Can an individual get paid to provide care to family members?
Family caregivers are taking up increasing responsibilities for their loved ones. This will a significant impact on the workforce and on health care costs overall. A recent report by the American Association of Retired Persons (AARP) found that in 2017 alone, 41 million family caregivers provided 34 billion caregiving-hours to an adult whose daily activities were limited. The value of those hours — $470 billion.
Caregivers duties can be thought of two ways:
- External: Interacting with health care and social-service providers like
- advocating their family member’s preferences,
- accompanying their family member to health appointments
- managing insurance claims
- Internal: Hands-on daily activities and complex medical and nursing tasks at home
According to the AARP report, there is no typical description for a family caregiver because they can include both men and women who span all age groups, races, socioeconomic backgrounds. Often, a caregiver juggles their career and caregiving or they give up paid work for full-time caregiving duties, which can be both a financial and emotional strain.
Family caregivers spent on average $7,000 out-of-pocket on caregiving costs in 2016.
A NEED FOR POLICIES
There is a need for policies that will recognize, support and compensate-for the significant contributions of family caregivers. Certain federal and state-level policies have been developed to support caregivers:
- Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act, which became law in January 2018, directs the Secretary of Health and Human Services to develop a national family caregiving strategy that will identify the actions of communities, providers, government and others to support family caregivers.
- Caregiver Advice, Record, Enable (CARE) Act: The CARE Act was formulated to ease a patient’s transition between their home and hospital by requiring hospitals to record the name of the family caregiver on the electronic medical record and educate them on the medical tasks they’d need to perform for the patient at home. CARE is now a law in 43 states.
- CARE Act wallet card for your state can be found here
- Family and Medical Leave Act (FMLA): FMLA is applicable to private-sector employers with at least 50 employees, public agencies and public or private elementary and secondary schools. This act offers job protection and allows you to take up to 12 weeks of unpaid leave over 12 months for the following family and medical reasons:
- Birth of a child or adoption
- To care for an immediate family member
- If you have a serious health condition
- An emergency associated with an immediate family member being on, or called to, active duty.
State-based FMLA information is available here.
- Paid family leave: 8 states (California, Connecticut, Massachusetts, New Jersey, New York, Oregon, Rhode Island and Washington) and Washington, D.C., have enacted paid family leave laws. Specifics on who and what qualifies for coverage can be found here.
- Some states are compensating caregivers who work full time. Hawaii passed the Kupuna Caregivers Act in 2017 to assist caregivers who are providing for their elders so they can remain in the workforce. The program provides a voucher of $70/daily to cover specified costs that would otherwise be paid for by a qualified caregiver.
Directly and Indirectly Getting Paid to Provide Care to Family
Resources are available that can ease the financial stress on patients and their family caregivers—it’s simply about knowing where to look.
- Long-term care insurance: Paying out-of-pocket, especially for a home-health aide, can be very expensive (the national average is $4,385/month). If planned in advance, older adults can buy a long-term care insurance plan or a life insurance policy that covers long-term care (hybrid policy). Those younger than 60 years are less likely to be approved for long-term care policies.
- Government assistance: This comes in various forms.
- Medicare: Original Medicare can completely cover necessary home health care, including nursing care; home health aide services and occupational, physical and speech therapy. It also covers intermittent or part-time routine home care. Medicare Advantage plans (Medicare provided by private health plans) offer broader benefits.
- Medicaid: It pays for in-home care, some residential and assisted living care and nursing home care. Eligibility for home health services may vary by state.
- Veterans programs: Veterans can qualify for 4 plans:
- Veteran-Directed Care: Veterans can manage their own long-term services and support at home (their own or a caregiver’s home) instead of a long-term care facility. The budget averages at $2,000/month.
- Aid and Attendance benefits: This supplementary assistance is meant for a caregiver who could be a family member.
- Housebound benefits: For veterans who are confined to their residence due to a permanent disability.
- Program of Comprehensive Assistance for Family Caregivers: Provides a monthly stipend for family caregivers who care for veterans who sustained a traumatic injury in the line of duty on or after September 11, 2001.
Contact your local VA center for specific health benefits.
- PACE: Programs of All-Inclusive Care for the Elderly provides community-based care for Medicare and Medicaid beneficiaries, instead of in a nursing home or care facility.
- Tax breaks for caregivers: Medical home care can qualify for a federal tax deduction.
Adult children caring for their live-in parent can get a tax break for a dependent parent if they provide more than 50% of the financial support. The IRS has a tool to help you determine if you qualify.
There are programs where you can get paid to provide care to family who are elderly, but these vary by state. You can find specific programs in your state here.
Several non-profit organizations also provide financial assistance in the form of grants for specific disease conditions. A list of such disease-specific organizations is available on the website of the Family Caregivers Alliance here.
- Medicare’s tips for family caregivers: https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/AskMedicareCaregiverSupport.pdf.
- HHS resources for caregivers: https://www.hhs.gov/programs/providers-and-facilities/resources-for-caregivers/index.html.
Additional caregiver resources:
Articles about Caregiving from the caregiver’s perspective:
The Challenge of the Alzheimer’s Caregiver – By Patients Rising
When You Become a Caregiver, Everything Will Change – By Sylvia Faircloth
Patients Rising University acknowledges the important contributions of Surabhi Dangi-Garimella Ph.D. in this article. Improving patient access is our mission and we’re happy to utilize a variety of experts to carry that out.