Hidden Alzheimer’s Costs and the Impact on Families
When policymakers consider the costs of dementias like Alzheimer’s disease, they consider both direct and indirect costs. Direct costs, in this instance, are the medical and social/non-medical care costs related to dementia. Indirect costs, on the other hand, include informal care and reduced productivity as well as impacted financial security for informal caregivers and their children. Dementia is one of the costliest diseases to society. In fact, it is the third most expensive disorder in the United States. And that is before factoring in the difficult-to-calculate or “hidden” costs.
These “hidden” costs, often indirect rather than direct costs, aren’t being considered by policymakers when making decisions related to dementia care. Examples include: costs prior to diagnosis, the healthcare costs for family caregivers who develop health issues from the strain of caregiving, and cutbacks in family’s spending to support care. Almost 70% of caregivers reduced their living expenses to pay for caregiving costs in 2018; 34% reported spending between 21 and 100% of their monthly budget on caregiving expenses. These costs clearly represent huge portions of household wealth for those suffering from dementia and their families.
And then there are also costs that are difficult to calculate monetarily, such as impacts on quality of life. 76% of caregivers said that they have had to choose between taking time for themselves and providing care frequently or at least occasionally; 57% have had to choose between providing care and spending time with a partner; 62% had to choose between providing care and spending time with friends; and 49% had to choose between providing care and spending time with their children. Half of current caregivers spend upwards of six hours a day providing care, which is a significant impact on their lifestyle, and has resulted in many caregivers reducing their work hours or changing their work schedule.
Furthermore, costs per dementia case may be higher in the future. Health care costs in general are rising, and there is an expected shift of caregiving from informal to formal.
It can be daunting to consider how costly a dementia diagnosis can be. However, there are steps that can be taken to ensure your loved one is taken care of and that appropriate legal documents are in place that reflect their wishes about their home, their savings and their care.
We help families come up with a plan to make sure a loved one who is diagnosed with dementia gets the best care possible without running out of money. Please don’t hesitate to reach out if we can be of assistance with your planning.
- Your military service discharge is deemed anything other than dishonorable conditions,
- Your service was 90 or more active duty days with at minimum one day of service during a period of wartime.
- You are age 65 years or older,
- Your countable family income is below a threshold set every year by law.
2020 Family Income Limits (Effective December 1, 2019)
|If you are a…||Your yearly income must be less than…*|
|Veteran with no dependents||$13,752*|
|Veteran with a spouse or a child||$18,008**|
|Housebound veteran with no dependents||$16,805|
|Housebound veteran with one dependent||$21,063|
|Veteran who needs aid and attendance and has no dependents||$22,939|
|Veteran who needs aid and attendance (A/A) and has one dependent||$27,195|
|Two veterans married to each other||$18,008|
|Add for each additional child to any category above||$2,351|
|*Some income is not counted toward the yearly limit (for example, welfare benefits, some wages earned by dependent children, and Supplemental Security Income. It is also important to note that your medical-related expenses are considered when determining your yearly family income. *To be deducted, medical expenses must exceed $687 ** To be deducted, medical expenses must exceed $900|
The financial information chart above, published by military.com, is commensurate with the numbers posted on the Veteran’s Administration website. Be aware; there is a look-back period that will determine if you have transferred assets in the three years previous to filing your claim. There would be a penalty period rate of $2,266 if you did move assets for less than fair market value during this period.
The VA will pay a qualified veteran the difference between personal countable family income and the yearly income limit category into which they fall. Payments are made in 12 equal installments per month and rounded down to the nearest dollar. As an example, a single veteran with a $5,000 annual income qualifies for an annual limit of $13,752. Subtracting that veteran’s income from the income limit yields an annual pension rate of $8,752, which translates into a VA monthly pension check of $729.33 or $729.00 rounded down to the nearest dollar value.
The VA website recognizes the following wartime periods that determine if your service was during an eligible wartime period:
- World War II (December 7, 1941, to December 31, 1946)
- Korean conflict (June 27, 1950, to January 31, 1955)
- Vietnam War era (February 28, 1961, to May 7, 1975, for Veterans who served in the Republic of Vietnam during that period. August 5, 1964, to May 7, 1975, for Veterans who served outside the Republic of Vietnam.)
- Gulf War (August 2, 1990, through a future date to be set by law or presidential proclamation)
In addition to VA pension, wartime Veterans may also qualify for an additional allowance called Aid and Attendance. To qualify medically for VA Aid and Attendance, one of the following must be true:
- Another person is required for you to perform daily activities such as bathing, dressing, and feeding, or
- You spend a large portion, or all of your day in bed due to illness, or
- Due to a loss of mental or physical abilities related to a disability you are a patient in a nursing home, or
- Your eyesight is severely limited (wearing glasses or contacts your eyesight is 5/200 or less in both eyes or your concentric contraction visual field is 5 degrees or less)
There are similar benefits available to surviving spouses of wartime Veterans. If you are a wartime veteran or the surviving spouse of a wartime Veteran, we can help you determine whether you could qualify for pension benefits.
While eligible veterans or surviving spouses can apply for benefits on their own through the www.va.gov website, it is advisable to seek the advice of counsel before applying. There may be planning options available to avoid a penalty period and speed up the qualification process. If you would like to explore whether you might qualify for VA pension benefits, please give us a call at 352-205-4455.
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