Elder Care: Finding the best care-giver and knowing the costs

Caring for an aging parent or loved one can be overwhelming especially when it comes to understanding the often confusing details about what type of care to choose, the cost of care and how to pay for it.

In my previous article, Elder Care: Know Your Options and Where to Get Help, I explain the difference between Geriatric Care Managers and Care Coordinators, what services they perform, and when you might use one rather than the other.  Just as important is knowing how to find the best care-giver and the costs of care.

Choosing the Right Provider

As soon as a client calls to tell me that their loved one needs care, I let them know that help is out there.

If they have a long-term care policy, I suggest they call the insurance claims department to get the process started and meet with the care coordinator provided through their long-term care policy. Should they want additional assistance, or don’t have a policy, then I suggest they contact a geriatric care manager. The National Association of Geriatric Care Managers has a comprehensive list online; our firm also maintains a list of recommended professionals in our area. Clients have also found help by seeking recommendations from friends, neighbors, or their religious community.

Pricing models vary but services are commonly billed on an hourly basis, based on the needs of the patient and family. In the Washington, D.C., area, where we are based, the average rate is about $130 per hour; by contrast, hourly rates in California can top $250.

Payment Strategies

Most commonly, clients cover the cost with long-term care policies, because geriatric care managers can qualify as private care help.

But today’s policies are not as generous. I recently spoke with Janet Kidd Stewart, who writes a syndicated retirement column for the Tribune papers. In her article, How to Choose the Best Options for Long-Term Care, I mention that several years ago, long-term care policies were cheaper, had better daily benefits and unlimited riders – things that don’t exist today. As rates rise, you may have to decide whether paying a higher premium or settling for lower benefits makes more sense for your situation.

If the bill needs to be paid out-of-pocket, however, our recommendation for doing so depends on the financial resources and status of the patient. Patients who have the financial means should pay the bill and perhaps look to reduce the burden by writing off the medical expense.  If the patient is getting financial help from a relative or other loved one, that person could pay the provider directly to avoid making a gift. And if the patient is considered a dependent, the custodian could use their pre-tax HSA dollars.

Be sure to check with your tax advisor before deciding on a payment strategy.

Taking care of an aging parent or loved one can be an exhausting act of love. The peace of mind in knowing that a qualified caregiver is available to help manage and coordinate the care of your loved one could mean the world to you and your family.