Home Helpers Senior Care Services Blog

Caregivers Find Tax Relief

While meeting with families who are considering homecare options, we're often asked if caregiving services are tax deductible. We found an article published by the Society of Senior Advisors that might answer some of your tax questions.

An www.AgingCare.com survey found that the majority of adult children who are responsible for paying for their elderly parent's care are financially unprepared to do so. Specifically, the survey found that 63 percent of caregivers have no plan for paying for a parent’s care, and 62 percent say that the costs of the parent’s care will negatively influence their capacity to financially plan for their own futures.

"With an estimated 34 million Americans providing care for older family members, the survey's results indicate a financial crisis in the making," says Joe Buckheit, Publisher of AgingCare.com, a website and online forum for family caregivers.

"Medicare only covers long-term care for a short time and only under strict rules. Medigap insurance helps, but does not cover all costs. The burden of paying for long-term care often rests with the family," Buckheit says. "The caregivers' lack of planning is impacting their own financial future."  

Find more information on financial assistance available to caregivers: Financial Relief for Family Caregivers: Knowing How to Find it   VA Financial Assistance for Caregivers   Veteran Financial Aid for Long-term Care and Home Healthcare   10 Government Programs You Can Access for Your Elderly Parents

Adult children are often paying out of their own pockets to provide for an aging parent. The AgingCare.com survey indicates that 34 percent are paying $300 or more a month for caregiving expenses such as medications, groceries, medical copayments and transportation. The survey shows that 54 percent have sacrificed spending money on themselves to pay for care of their loved one.

Criteria for benefitting from tax rules
However, adult children can benefit from understanding how tax rules provide some relief from this situation.

www.Eldercareanswers.com notes five tests to determine whether one can claim a parent as a dependent. The person being claimed as a dependent:

• Must be related to the person claiming them as a dependent. This includes in-laws.
• Must be a citizen or resident of the United States or a resident of Canada or Mexico.
• Must NOT file a joint return. If the person being claimed as a dependent is married, he or she must file separately. There is an exception if the person is filing jointly, but has no tax liability. If the person files a joint tax return solely to get a refund, one can claim him or her as a dependent.
• Must NOT have a gross income of a particular amount that is determined by the IRS. For 2011, that amount was $3,700 or more. Gross income does not include Social Security payments or other tax-exempt income.
• Must receive more than half of the support from the person claiming them as a dependent during the year (see below under “Determining level of support” for further guidance).

Determining level of support

Support includes money spent toward food, lodging, clothing, education, medical and dental care, recreation, transportation and similar necessities. If more than one person pays for these expenses, a Multiple Support Declaration (form 2021) can be filed to receive an exemption.

If the dependent lives with the taxpayer, a reasonable percentage of the mortgage, utilities and other household costs can be used to determine the level of support. However, a parent does not have to live with their child. When a parent is able to remain in his or her own house, in an assisted living facility or a nursing home, the costs paid for parental support at those locations count toward meeting the IRS requirement. Those who are in an assisted living or long-term care facility can qualify as dependents if the income and support levels are met.

What are deductible expenses?

Always check with a tax or financial professional to determine which expenses are allowable. Once a parent or dependent loved one meets the IRS’s dependency tests, certain expenses can be treated as tax write-offs. These include:

Medical –Medical costs must exceed 7.5 percent of the adjusted gross income of the individual filing the tax return. The dependent’s medical costs can be counted in that 7.5 percent. For example, if the taxpayer’s adjusted gross income is $50,000, medical costs must exceed $3,750.00 to be taken as a tax write-off.

The IRS says, "Medical expenses are the costs of diagnosis, cure, mitigation, treatment or prevention of diseases, and the costs for treatments affecting any part or function of the body." For more information on allowable medical expenses for tax deductions download Publication 502.

The taxpayer can deduct medical expenses for himself/herself, spouse and any dependents. Following are some of the items included in the definition of medical expenses:

• The cost of drugs that require a prescription. Insulin is deductible without a prescription.
• The cost of dental treatment, including x-rays, fillings and dentures.
• The cost of travel to medical appointments.
• Premiums paid for insurance policies that cover medical care are deductible, unless the premiums are paid with pretax dollars. Generally, the payroll tax paid for Medicare Part A is not deductible, but Medicare Part B premiums are deductible.
• Payments made for nursing services. An actual nurse does not need to perform the services as long as they are the kind generally performed by a nurse.
• The cost of long-term care, including housing, food and other personal costs, if chronically ill.
• The cost of meals and lodging at a hospital or similar institution if a principal reason for being there is to receive medical care. Not to exceed $50 for each night for each person.
• Costs for medical equipment installed in a house or improvements made to the home if the equipment or improvements are needed for medical care. If one makes an improvement, the deduction must be reduced by the increase in the property value.
• The portion of a lump-sum or “founders fee” payment to a retirement home that is for medical care. The agreement with the retirement home must require a specific fee as a condition for the home's promise to provide lifetime care that includes medical care.

Home modifications
Home modifications made to accommodate special conditions or disabilities may be deductible as medical expenses. Allowable expenses include, but are not limited to, a ramp leading to the door, grab bars in the tub or shower, handrails in hallways or stairs or special doorknobs for easy access.

Dependent care credit
Caregivers often need to hire someone to assist them with the care duties. The dependent care credit allows the taxpayer to deduct up to 35 percent of expenses for hiring care providers. IRS Publication 503offers complete information about the credit, and qualifying factors for dependent care.

Approximately 20 states also offer caregiver tax advantages above and beyond the federal ones. Check with the state’s tax agency or a qualified tax or financial professional to find the most beneficial path for each caregiving situation.

 

 

 

 

 

A Caregiver Activity: Capturing your Loved One's Sayings

Helping Manage Your Care – Prevent Hospital Readmissions

Hospitals are under pressure to continue to develop plans to reduce and eventually prevent hospital readmissions.

This is smart medicine and can be very good for each of us if we are active participants in our own care.

The following is from the National Patient Safety Foundation and is provided in a handy download for individual use.

A Readmission is When

I am admitted to the hospital after being discharged for the same diagnosis or condition.

Understanding My Discharge Instructions

Know what I need to do before and after I leave the hospital

Ask questions early and often

Ask when I do not understand my follow-up care instructions

Arrange for the support and follow-up care I will need post discharge 

Knowing My Diagnosis

Understand my main medical problem or condition

Know the potential complications and who to call if I need assistance 

Learn how my condition impacts me and my family 

Following Up With My Care

Be sure to communicate with my primary care provider

Ask my healthcare team to help me find a primary care provider if I don’t have one

Schedule and go to all my follow-up appointments

Keep a medical journal and bring it to all my appointments

Tell my primary care physician and other providers that I was admitted to the hospital

Ask my provider if they have received all of my test results and medical reports

Ask questions at the follow-up visit about what I need to do and why I need to do it

Understand and follow my post- discharge activity and dietary plans

Protecting Myself from Infections

Avoid people who are sick

Wash my hands often

Learn how to care for my surgical site 

Managing My Medications

Understand my post-discharge medications, and if they are different than before admission

Keep a current list of my medications, including over-the-counter and herbal medications (note any allergies)

Bring my current medication list to appointments and review the list with my doctors

Update my medication list when my medications change

Take my medications as directed

Understand what medications to take and when, and why it is important to take my medications

Know the reason for taking my medication and how they help with my condition

Let my healthcare providers know if I am having problems taking my medication 

HOME HELPERS CAN ASSIST IF YOU OR A LOVED ONE IS RECUPERATING FROM A HOSPITALIZATION. CLICK HERE FOR A LOCATION NEAR YOU!

Download your own personal copy of the NPSF form to use in your own efforts to prevent readmissions

http://www.npsf.org/wp-content/uploads/2011/10/Post-Discharge-Tool.pdf

How to Evaluate Homecare Help

How can you be sure that an in-home care provider is doing his or her job well? Run a periodic home care review.

In this informal review, you check every month or so that care tasks are being performed well by watching the person demonstrate them.

Some tips:

No need to spy; just ask. You want to make sure that instructions are being accurately followed, safe procedures are being used (for lifting, for example), and equipment is used properly. Observe your loved one, too. How is he or she faring through the task?

Don't be shy. Ask questions, make suggestions, or correct things that aren't being done to your satisfaction. A satisfying experience for your loved one is what you're paying for, after all.

Demonstrate your expectations. It's a good idea for you to periodically demonstrate expectations of how to do care tasks, especially if there's been a change in a medication or your loved one has a change in the level of care required. Showing exactly what you need -- and having it performed back to you -- is the best way to keep everyone on the same page and give you peace of mind.

Run a review whenever there's a new face helping you. Timing this for the beginning of the new person's time with you, and again a week or so later, will get things off to a productive start.

Provide a written record book. This is where the aide can note what happened during the shift. You may choose to use a system that's as simple as a checklist of everything that should happen during the shift, and a space for recording any new observations or notes on mood or symptoms, depending on your loved one's needs. That's not only informative for you; it can be a useful record for the doctor if there are health complications.

You'll be more likely to enjoy your freedom when help is around if you have peace of mind that things are being done right. Then be sure to take advantage of that good help, rather than hovering. Remember also that your loved one may find it a refreshing change of pace.

Article from Caring.com http://www.caring.com/articles/how-to-evaluate-home-care-help?utm_medium=email&utm_source=suggests&utm_content=20120621

3 Ways to Ease Awkward Feelings About Personal Care

At Home Helpers, we often come across clients who are resistant or hesitant to receive help with personal care. We stumbled upon this article from caring.com that might be of help to you or a loved one:

Caregiving is often an intimate business -- and the awkwardness about helping with personal care affects both sides: the helper and the helped.

You can help your loved one feel less embarrassed about being dependent during bathing, dressing, and toileting by trying tactics like the following. Bonus: They'll help lessen your uncomfortable feelings, too.

Put the situation in perspective. A caregiving adult child, for example, can remind a parent, "Just think about all those years you did these things for me." A spouse can invoke the "for better or worse" clause, reminding his or her mate that a partnership is meant to include these moments, too.

Give your loved one a little space to try. Even if you know the person can't manage a particular task without help, let him or her try, if an interest to do so is expressed. It can sometimes provide a measure of dignity -- and a lessened feeling of complete helplessness -- for a dependent person to at least make the attempt rather than having you rush in and do everything for him or her. Then when the struggle becomes obvious, you can gently say something like, "Here, let me help." Or, "Almost . . . try this."

Make a joke. Poke fun at a pair of absorbent underwear, the temperature of the water, the stubbornness of a sleeve that won't go on. Humor is not only distracting; it helps change the tone.

A Letter from A Mother to a Daughter: Happy Mother's Day

It's May and Mother's Day is just around the corner. We stumbled upon this and thought there was no better way to express our gratitude for every mother out there. Grab the tissues:

Letter from a Mother to a Daughter: "My dear girl, the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If when we talk, I repeat the same thing a thousand times, don’t interrupt to say: “You said the same thing a minute ago”... Just listen, please. Try to remember the times when you were little and I would read the same story night after night until you would fall asleep. When I don’t want to take a bath, don’t be mad and don’t embarrass me. Remember when I had to run after you making excuses and trying to get you to take a shower when you were just a girl? When you see how ignorant I am when it comes to new technology, give me the time to learn and don’t look at me that way... remember, honey, I patiently taught you how to do many things like eating appropriately, getting dressed, combing your hair and dealing with life’s issues every day... the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If I occasionaly lose track of what we’re talking about, give me the time to remember, and if I can’t, don’t be nervous, impatient or arrogant. Just know in your heart that the most important thing for me is to be with you. And when my old, tired legs don’t let me move as quickly as before, give me your hand the same way that I offered mine to you when you first walked. When those days come, don’t feel sad... just be with me, and understand me while I get to the end of my life with love. I’ll cherish and thank you for the gift of time and joy we shared. With a big smile and the huge love I’ve always had for you, I just want to say, I love you... my darling daughter. " -Author Unknown

Feel free to comment below and honor your mother. Let us know why she's so important to you!

 

Older Americans Month- Get Out and Get Active!

May is Older Americans Month- a perfect time to celebrate and show your appreciation! As a caregiver, formal or informal, it’s nice to switch up your routine and have some fun with the older adult in your life. Take this opportunity to add some excitement to the month of May!

The theme for Older Americans Month 2012, Never Too Old to Play, encourages older Americans to stay engaged, active and involved in their own lives and in their communities. We can’t stress enough the importance of staying active- physically and mentally.

In celebration of Older Americans Month, Home Helpers invites you to participate! The U.S. Administration on Aging created a website which offers useful resources and tools to help you plan and promote events and activities honoring older Americans. You’ll find a helpful tool kit to get started. Additionally, you’ll find a calendar where you can share your events, pictures and stories. Have fun and get involved during this month of celebration!

What activities will you plan? Feel free to leave comments on our blog to share your ideas with others!

For more information, please visit: http://www.olderamericansmonth.aoa.gov/Home.aspx

Relief for Caregivers

About one-quarter of the adult population, approximately 44.4 million Americans, is providing unpaid care to an adult loved one (National Alliance for Caregiving, AARP and the MetLife Foundation, 2004). These caregivers are present in an estimated 21% of 22.9 million households. In a world where more and more adult children are taking care of their aging parents, the stress of caregiving for a senior loved one is felt wide and far.

In addition to supporting a senior loved one, caretakers often have other responsibilities, such as a family or job. Caregivers report their own emotional stress, physical strain, or financial hardships as a result of caregiving responsibilities.

Fortunately, good options for caregiver support are popping up. The senior care industry is seeing an increase in a couple of respite care opportunities. In-home care providers and adult day care centers, also called adult day services, deliver much needed assistance. Providers, some of whom are specially trained or skilled, care for the senior when a caregiver and senior need additional support.

While in-home care is a viable option for some, adult day services are also a growing trend for supportive care outside the home without the commitment of an assisted living or nursing home.

To read this article in its entirety, click here: http://www.csa.us/ReliefThroughAdultDayCare.aspx

Why Seniors are Moving from Institution Back Home

After living for three years in a nursing home following a stroke, Gail, 78, went through his life savings paying for the nursing home and eventually qualified for Medicaid. He had always wanted to and intended to move back home, but his condition required that he stay in the nursing home. His ex-wife, Sue, and a social worker at the nursing home informed him about a program called “Money Follows the Person” (MFP), which supports efforts to move institutionalized individuals back home.

In 2009, MFP enabled Gail to move into Sue’s house because she is his main care provider. The program allotted $1,500 for home services, modifications to the home in the form of ramps and a handicap accessible bathroom, 16 hours of personal care services each month, and attendance at adult day care each day. Gail’s health has remained steady, he is able to enjoy more of a routine life, and he is able to get the care he needs at home while surrounded by friends and family.

OHIO MFP CASE STUDY Source: Kaiser Family Foundation, www.kff.org Overview: In January 2007 Ohio was one of 17 states to receive funding for the Money Follows the Person rebalancing demonstration. The state was awarded up to $100 million in enhanced federal matching funds in order to transition roughly 2,200 seniors and people with disabilities from institutions to home- and community-based settings and to help Ohio balance its long-term services and support system. Ohio’s MFP demonstration known as HOME Choice and these statistics come from a survey that was conducted in November 2010. It describes key features of the program and highlights early program experiences. Program Features: Ten people currently work for the MFP program in Ohio, including specialists in each of the following areas: outreach, enrollment, housing, population-specific community living administers, data, and balancing long-term services and supports within the state. Recognizing the importance of safe, affordable housing in a successful transition, Ohio is one of six states that employ a housing specialist within its Medicaid agency to help build partnerships with state public housing officials. Services Provided: Ohio provides the following services: independent living skills training, community support coaching, HOME Choice nursing services, social work/counseling, nutrition consultation, community transition services, transition coordination, communication aids, service animals, respite, emergency rental and utility assistance, community living specialist, and care management. Transition Progress: Since Ohio began enrolling MFP participants in October 2008, almost 900 individuals have been transitioned back to the community and another 626 individuals are in the process of transitioning. As of January 2011, the number of seniors who were transitioned was 208, with another 149 in progress, and 29 had been reinstitutionalized. Cost: On average, the cost of a HOME Choice transition for a senior was $2379/month, the lowest cost of all categories, which included developmentally disabled ($8554/month) and physically disabled ($4519/month).

The U.S. Congress authorized the MFP as part of the Deficit Reduction Act of 2005. MFP was designed to assist states in rebalancing their long-term care systems and help Medicaid enrollees transition out of institutions and back to their communities.

Since 2008 when the first senior moved back home through the MFP program, an increasing number of states have been making stories like Gail’s a reality for seniors and others with disabilities. As of February 2011, 43 states and the District of Columbia participate in the “Money Follows the Person Rebalancing Demonstration Program.” The significance of this program for seniors is found in its intention for establishing a strong foundation of person-centered, consumer-directed, and community-based services. Seniors are receiving the services they need in an environment that is more comfortable for their recovery and/or daily living. Ultimately, the service model is no longer provider-driven and institution-based, but rather it is more conducive to successful living because of the personalized approach. (Centers for Medicare and Medicaid Services).

More recently, with the passing of the Affordable Care Act in March of 2010, the MFP received a boost in funding and a time extension through September 30, 2016. Additionally, the MFP program expanded the eligibility requirements to include anyone who is in an institution for more than 90 consecutive days. The old restriction was anyone who had been institutionalized for six months to two years. The longer an individual has been institutionalized the more likely they are to have relinquished a community residence and it is often more challenging for them to again establish a community residence. Individuals who have been institutionalized for a shorter period of time may still have a home to which they still have access.

States have their own methods for identifying appropriate candidates for the MFP program. Once identified, the individual has access to the designated funds for their case for a period of twelve months and receives assistance in achieving the needed transition services.

After the program is complete, the continuity of care in each state will vary. Generally, MFP participants may be able to access existing waivers. Participants will continue to be served through these waivers as long as they continue to meet the eligibility criteria. Therefore, there will not be a lapse in services for MFP demonstration participants. Check with your state on the plans the Medicaid office has in place for the post-demonstration period.

To read more of this article from the Society of Certified Senior Advisors, click HERE.

Easing Caregiver Stress- Using Checklists

Checklists for Life – How Using Checklists Can Help Ease Stress and Avert Crisis for Both Seniors and Boomers Alike

At Home Helpers, we often come across people in the “Sandwich Generation” as well as spouses caring for aging loved ones. Caring for an aging spouse or parent is demanding while juggling your normal day-to-day life. We thought this article from The Society of Certified Senior Advisors might be helpful. (Original article reprinter with permission by author Carrie Roberts):

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For many people, as they get older, their needs change dramatically. Depending on a person’s age, health and mental capacity, there may be many things that a senior just can’t keep up with the way they used to, or many things a Boomer doesn’t have (can you say “Advanced Directives”) and doesn’t know they need until it is too late.

We believe that one of the best ways to get boomers prepared for their futures, as well as to keep seniors organized in the present, is by equipping them with checklists that cover major areas of their life. We believe that while checklists may not have the minute details laid out (checklists are meant to deliver concise advice), they are a great planning tool that give people a macro-view of what needs to be learned, gathered, prepared, and ultimately executed, especially when preparing for the most unexpected moment; moments where without a plan in place becomes a crisis situation.

Many times a checklist can prevent an unavoidable situation from turning into an emergency situation. By implementing a checklist you likely will have planned well enough that you will be able to quickly put a plan into action and avoid the crisis.

To really be prepared (there are so many aspects to our lives that integrate together, yet are distinctly different) there are many different types of checklists that are needed so you are ready when any given situation arises. Here is a list of some of the checklists you will need to start your planning process:


Checklists for Maintaining Independence - Losing one’s independence, in many cases, is the most frightening and feared things for many seniors as they grow older. Having checklists in place with such things as how to avoid falls and other accidents, how to avoid loneliness, how to approach senior driving issues, aging in place concepts and caregiving/caregiver stress management are all good checklists to have on hand to help seniors (and their adult children/caregivers) maintain their independence and be prepared for the future.


Checklists for Estate Management - Your estate management checklist will make sure that you have done all the necessary paperwork to make things manageable after you are gone, ensuring that your life and legacy are carried out how you intended them to be. This list will include things like wills, estate planning, titling assets and funeral planning and expenses.


Checklists for Financial and Legal - Money and legal issues go hand in hand with aging. Financially, life is different after you are retired and it takes good planning to make sure your money lasts long enough to cover your expenses or leave a legacy behind. Your checklists for financial and legal should contain things like how to hire an attorney, what to look for in a good financial planner, how to set up a power of attorney, things to consider in retirement, or how to avoid scams targeted at the elderly.

Checklists for Housing and Care - Where you live and who cares for you are things that can change quickly when you are older, especially if you are struck with an illness or accident. Having alternate plans in place that everyone understands ahead of time makes it less likely you will end up having to live somewhere you don’t want or where you won’t get adequate care. Checklists for housing and care will include things like how to make sure you ask the appropriate questions when looking for housing, the different types of housing options available, details about independent living, assisted living, nursing home care, in home care and even hospice care.

Checklists for Health and Medical - Health issues for senior are unique and there are many things to consider when deciding how medical decisions will be made if the need arises. Seniors also have different dietary and exercise needs too that should be considered. Your checklists for health and medical should include things like how to find a good doctor, creating a hospitalization plan, medicine management, vision, hearing, dehydration, heart attacks, Alzheimer’s and Cancer and information on other medical conditions affecting seniors.

Checklists for Discounts and Free Stuff - The one big upside to being a senior is the fact that there are so many discounts available to seniors. You can get discounts on everything from food, lodging and even senior shopping days in the stores. Getting a list of all the discounts available can save you big money which is always a good thing for your retirement budget.

Checklists for Fun and Travel – One great thing about retirement is that you have a lot more free time to do the things you love. Many people like to use these years to do all the traveling they wanted to and never had the time. Seniors can find many great travel discounts and checklists for safe travel available to them. Leisure time for seniors many times also equals great times and memories with grandchildren, so having checklists in place (especially for grandparents who haven’t had small children at home for quite some time!) are helpful.

Having a set of standard checklists will make life so much easier and more organized for you. When you have that kind of organization in play things don’t have to turn into emergencies, which equals better outcomes for everyone. It is a little bit of work to get it all set up but once you have worked through the steps the peace of mind you will get knowing that you have a plan is priceless.

Universal Senior Living created a downloadable Checklist E-book called Checklists for Life with over 200 easy to use checklists covering all of the topics mentioned above, giving you or your clients instant access to the lists they need most.