competencies which the caregiver can utilize to better assist the elder for whom they provide care as well as to protect themselves:
- Understand decisional capacity
- Know what legal authority you have
- Appoint a health care agent
- Complete a financial power of attorney
- Manage Social Security/ Veteran’s benefits
- Know your rights of access to health care information
- Know the signs of abuse, neglect and exploitation
- Know your rights if you face Family Responsibilities Discrimination (a form of employment discrimination)
- Understand your rights under the Family and Medical Leave Act (federal legislation)
- Consider a Personal Care Agreement (to counteract some of the financial losses described above)
This tip sheet, like other public resources made available by the American Bar Association, contains useful and helpful information. It is a welcome reminder for caregivers that they should not wait until a health crisis to figure out the basics of how best to provide care for their elder. Making advance care arrangements and learning more about how to manage information and choices for another (using durable powers of attorney) can help take some of the anxiety out of the “what if’s” so many caregivers face on a regular basis. Turns out that taking care of the caregiver allows for better care to be provided for the elder who needs care. That’s all for now!
© 2017 Barbara Cashman www.DenverElderLaw.org