It is no secret that LGBTQ people experience unique challenges throughout the aging process. Securing an affirming caregiving resource is a critical component for any long-term care plan. During this third installment of “LGBTQ & Long Term Care, What You Need to Know” column, we explore caregiving options.
Caregivers are often needed when an individual requires assistance to complete activities of daily living ( also known as ADL’s ), such as bathing, toileting, dressing, exercise or feeding. They can also assist with housekeeping tasks, meal preparation, medication reminders, companionship, and transportation.
Types of Caregiver Support
There are five general types of caregiver support, and each come with their own pros and cons. Identifying these benefits and risks can help in determining the right choice.
The types of caregiver support are as follows:
1 ) Family Caregivers
2 ) Independent Caregivers
3 ) Placement Agencies
4 ) Home Services Agencies
5 ) Adult Day Care
For most people, the preference is to have family and friends take on caregiver tasks. However, prior to engaging in this type of arrangement a number of factors should be considered. Skill set, capacity, and personality traits of family and friends should be assessed to best match individuals with appropriate responsibilities.
For example, if there are three people who care deeply and want to contribute as caregivers, identify their strengths and your corresponding area of need. If one of those people is a nurse, another is a chef, a third a personal trainer, try to match skill sets in a way that makes sense. Perhaps the nurse could attend doctor appointments, the chef could make meals twice a week, and the personal trainer could assist with therapy and rehabilitation efforts. In this way the strengths of family and friends are maximized and the potential for burnout minimized.
Be realistic about the capacity of family caregivers to avoid risky situations or inconsistent care. Raise conversations early about support in older years and strive for clarity amongst family and friends. Spread responsibility amongst the support system, and supplement with one of the other caregiver categories if necessary.
LGBTQ individuals are twice as likely as the general population to live alone in older years, and three to four times less likely to have children, according to SAGE ( Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders ). This means there may be a limited circle of family caregivers to engage when the time comes.
If family caregivers aren’t a complete solution, the next step is to identify which of the remaining four categories is the best fit. When choosing a caregiver from an agency, be sure to ask what type of LGBTQ competency training they provide staff and what measures they have in place to prevent discrimination. For more information, check out these “Nine Tips On Finding LGBT Affirming Services” from the National Resource Center On LGBT Aging: http://www.lgbtagingcenter.org/resources/resource.cfm?r=4
Independent caregivers are often found through informal means such as online advertisements or word of mouth. The price for independent caregivers is the lowest of the paid options, typically $10- 15 per hour, and is arranged directly with the caregiver. However the low price tag comes with a high degree of risk. Independent caregivers become your employees, so worker’s compensation, tax reporting, and social security contributions are all your responsibility. In addition, there is little protection from fraud or financial abuse.
Placement agencies offer mid-range protection as they are licensed by the Illinois Department of Public Health ( IDPH ) and caregivers undergo an initial background check. Payment is arranged directly with the caregiver, and the agency may have guidelines and recommendations as well as a “finders fee.” Beyond the up-front screening, the same risks as an independent caregiver apply as they are still considered to be your employee.
Home Services Agencies
Home Services Agencies avoid the employment risks because their caregivers are bonded and insured to the company. Payment and any requests are arranged directly with the agency. The agency also has insurance in place should theft or injury occur on the part of their employees.
The cost ranges from $22-28 per hour, often with a minimum of three hours.
Adult Day Care
Adult day-care services focus on activity and engagement in a social setting, and the individual goes to a facility with other seniors. The cost tends to be $60-70 per day and operates Mondays through Fridays although how many days a week someone attends is flexible. This option can supplement family caregiver arrangements because it provides a cost-effective respite opportunity for the family.
Jacqueline Boyd is the founder of The Care Plan, a care-management and mapping company catering to the health and aging needs of Chicago’s LGBTQ community. Find more information at www.thecareplan.com