When most of us envision our golden years, the last thing we dream about is ending up in a nursing home. The reality is that millions of us reach a point in our lives where we need help with basic daily activities we take for granted—things like eating, bathing, or getting around. If you don’t have a loved one with the ability, time, and financial independence to take on the role as your caregiver, then a nursing home might be your only option. Fortunately, there is an emerging effort to help Marylanders and other Americans avoid the nursing home for as long as possible by supporting the loved one who wants to be your at-home caregiver.

Most of us do not have a solid plan for losing our independence. Sometimes it’s a gradual loss of physical or mental ability as we age. For some of us, the decline happens very quickly. Our need for part-time or full-time care can even happen instantaneously through an accident or medical emergency. Even if we do not have a plan, most of us would prefer to stay in our homes with the caring assistance of a loved one, such as a spouse, an adult child, a relative, or a friend. That type of care might seem “free,” but, in reality, it requires a caregiver who can work a demanding, full-time, unpaid job.

In fact, in the for-profit healthcare system, the same work done by a family at-home caregiver would cost big bucks.

The Cost of Elder Care

For your family to hire a 24/7 home health worker, the cost would be roughly $235,000 (which can vary widely depending on their health needs), according to the most recent Genworth Cost of Care Survey. Most families cannot afford that type of care, especially if it is required for an extended period of time. For people who qualify for Medicaid, the government will cover the cost of nursing home care. Whether you pay out-of-pocket or through Medicaid, the average cost of a nursing home room in Maryland is $124,000 to $146,000 annually, according to the American Council on Aging.

A 2018 AARP survey confirmed that the vast majority of adults over 50 want to stay at home as they age. Many of us have family members and friends who might be willing to offer this service to us or our elderly loved ones, if they could. Some legislators and nonprofits are calling for programs to support this family caregiver, both financially and with other resources, at a fraction of the taxpayer cost for nursing home care. 

Support Services

The Maryland Department of Aging has a program called the Maryland Family Caregiver Support Program. In addition to information, it provides the following services to eligible family caregivers (Source: Maryland.gov): 

• Counseling: A service designed to support caregivers and assist them in decision- making and problem solving.
• Case Management: A service provided to a caregiver, at the direction of the caregiver by an individual who is trained or experienced in the case management skills that are required to deliver services and coordination.
• Training: A service that provides caregivers with instruction to improve knowledge and performance of specific skills relating to caregiving. Skills may include activities related to health, nutrition, and financial management; providing personal care; and communicating with health care providers and other family members.
• Support Groups: A service led by an individual who meets state/territory policy requirements to facilitate caregiver discussion of their experiences and concerns and develop a mutual support system.
• Respite. Temporary, substitute supports or living arrangements for care recipients. It provides a brief period of relief or rest for caregivers.
• Supplemental services on a limited basis: Goods and services provided on a limited basis to complement the care provided by caregivers. It can include:
  • Assistive Technology/Durable Equipment/Emergency Response
  • Consumable Supplies
  • Home Modifications/Repairs
  • Legal and/or Financial Consultation
  • Homemaker/Chore/Personal Care
  • Transportation
  • Nutrition Services

To learn more about these services: Call 410.767.1100 or 1.800.243.3425.

Financial assistance for caregivers in Maryland (Source: Seniorlink.com)

1. Submit an application for Maryland Medicaid if eligible for benefits.
2. Contact your local Area Agency on Aging for information on the CFC program and how to apply. You may also contact Maryland Health Care Commission about Medicaid’s Long Term Care and Waiver Services at 410-764-3460.
3. Contact your county’s Health Department office to inquire about the Community Personal Assistance Services program. Or, to apply by phone or locate your nearest office, you may call Maryland Access Point at 1-844-627-5465.
4. If eligible, contact Maryland Developmental Disabilities Administration (DDA) to discuss the Community Pathways Waiver. Your local coordinator will advise you when funding is available and let you know when to complete an application for services.
5. Care recipients age 64 and younger should contact the Maryland Department of Disabilities at 410-767-3660 for information on the Attendant Care Program. An application which includes detailed eligibility criteria can be downloaded here.
6. Veterans should get in touch with the Maryland Department of Veterans Affairs to find the nearest office and get information on services and benefits.

Avoiding the Nursing Home

There is good reason to support at-home family caregivers. In addition to being expensive, the U.S. nursing home has a well earned reputation for creating miserable living standards and dangerously bad healthcare standards for its elderly residents.

Since the 1980s, there has been a trend in which corporate, private equity groups have acquired nonprofit and independent nursing homes, and the result has been a growing problem of nursing home abuse and neglect. Because the goal is to squeeze maximum profits out of nursing home facilities, there is a financial incentive to cut staffing and services to the bare minimum and frequently below the government-mandated standards. Although there are government inspections to enforce regulations, even the most serious infractions regularly go unpunished, even those involving gross insults of dignity, injury, and death of residents. In the rare instances when fines are given, the amounts of those fines are pitifully low.

Without financial motivation for nursing homes to provide adequate care, the result is often misery, injury, and death for many nursing home residents. Perhaps the most significant means to enforce quality care at nursing homes is the threat of a resident lawsuit. If you or a loved one suspects nursing home abuse or neglect, it’s wise to trust that instinct and have a nursing home abuse and neglect law firm investigate the matter. Law firms may offer contingency-based fee structures, in which the law firm is paid only if the firm is able to win damages for the client, which means that there is no upfront cost or financial risk to the victim or their family to investigate and pursue their legal options. For a free, no-obligation consultation, please call Brown & Barron at (410) 698-1717 or contact us online by clicking here.