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Challenges for Caregiving in the wake of COVID-19

January 22, 2021

Now that the Pandora’s Box of pandemics has been opened, the twist and turns in long-term care (LTC) that were experienced in 2020, due primarily to COVID-19, may impact people’s future LTC decisions for many years to come. To that end, the new 2020 Nationwide Long-Term Care Consumer Study was recently released and includes insights specific to COVID-19 and the concerns impacting caregivers and their loved ones being care for.

My own mother passed away before COVID-19 became an issue. While 71% of participants in the Nationwide survey reported they would prefer to receive care in their own home1—once my father passed away, my mother did not want to live alone in the home she shared with Dad; and she repeatedly made it clear for as long as I can remember that she never wanted to live with me and have me physically care for her. My parents loved going on cruises, and my Mom being a social creature wanted to live at the “cruise ship on land”—which meant a continuing care retirement community (CCRC) where there are activities and plenty of socialization, but with long-term care options available within the community if care is ever needed.

In-home care more important and challenging than ever during COVID-19

I can only imagine the turmoil we would have gone through trying to keep Mom safe in her facility in the environment we are facing today. While she started out in independent living, she eventually needed care due to her decline from dementia. Even with residents quarantined to their rooms, there is a revolving door of staff caring for the people in the need of services.

Residents who can still live independently are less exposed to numerous facility staff, but there is still a need for staff to provide certain essentials such as delivering meals to rooms and basic housekeeping. This has made all involved very nervous regarding the risk of being infected with COVID-19.

According to the Nationwide LTC Consumer Survey, the pandemic found more than 80% of respondents feeling it’s more important than ever for people to stay at home to receive long-term care services—and to have a financial plan that takes home care into account.1

But the survey also makes it clear that caregivers are struggling. 60% of caregivers report they are finding it more challenging to provide care while working from home.1 Yet even when there are funds available to help pay for outside assistance with care, 63% of respondents report they would not be comfortable bringing in an in-home health care provider specifically because of the pandemic.1

The challenge of paying your adult child to provide care and support

I remember buying things to take over to Mom at her residence, from bringing her a junior bacon cheeseburger and a frosty (her favorite fast food), to buying snacks for late evening munching in front of the TV. And when she was no longer able to go shopping with me, the list got longer with cosmetics and new clothing. She would ask me what I owed her. I would tell her “nothing,” but she was proud and wanted to carry her own weight—yet the thought of accepting money from my elderly mother felt terrible. I would tell her “don’t worry about that now, I’ll catch you next time”—and then I hoped she would forget.

More than two-thirds of respondents wanting in-home care said they would like to be able to have a family member care for them in their homes but added that they wouldn’t expect their loved ones to provide care unless they are able to pay them.1 This issue was brought even more to the forefront by the impact of COVID-19.

However, 64% of caregivers say the pandemic has affected their financial ability to provide care.1 These caregivers may have to choose between suffering the guilt of accepting their loved one’s offer of money in exchange for providing them with care and needed supplies—or suffer financially by refusing to be compensated.

The value of cash indemnity long-term (LTC) coverage

All of these insights bring up an interesting dynamic that long-term care coverage can help mitigate. Would an adult child find it easier to be paid or re-paid if the funds were coming from a source other than their loved one’s checkbook? For many, that would ease the guilt. And that is where cash indemnity long-term care coverage can help.

Cash indemnity benefits are paid with no restrictions from the insurance company regarding how long-term care benefits can be spent. That means 100% of the benefits can be used to pay an adult child to provide care as well as pay for other needs such as transportation, prescriptions, and daily essentials. There are no bills, receipts or monthly paperwork to submit, so the policy can be easy to manage. Cash indemnity long-term care benefits provide more flexibility in care choices, as well as the ability to pivot care needs quickly without needing to ask permission from the insurance company on how benefits can be used.

Most importantly, because the funds are coming from an insurance company policy, not from a loved one’s “lifelong savings,” the person in need of care can better maintain their dignity by paying their family caregiver, and the caregiver can accept the funds for payment or re-payment with less or no guilt. This may help relieve some of the family stress brought on by caregiving.

Whether care is needed in a COVID-19 environment or not, cash indemnity benefits allow for more choice, control and flexibility in handling care needs.

In summary

I’ll never know for sure how my husband and I would have dealt with Mom’s care in a COVID-19 environment. Despite her wishes, she may have ended up living with us —at least until a vaccine made it safe for her to go back to her “cruise ship on land.”

Sources and Disclaimers

  • 1

    This online survey was conducted by the Harris Poll on behalf of Nationwide from August 25 – September 16, 2020, among 959 U.S. adults age 24+ and 308 U.S. adults age 24+ who are or have been caregivers, identifies attitudes, behaviors and challenges around long-term care and caregiving during the COVID-19 pandemic.

  • Respondents for these surveys were selected from among those who have agreed to participate in our surveys. Because the sample is based on those who agreed to participate in the online panel, no estimates of theoretical sampling error can be calculated. Data are weighted where necessary by age by gender, race/ethnicity, region, education, income, marital status, and propensity to be online to bring them in line with their actual proportions in the population.

    This information is general in nature and is not intended to be tax, legal, accounting or other professional advice.

    The information provided is based on current laws, which are subject to change at any time, and has not been endorsed by any government agency.

    Neither Nationwide nor its representatives give legal or tax advice. Please have your clients consult with their attorney or tax advisor for answers to their specific tax questions.

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