BOSTON – Workers who take time off to provide care of one sort or another to family and friends cost American business somewhere between $17.1 billion to $33.6 billion, says a new MetLife Mature Market Institute study. This week, I would like to add my two cents, both literally and figuratively, to that amount.
I have recently returned from spending four days in Florida providing care to my 76-year-old father, who is for all intents and purposes wheelchair-bound, and to my 71-year-old stepmother, whose recent surgery will leave her unable to lift or drive for about two months and will, likely, leave her unable to serve as my father's primary caregiver for a spell.
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In the wake of her surgery, my father needed help getting in and out of bed, as well as help bathing, getting dressed and eating. So, I purchased a $438.60 roundtrip ticket to fly 1,400 miles from my home to my dad's condo in a retirement community and, in the parlance of professionals, became a "Level 3-5 intense caregiver."
Before hopping on the plane, however, I followed my own advice. I contacted a geriatric-care-management firm to schedule an appointment with a professional who could assess my father's and stepmother's health-care needs, create and implement a plan and monitor progress. The cost for that plan? Roughly $600. And the cost to provide ongoing management would be $130 per hour and $45 for every visit.
The situation wasn't desperate, but it was difficult. Six of the seven adult children in this now blended family live and work in New England and one lives about 700 miles away. In essence, there is no adult child who could provide ongoing care for any extended period.
Yes, in the short term, the adult children could and did vacation time and an unpaid leave to serve as caregivers. In the week of my stepmother's surgery, two step-sisters flew down to provide care to their mother and I flew down to take care of my father.
While there, my step-sisters and I went full tilt. The geriatric-care manager, for instance, gave us several tips to make the condo more livable and safe. We pulled up all the throw rugs, for instance. Such rugs are an accident waiting to happen to walkers with canes and the like, the geriatric-care manager said. We bought a cordless phone (about $28) to put in the living room. We bought two condo keys (about $4) to give to neighbors, just in case someone needed to get in the condo in an emergency. And we removed the glass doors on the shower stall and installed a shower curtain and rod (about $25) so that our respective parents could easily enter and exit the shower.
Affairs in order
The geriatric-care manager also suggested that our parents put their legal affairs in order, just in case either or both of them became incapable of making decisions for themselves or, worse yet, died. She advised, at a minimum, naming a durable power of attorney to take care of their financial affairs, naming a health-care surrogate to make health-related decisions on their behalf and signing a living will expressing their wishes about medical treatment and end-of-life decisions.
She also offered the names of several attorneys in the area who could execute those and other legal documents, including wills and trusts, if need be. In one call to a law office I learned that the cost of the incapacity documents would be $850. I also learned that with the help of a notary public I could execute the "incapacity planning" documents for free. My step-sister, who works for a lawyer, will be able to hand walk them through the documents and help them understand what they are signing. The lawyer's office also spoke of the need to learn more about Medicaid, and the possibility that my father and stepmother could qualify for state help.
And, the geriatric-care manager provided the names of several home-aide firms that might fulfill my father's health-care needs after all the adult children caregivers returned to their respective homes. He needed, as best as I could judge, about one hour of help in the morning getting out of bed, bathing and dressing and about one hour of help at night getting back into bed.
I called several firms, most of which said the same thing. Most don't provide split shifts and most had a three-hour minimum, which best case would cost $15.50 per hour for hands-on care and slightly less for companion care. (Companion care, I learned, means the aide cannot do any lifting in and out of beds and wheelchairs, among other things.) The aide provides, in addition to the heavy lifting, other services including housekeeping, meal preparation, bathroom cleaning and sheet changing as well as grocery shopping and errand running.
In the end, after a couple hours, I finally found a firm that could provide the care I wanted for my father but at a cost — $25.95 per one-hour visit, which was called a bath visit, or $51.90 per day.
I also called, again at the geriatric-care manager's suggestion, electronic-monitoring services that provide customers with either a pendant or wristband that they can press in case of an emergency. The cost for one of the more popular services was $89 for the setup and $39.95 per month. (I ultimately agreed with my father that he could do without those services.)
Along the way, I also drove to the pharmacy to pick up more than $100 in prescriptions, still unsure which Medicare Part D prescription plan my father and stepmother have.
True costs
After four days came and went, I took a taxi to the Florida airport and another from the airport in Boston home. The cost with tips and food along the way? $150. It's turning into a pricey trip as well as (with all apologies to MasterCard) a priceless trip. My father and I accomplished a lot more in four days than we did in the previous four decades. What's more, my stepsisters, who once were nothing more than acquaintances, are sisters.
And I have learned another important lesson. I'm keen of mind and yet I found navigating the health-care, legal and financial maze near impossible. If you know the loopholes, some people can qualify for Medicaid. I can't imagine how the elderly in this country can do the same, especially in times of distress, without some sort of help from family, friends or professionals.
For me, I have learned that the true cost of caregiving in this country goes far beyond the statistics about absenteeism, partial absenteeism, workday interruptions and unpaid leave. The true cost is much greater than what can be calculated in dollars and cents. The true cost is immeasurable — and devastating.
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