Formal & Informal Long-Term Care in Boise, Idaho

Yester day we discussed the concept of the "Accidental" caregiver. Whether we plan on it or not the chances we will be involved in a long-term care situation are growing every year. Today I would like to talk about the difference between formal and informal caregiving.

Formal Caregivers

Formal caregivers are care providers associated with a service system.  Service systems might include for-profit or nonprofit nursing homes, intermediate care facilities, assisted living, home care agencies, community services, hospice, church or charity service groups, adult day care, senior centers, association services and state aging services. Professional care managers and legal and financial professionals can also be of help.  Some these formal caregiver services are covered by Health Insurance, Long Term Care Insurance, Medicare and VA Benefits.  Otherwise for formal care where there is a charge, payment is out-of-pocket by the individual or family members.  Private pay, out-of-pocket for long term care services can be costly and advance financial planning is advised when possible.

Informal Caregivers

Informal caregivers are family, friends, neighbors, or church members who provide unpaid care out of love, respect, obligation, or friendship to a disabled person.  
The number of informal caregivers range from 20 million to 50 million people.  This could represent about 20% of the total population providing part-time or full-time care for loved ones. 

About two-thirds of those caregivers for people over age 50 are employed full-time or part-time and two-thirds of those–about 45% of all working caregivers–report having to rearrange their work schedule decrease their hours or take an unpaid leave in order to meet their caregiving responsibilities. 

The average amount of time informal caregivers provide assistance is 4.5 years, but 20% will provide care for 5 years or longer (National long term care survey 1999).

Below are some of the activities provided by or supervised by informal caregivers. The Accidental Caregivers, involved in this type of care, will find themselves picking up a few things that need to be done or supervised in the beginning and adding more as the need increases.

  • Managing money and paying bills
  • Writing letters or notes
  • Making repairs to the home, maintaining a yard, and removing snow
  • Providing comfort and assurance or arranging for professional counseling
  • Answering the phone
  • Making arrangements for meeting medical needs and doctors' appointments
  • Shopping and running errands
  • Providing transportation
  • Maintaining the household
  • Attending to personal hygiene and personal grooming
  • Administering medications
  • Help with walking, lifting, and bathing
  • Help with using the bathroom and with incontinence
  • Providing pain management
  • Preventing unsafe behavior and preventing wandering
  • Feeding
  • Providing meals
  • Doing the laundry
  • 24 hour care and monitoring
  • Nutrition management
  • Financial planning
  • Legal directives
  • Medical directives
  • End of life planning

Understanding the Progression of Care Commitment

The chart below provided by the National Care Planning Council illustrates the relationship of informal care to formal care.  As care needs increase, both in the number of hours required and in the number or intensity of activities requiring help, there is a greater need for the services of formal caregivers.

The Progression of Care Commitment
(The Four Steps of Long Term Care Planning, National Care Planning Council

"Unfortunately, many informal caregivers become so focused on their task, they don't realize they are getting in over their heads and that they have reached the point where partial or total formal caregiving is necessary.  Managing their own needs and daily schedule along with those of the person they are caring for can become so consuming and energy depleting that the caregiver themselves are in need of care.  It becomes time to bring in other family members, professional services and medical advisors to create a plan of care that is best for all involved." -National Care Planning Council

Caregiver stress and caregiver burnout are serious issues that face caregivers providing both formal and informal care. Make certain you take care of yourself as well as take care of your loved one. The work of caregiver is difficult, but as caregiver Marlo Solitto said "Caregiving can be one of the most rewarding experiences of your life."

At IdahoEstate Planning we are the experts you need to know and trust. As a member of the National Care Planning Council we have a vast network of resources at our disposal. Work with us and we'll put together a plan that works for you and your lovedones. Remember, goodplanning is no accident.



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