Keeping seniors with the family

01/09/2007

More than half a million Minnesotans care for elderly relatives at home, and legislators want to help them with a $2,400 tax credit.


By Patricia Lopez,
Star Tribune
Last update: January 09, 2007 – 12:05 AM


At 94, Roy Myers can't do as much as he once did. He still drives himself short distances around Waseca. He still volunteers a couple of hours a day at the Waseca Area Hospital. When he's done, he returns to the house he's lived in since 1912. There he finds Emily Myers, his 33-year-old granddaughter, who quit her job up north to help "Red" (his hair's snow white now) stay out of a nursing home.

Emily is one of more than 500,000 Minnesotans who, according to the National Alliance on Caregiving, provide care to elderly relatives. Their donated services, the Alliance says, would cost $5 billion a year to purchase.

To ease the burden a bit, the majority DFLers in the Minnesota House are pushing pilot legislation that would provide a $2,400 tax credit to each of an estimated 2,500 families that help elderly relatives avoid institutional care.

The goal, said Rep. Paul Thissen, DFL-Minneapolis, is to slow the mounting state cost of nursing-home care by recognizing and helping those who provide care willingly for free.

"This really is the most cost-effective way of taking care of our aging population," Thissen said. "It [the tax credit] amounts to about $200 a month to offset expenses incurred, time lost from work."

Cost effectiveness is debated

Between teaching high school Spanish 20 miles away in Medford, coaching the school's cheerleaders and caring for Roy, Emily has little free time. But she says the sacrifice she's made has been well worth it.

"It was getting to the point where it would have been dangerous for him to live alone," she said of her grandfather. "His personality is so much better now, he's healthier and happier now that I'm there.

"He thinks he's taking care of me, and in a way he is, just by being there."

Loren Coleman, assistant commissioner of the state Department of Human Services, expressed doubts about the tax-credit proposal. He said the state already spends $43 million on alternative care programs that help people like Roy and Emily with purchased services -- adult day care, respite care, home-delivered meals and even a way to hire a friend or family member to deliver trained care.

"We don't view it [the tax credit] as the best use of resources," Coleman said, adding that such a program might quickly become unsustainable.

Thissen said the proposal would be capped at $8 million to $12 million for the two-year budget period.

Iris Freeman, a longtime elder-care advocate with the Alzheimer's Association, said that purchased care can seldom replace in-home care from a relative.

"This would make a difference for individuals with marginal income," she said. "It could let them put a ramp in front of the house, grab bars in the bathroom, maybe hire a few hours of help a week to spell them."

The cost of such a program wouldn't begin to approach the $60,000-a-year price tag for a nursing home, Freeman said, and much of that is borne by the state.

Even more expensive is care for the nearly 90,000 aging Minnesotans who have been diagnosed with some form of dementia, Freeman said. As the disease advances, she said, their care can run $175,000 a year. "Most of them can remain in their home if someone can take care of them," she said.

Career left behind

Amy McDonough, spokeswoman for AARP Minnesota, said the costs of elder care extends to businesses. Recent studies, she said, have shown that lost productivity among those caring for the elderly costs American businesses between $11 billion and $29 billion annually. "We're very supportive of this legislation," McDonough said.

Sheila Oliver, 42, was director of social services at a nursing home until October. That's when she quit her job to care for her ailing 75-year-old mother, Kathleen Johnson, at Johnson's Shoreview home.

Johnson has Parkinson's and recently developed congestive heart failure. Her health started to deteriorate after she fractured a hip last June. "She's not able to do anything for herself now besides feed herself," Oliver said.

Oliver does it all, including caring for Johnson's permanent catheter implant.

"She's my mom," Oliver said. "She took care of all seven of us kids. I couldn't take care of her and do my job, and I've been exposed to nursing homes enough that I don't want her there."

The problems in senior care delivery "are huge," Oliver said. As director, she had a caseload of 75 shared with just one other social worker. "We did the care conferencing, acted as the family liaisons," she said.

A majority of nursing-home residents now, she said, suffer from some form of dementia, making it impractical to put people like her mother in that setting.

"It would depress her," Oliver said. But the pressures of providing 24/7 care is "pretty intense" she said.

"Sometimes you just need someone to come in and sit with them," she said. "If caregivers don't take care of themselves, they'll just fry."