The Reporter (Lansdale, PA)

There’s much to consider before becoming a caregiver

- Janet Colliton Columnist

Deciding when or whether to give up doing tasks on your own or hiring someone or an agency employing someone to do it for you is one of the most unrecogniz­ed stressful activities that we are called upon to accomplish on a regular basis. This becomes especially relevant when considerin­g whether to hire caregivers for parents or your spouse or even yourself or to try to plow through on your own.

When mom or dad or your husband or wife needs assistance it is tough to tell when and how much and whether things are getting better with our help.

We can console ourselves with the idea that a crisis is a one-time event or that if we just hang in there we will get used to it. Sometimes conditions do improve and it is a one time or infrequent event and we can settle back into daily living but sometimes we have to have a conversati­on with ourselves recognizin­g when things are too much. This self-conversati­on is complicate­d by a number of factors including, not the least, the following:

• Money. Cost of outside providers could cause you to hesitate. This is not unreasonab­le but should not necessaril­y end the conversati­on. Just as you may not know all the answers on the best techniques for caregiving, you might not have considered all the possibilit­ies for help either. One of the factors that our office considers is what help is available – either through government sources or by pooling family resources – to provide that help. Another factor we consider is how realistic are the plans both for outside caregiving and for home care by family also taking family finances into account.

• Guilt. You should be able to do it yourself, right? You always have. Even though you, your parents or your family may have the money to provide outside care where you have been the caregiver, guilt can play a major role against deciding to allow someone else to come in. You might even have family that assumes you should be the one providing the care.

• Inertia. Once you begin down a road it may be difficult both for you and your family to reverse gears and try something different. They may think it always worked. Maybe it seemed to from an outside perspectiv­e but you would be able to decide yourself whether the burden it too great.

• Caregiving Preference­s. Spouses might only want their spouse to care for them. Parents might only want their daughter, son or daughter-in-law. The per-

son needing care might simply say he or she does not want a stranger in their house.

• Uncertaint­y. If you choose a cheap but unreliable agency or person be prepared if they do not show or cause other problems.

On the positive side, consider this:

• Money. In looking at the money equation, you need also to consider the personal cost to yourself if you become a full time caregiver. If you give up your own employment and with it your Social Security credits and contributi­ons to retirement or 401(k) to stay at home as a caregiver, you need to balance this out against the cost of bringing someone in even to do jobs you could handle yourself such as taking mom to the doctor’s or simple meal preparatio­n.

• Capacity. Twenty years ago the dividing line between staying at home and moving to skilled nursing was often whether a person suffered from dementia with relatively little help at home. Now, more often, the distinctio­n is whether it takes more than one person to lift or attend to the person who needs care. There can come a time when you need to decide either on extensive at home help or move to skilled nursing or assisted living with backup.

• Your Own Health. One in three caregivers dies before the person needing care. If caregiving is destroying your own health and wellbeing, consider how far you can go both for yourself and your family member.

• Caution. Finally, payment “under the table” can present dangers for tax purposes and whether the payment is later considered a “gift” that would disqualify it for benefits purposes. Seek help if you need it.

For more, listen to “50+ Planning Ahead” a weekly radio program on WCHE 1520 on Wednesdays from 4 to 4:30 p.m. with Janet Colliton, Colliton Elder Law, Assocs. and Phil McFadden of Home Instead Senior Care.

Janet Colliton is an elder law and estates attorney with offices at 790 E. Market St., Suite 250, West Chester, PA, 19382, 610-436-6674, colliton@collitonla­w.com. She is a member of the National Academy of Elder Law Attorneys. She is also, with Jeffrey Jones, CSA, co-founder of Life Transition Services, LLC, a service for families with long-term care needs.

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