Are you overpaying for care?

Though this article is titled “are you overpaying for your parents’ care,” this article applies to care that spouses, siblings, etc. receive.

The author offers six suggestions to trim the care bill:

  • Hire your own home-care professionals—or become one yourself.  “There are caveats: Background checks are important, as is following state laws about working hours, disability insurance and payroll taxes…”
  • Take the tax breaks.  “If you hire paid caregivers on your own, rather than working through an agency, the parent has to report that caregiver’s income, either on a W-2 or 1099 form, to be able to deduct the expense… Home improvements made with a doctor’s prescription are tax-deductible as well…”
  • Designate a bookkeeper.  I would add that it’s important for the person with a neurological disorder to start working with the designated bookkeeper sooner than the person will need to take control over finances.  Same is true for the parent who is well to start working early on with the designated bookkeeper.  Recently a caregiver support group member complained that his daughter couldn’t remember the father’s online passwords.  I suggested that the caregiver either use a system that keeps track of passwords or designate a different bookkeeper.  (We use keepass in our family.
  • Remember the veterans.  Families often don’t know about the “aid and attendance” benefit.
  • Embrace respite care.
  • Know when to consider a permanent facility.  The certified financial planner quoted for this suggestion says that in-home care is sufficient “if you need a visiting nurse three or four times a week.”  I think the CFP should’ve referred to a non-medical home care aide rather than a nurse.  Most people, even those who require round-the-clock care, don’t need a nurse; they need non-medical personal care.

Many of the suggestions are useful only to those with financial resources.  I was at a support group meeting once where a caregiver said that “neurological disease is not for poor people.”

Here’s a link to the full article:

Family Value
Are You Overpaying for Your Parents’ Care?
Overseeing home health care for loved ones can be as big a drain on families’ resources as paying for institutional care. Here are some overlooked ways to trim the bill.
Wall Street Journal
By Kelly Greene
July 19, 2013

Beneath the article is a chart from Genworth Financial about what long-term-care costs.