Posted: Monday, August 21, 2023

The Costs of Middle-Class Caregiving

No doubt about it, giving full-time care to an aging loved one comes with multiple challenges to navigate. In the United States, most of the care for people with health problems, a disability, or a mental or long-term illness is provided through family and friends. Long-term care is expensive, each generation is living longer, and with inflation and the cost of everything rising, middle-class savings are being depleted during long-term care. Once all private funds are used, Medicaid can pick up the tab under certain and specific eligibility requirements, but then the state is responsible for the remainder of the bill. Estimates for individuals requiring long-term care under Medicaid and the state are 24 million by 2030, compared to 14 million in 2022.

The financial burden of caregiving can be substantial and devastating to middle-class finances. With annual costs upwards of $93,000-$120,000 for skilled nursing homes, many middle-class caregivers are left trying to figure out how to provide sufficient care without dipping into their own retirement funds. Many are trying to keep a loved one at home to cut costs and keep them comfortable, thinking it will be less expensive than a skilled nursing home.

For those who are no longer able to live independently, hiring home health aides, patient sitters or caregivers becomes necessary. “In-home, non-medical, 24-hour care often exceeds $700 per day, or more than $21,000 per month. This type of care is now more costly than skilled nursing facilities,” Blount Memorial licensed clinical social worker Edward Harper said. The continuous stream of nurses, aides and caregivers necessary to keep loved ones comfortable and safe means difficult decisions must be made about how to pay and who pays for these services. “Many are hit with sticker shock when looking into non-medical in-home care. In-home care costs increased from $17-$20 an hour in 2018 to $28-32 an hour in 2023. Middle-class families are being priced out of this service,” Harper explained.

The burden is not only financial. Most families are juggling multiple schedules for their loved ones—therapists, companions, home health aides to help bathe or dress wounds, doctor appointments, and overnight caregivers—on top of what family and friends can find time to provide. In addition to financial strain, caregivers are experiencing increased mental stress and strain, and not finding enough time to take care of their own needs. “Caregiver time, energy and attention are the most crucial and non-replenishable expenditures,” Harper added. On top of the financial, emotional and mental costs, many elderly need medical and safety equipment. For some, there are requirements for oxygen, wheelchairs, walkers, and safety items in the bathroom - such as handles and bath chairs - that become another added expense.

Many caregivers also don’t know where to turn for help in navigating the labyrinth of needs and available services for caregiving. Thankfully, in Blount County, we have multiple resources to help our caregiver community, such as Senior Services and the Dementia Care Team at Blount Memorial, as well as the Blount County Office on Aging, Blount County Sheriff’s Senior Outreach and the Blount County Office of Veterans Affairs, all of which Harper explains in his caregiver consultations. For more information about caregiver consultations, contact Blount Memorial Senior Services at 865-977-5744.

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