Compensating family members who care for elderly relatives in the home
Abstract
Nationwide, more than 8 million family members are providing unpaid care for loved ones 50 and older living in their household, and many who are providing constant care say that it poses a financial hardship, according to a survey conducted in 2004 by AARP and the National Alliance for Caregiving. As baby boomers face the challenge of caring for aging parents, receiving state funds for their efforts may be one way to ease the burden. In Massachusetts, the Caring Homes Program provides financial compensation, as well as training and support to these caregivers, allowing seniors to stay in their homes and communities.
Issue
As the population ages, the problem of how best to deliver care to elders becomes imminent. Allowing seniors to stay in their homes as opposed to residing in expensive nursing homes provides a family-centered multi-generational solution. However, for adults who are administering the care — increasingly those of the baby boomer generation — adding the role of caregiver to an already full schedule, can be a challenge.
Action
According to an article that appeared in the July 8, 2005 edition of The Boston Globe, the Caring Homes Program is designed to help ailing seniors remain in their homes by paying $1500 a month to caregivers. This makes it more feasible for family members to provide round-the-clock care to a senior who needs extensive help with everyday tasks, such as eating, bathing, dressing and using the toilet. Effective practices for administering the program include:
- Elders age 60 and older who meet the eligibility for the State Home Care Program, who are not receiving MassHealth, and who require assistance in at least two activities of daily living are eligible. (MassHealth offers a broad range of health-care services by paying for part or all of a MassHealth member's health insurance, or paying medical providers for services given to MassHealth members.) Additionally, participants must be able to communicate their needs for care to their caregiver in an effective manner.
- Before the state begins paying the family for the care, state contractors evaluate the senior's needs, the home's safety, and the caretaker's qualifications.
- The caregiver, who must be competent, may be a family member (except a spouse) or unrelated adult. He or she must be able to provide a supportive home environment for the elder, pass a Criminal Record Information (CORI) check, complete necessary training and be willing to take direction involving direct care from WestMass ElderCare staff. WestMass ElderCare was selected by the Massachusetts Executive Office of Elder Affairs to be one of six organizations statewide to participate in the program. WestMass ElderCare is an Area Services Access Point and an Area Agency on Aging.
- The home must meet certain physical requirements, including a bedroom for the elder. Once approved, the elder enters into a formal agreement with the terms of the program which include payment of a mutually-agreed upon room and board rate to the caregiver, a care plan developed by WestMass ElderCare and notification of status changes.
- The caregiver is responsible for assuring that the elder has appropriate services, including, but not limited to, personal care and dressing assistance, meal preparation, homemaking, shopping, transportation, medication reminders and refills. In return, the caregiver will receive an additional $50 a day tax-free stipend from WestMass ElderCare, as well as supplementary services and ongoing support from agency staff.
- A nurse, who visits monthly, and a care manager who checks the family regularly, monitor the quality of care.
Context
- In 2005, the state of Massachusetts expects to spend 1.6 billion for nursing home care.
- More and more states pay family members to house and care for seniors, but the practice has spread slowly because some people question whether society should pay for services that relatives have traditionally provided for free. Additionally, there are fears that the quality of the care will not be adequate and that the potential for abuse is greater in this type of situation.
- Massachusetts has historically had a larger percentage of its seniors in nursing homes when compared to other states. In 2001 6.8 percent of those over 65 were in nursing homes in Massachusetts as compared with 4.4 percent nationally.
- A precursor to this program — Adult Foster Care — has been in place in Massachusetts for several years, paying people to take in seniors and disabled adults who need help. But this program excludes relatives as caregivers.
- Although Caring Homes provides for paid caregiving by relatives to elders in the home, federal rules require that the program exclude spouses and dependent children as caregivers. Vermont and North Dakota, two states with similar programs, have won federal waivers or use state funds to allow spouses the ability to get paid for their caregiving services.
- Caring Homes is modeled on a program in Oregon, which was the first in the nation when it was set up in the 1980s. The Caring Homes program began in Massachusetts in March 2005 by enrolling 21 seniors on a trial basis.
Citation
Alice Dembner's article, "Program Pays Families to House Seniors," originally appeared in The Boston Globe on July 8, 2005.
Outcome
- The Caring Homes program offers the elderly a more compassionate level of care provided by people they know and are comfortable with, at a cost of about half that of a nursing home.
- Additionally, family members who must meet the needs of providing care to elders, along with other personal and professional obligations, receive financial compensation.
- In 2005 the program serves 2,000 seniors.
Evidence
By the fall of 2005 the program will expand to as many as 80 low-income seniors or disabled people, funded by $2 million in the state budget.
For More Information
Resources
* * *
DID YOU FIND THIS PAGE BECAUSE YOU ARE YOU LOOKING FOR CAREGIVER ASSISTANCE?
Be advised that the Resource Center’s Effective Practices Collection is not affiliated with the program described on this page. We do not have information about, nor can we provide assistance with, compensation for family members providing care for elderly relatives.
For more information specific to this topic, we recommend visiting the National Family Caregiver Support Program at aoa.gov/prof/aoaprog/caregiver/carefam/carefam.aspx.
Related Practices
Related sites
National Family Caregiver Support Program