This month is a time to reflect on the sacrifice and benevolence of family caregivers. These caregivers are almost always unpaid, dedicating their lives to supporting a family member or loved one in need, with little or no training or additional financial support. Usually, the decision to become a family caregiver is not much of a choice, people become family caregivers out of necessity. Even with hospice or other support, caregiving is more than a full time job and caregivers are often forced to dip into their savings, use all their sick days/PTO days and then some, or even quit or take leave from their job. Whoever you are caregiving for, your care is a selfless gift to your loved one. If you are a caregiver for a loved one who is not in a mindset to understand or appreciate the sacrifices you make for them, or who is hostile towards you, the already thankless job of being a family caregiver can feel even more hopeless. This month, we recognize and support you.

Steps You Should Take Now to Put Yourself and Your Loved One in the Best Position Possible Once it is Time to Start Providing Care

1. Hire an Attorney to Execute Power of Attorney for Finances and Healthcare

As a caregiver, it’s going to be necessary for you to talk to doctors and possibly manage finances for the person you’re providing care to, and you should be listed as an agent on powers of attorney. If your loved one is in a position where they need a caregiver, they certainly need a power of attorney. Don’t wait until it’s too late and your loved one lacks the capacity to sign these documents. Contact an elder law attorney to get a Power of Attorney in place at the same time that you start caregiving.

2. Create or Update Your Loved Ones’ Estate Plan

Even if Estate Planning documents (like a Last Will and Testament, Revocable Living Trust, Beneficiary Deed, etc.) are in place for your loved one, do they still reflect their wishes? Now it is the time to sit down as a family and discuss what they want. As your loved ones health declines, you want to be able to focus on their care and comfort - not scrambling to avoid probate on their assets after death. Finalize the estate plan before you need to, because fighting through the red tape and delays of probate will be that much more difficult when you’re mourning.

3. When the time Comes, Execute a Proper Care Contract

For family caregivers, a well drafted Care Contract is the strongest weapon in your arsenal to preserve your loved one’s Medicaid eligibility if they need to enter a skilled nursing facility in the future. If you are caregiving for someone and receiving or transferring any money out of that person’s accounts, it is extremely important to have a care contract which complies with your State’s Medicaid laws. If there is no Care Contract in place, the payments made to a family caregiver are considered a “gift” or a “transfer of assets” for Medicaid eligibility purposes and the State will impose penalties which can result in ineligibility. Both Kansas and Missouri have specific requirements for personal care contracts. Generally speaking, both states require a written agreement, signed and dated on or before the date the services are to begin, specifying the services that are to be provided and the rates that are to be paid (which must be fair market value).

4. If You are Providing Shelter in Addition to Care, Execute a Rental Agreement

Rental Agreements are useful for family caregivers when the family caregiver lives with the person they provide care for. Like a care contract, a valid rental agreement will preserve your loved ones’ Medicaid eligibility by preventing Medicaid from penalizing transfers and payments that are made to a family caregiver in exchange for living expenses.

Taking Care of the Caregiver (That’s YOU)

Remember that you are More Than a Caregiver

Take care of yourself. Constantly putting the needs of others before your own is exhausting, and it’s easy to feel depressed because your hard work goes unnoticed. Dementia can cause people to become bossy or critical of the ones they need the most, and separating your loved one from their diagnosis is easier said than done. Be aware of your limits. If you are jeopardizing your own health and well-being to fight through a situation that has become unsustainable, it’s time for a new solution. Don’t go down with the ship - sometimes caring for your loved one means recognizing that you can’t do it alone and reaching out for help. Placing your loved one in a facility doesn’t mean that you’ve stopped caring for them, just that you’re caregiving in a different way. Let go of guilt and societal expectations and focus on what’s possible, not on what your situation might look like in an ideal world.

Take Advantage of Adult Daycare and Respite Programs Available

Adult day care programs are community-based and provide a safe, supervised alternative to seniors who are unable to live on their own, but do not yet require 24-hour skilled nursing. They are an important step for individuals between living independently in their own home and round-the-clock care in a care facility. Not only are adult day care programs therapeutic for the senior, often postponing or even eliminating the need for nursing home care, but they also provide much-needed respite to family members caring for their loved ones.

Some programs accept Medicaid which means if you or your loved one otherwise meet the income and resource requirements, Medicaid may pay for all or a portion of the cost of this service. The VA may assist with the cost depending on your financial resources and level of need. Other sources of funding available include Federal Older Americans Act funds, public and private grants, and in Kansas, the Kansas Senior Care Act Program.

Join a Support Group

Groups like the Caregiver Action Network, The Alzheimer’s Association, and The Family Caregiver Alliance (to name just a few) host a variety of support groups online and in communities across the Nation. Whether you need answers, support, or just a listening ear, these support groups can go a long way to alleviate the isolation and hopelessness that can come along with caregiving.

Don’t Lose Sight of the Need to Plan for Yourself

Many clients, as they shepherd their elderly parents through the elder care journey, ask us the same question: “What can I do now to prevent my children from having to deal with all this?” The answer is, get an Estate Plan in place, get a Power of Attorney, consult a financial advisor. Tie up any loose ends now while you’re still the one who is able to tie them.