Family Caregivers: Elder Care in a Post-Federal Era?

APRIL 15, 1996 VOLUME 3, NUMBER 42

Since the adoption of Medicare and Medicaid in the mid-1960s, nursing home placement has become the norm for seniors needing nursing services. Now that legislators are actively working to scale back the cost and scope of both federal and state programs providing elder care, new approaches to caregiving are being considered.

According to a recent Wall Street Journal article, one of those “new” approaches to elder care is decidedly old-fashioned. The article reports on a budding trend toward family members providing care in their own homes.

The article reports on the Bodlander family in Washington, D.C. Mother Lucy Bodlander, 80, requires assistance with activities of daily living, but family members have decided to provide that assistance at home. Mrs. Bodlander’s two children, Deborah and Gerald, alternate caring for their mother, moving her between their homes each month. Along with Mrs. Bodlander’s personal effects, they transfer one other thing each month: a full-time caretaker who lives with Mrs. Bodlander at whichever child’s house she currently calls home. The children also pay the cost for the caregiver, which averages about $2,000 to $3,000 per month.

With federal cutbacks in Medicaid and Medicare, such arrangements may become more commonplace. Currently, elders and their families pay about two-thirds of in-home care costs (up from slightly over half in the early 1980s). Elders, family and friends account for over three-quarters of all long-term care already, much of that through unreimbursed caregiving.

The Wall Street Journal article also reported on several trends which may assist with family caregiving in the future:

  • Better support for caregivers. Government, employers and others are recognizing the importance of family caregiving and the need for support and respite.
  • More flexible long-term care insurance. Home care benefits are becoming more common and more flexible, though the cost of policies remains high.
  • Technology. In-home monitors, telemedicine and other technologies promise to make care more effective and less expensive.
  • Innovative programs. In-home services, ranging from snow removal to home repair, are being developed in select elder markets.
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