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Women and Caregiving: Are They Synonymous?

by Betty Soldz

Caregiving for a sick and aging spouse, companion, sibling or parent is still seen as a woman's responsibility. There are over seven million caregivers in the U.S. and 75% of them are women. It is quite likely that sometime in your life you will be called upon for caregiving assistance.
    The role of women today has changed dramatically. Many women have family and/or work obligations that conflict with caregiving responsibilities. We have become a very mobile society and many of us live far from those who need care. Due to the increase in life expectancy, many women who are called upon to care are in their late 60's or 70's or even older.
      Caregiving, especially of a spouse, comes at a time in a woman's life when she should be thinking about who will care for her in her own later years when she may well be alone. Many women who visit this website are thinking ahead to their own retirement or have retired and are looking forward to the opportunities the years ahead can offer. Others are working and raising their children and at the same time trying to care for parents and other family members. What is a woman's responsibility? What are her options?
     Every caregiving situation is affected by the caregiver's age, health, finances, family network, where the person needing care (care recipient) lives, and what they can do for themselves. Always make an effort to involve the person you are caring for in the actual planning aspects of their care and allow him/her to do as much as they are able to do.
     If you are 50 or 55 years of age you will be affected by this task differently than if you are older. The younger you are the easier it is to handle this physically and mentally exhausting task. However, if you are employed and/or raising children this could be daunting. If you are in poor health this, too, adds to your burden. If you or your care recipient have adequate resources you have the ability to purchase services, usually referred to as formal services. If one has a very low income, help may be obtained from government programs but, unfortunately, many of those who need or give care fit in the middle. In spite of available formal services many caregivers, especially spouses, do not seek formal help until they have been caregivers for four years or more. This is because they fear becoming impoverished and worry about how they will be able to purchase services when they need them.
     If the one who will need care has a caregiving friendly home without stairs to climb and with safeties such as grab bars in the tub and toilet, etc., or he/she lives in an assisted living or life-care facility, your task will be easier. Lastly, if you have a large family network you may be able to get some assistance with caregiving.
     What do you need to do to prepare yourself for this job?

Investigate availability of services and how to access them

Determine how to pay for services

Investigate care managers

Develop a plan to prioritize needs

Investigate alternative housing

Learn how to ask for help

Learn what changes make a home "disabled friendly"

Organize care recipient's personal and emergency information

Recognize your personal limitations

     In other words, knowledge, preparation, having a plan and setting limits lead to effective caregiving.
    The first place to start in seeking the information you need is at your Area Agency on Aging. Many will have a resource list of available services to assist caregivers. Once you know what services are available you need to consider how they can be financed.
      If the care recipient has Long Term Care Insurance (see Betty's previous article Long Term Care Insurance), it will assist in paying for services. The care recipient's or family's assets may be sufficient to provide needed services. Those with low income and assets should look into public programs such as Medicaid and In-home Support Services (IHSS); more information about these services can be found through the Social Services or Human Services department in your county (look under 'County Offices' in your phone book). If the person you are caring for owns a home, you may want to investigate a Home Equity Conversion or 'Reverse Mortgage'. Life insurance policies are now being sold with long term care benefits which will help in the purchase of formal services. Some companies are making Viatical (financial) settlements on life insurance policies.
    The first step in managing caregiving is to determine what type of help will be needed and then make a plan. Some, who can afford the expense, especially if they live far from their care recipient, choose to hire a care manager who can help with the caregiving plan and even employ the needed services. The cost of a care manager can be anywhere from $75 to $150 per hour.
    Others of you will make your own plan. For those making their own caregiving plan, the next step is to assess what help may be needed. The following is just a short list of possible assistance needs that should be prioritized: dressing, bathing, walking, toileting, eating, paying bills, household help and transportation. Care needs will change as the situation changes and your plan will then need adjustments. In the beginning care recipients may need very little help but later they may need further assistance in making and executing additional decisions.
     Next, anticipate what you will be able to do and, in doing so, be realistic. Know what you can handle and do not take on more than you can do. If you are employed and raising a family, you may want to plan for as much help as possible It is important to recognize your responsibility but also your limitations. Now is the time to ascertain what help others can offer. To do this, have a family conference. Find out what help each member can realistically provide. Although the majority of sons are not involved in hands-on-care, many are willing to help financially, perhaps assist with paperwork, home repairs or provide a respite from your duties.
    Neighbors, friends and members of a religious organization can sometimes be called upon. Friends can call and check on the one who needs care and perhaps provide transportation to the doctor, pay a visit to give you some respite or assist with small home repairs. 'Meals on Wheels' delivers cooked food to a home free of charge or for a small contribution; get in touch with your local senior center to investigate this option. Neighbors may be willing to bring in the mail and pick up groceries when they are going to the store.
    Now that you have some idea of what help is available, it is important that the home be made safe for a disabled person. Some suggestions are to pick up all throw rugs, put grab bars by the tub and toilet and install improved lighting at stairways and entrances.
     If the one who needs care moves to an assisted living or continuing care facility your burden will be much lighter. (I'll address this in a later article on alternative senior housing.) Many women are deciding that this type of housing is a viable alternative when they cannot give hands-on-care. Most state Departments On Aging have lists of such facilities.
      In preparing for your own future needs, as well as those of the person you're caring for, be sure to organize pertinent personal and emergency information such as doctors' and lawyer's phone numbers, a list of medications, a living will and durable power of attorney for health care as well as a list of resources. An understanding of the finances of the prospective person needing care is necessary to aid in the decision-making process.
     Now you need to be sure that you have planned for your own respite and care. The first responsibility of a caregiver is to herself. If you do not care for yourself you will be unable to care for another so plan ahead so you will be prepared if the time comes for you to be a caregiver of another. Sometimes caregiving comes on slowly but sometimes it is an emergency. Investigating your options now will empower you and help you to empower a prospective care recipient so that you can both handle the situation.
     November is National Family Caregivers month. I would like to offer this article as a salute to all who have been through this experience, both as the caregiver and the recipient, and as encouragement to those who will be caregivers in the future. Please feel free to contact me at Milbet@aol.com if you have any questions concerning this article.
     Additional Information: Wise Choices Beyond Midlife, Women Mapping the Journey Ahead, Chapters Six and Seven, Eldercare Locator Services: 800/677-1116 to locate services in your area, AARP: 800/424-3410 for more information, and pamphlets on caregiving, National Alliance for Caregiving, phone 301/718-8444 for publications, National Family Caregivers Association, phone 800/535-3198, a membership organization where members can receive services, support and publications.