Ask The Expert: Kate Pomplum

During a recent telehealth meeting, my doctor noticed that my stress level has increased while caring for my husband who has dementia. She mentioned looking into respite care for him, to give me a break. What exactly is respite care and will my insurance cover it?

This is an excellent question and one that is being asked more frequently as caregivers have spent an increased amount of time in the home caring for their family member during this pandemic. In very general terms, The National Institute on Aging, provides this definition “Respite care provides short-term relief for primary caregivers. It can be arranged for just an afternoon or for several days or weeks. Care can be provided at home, in a healthcare facility, or at an adult day center.” So essentially, your physician is saying you need a break from your caregiving responsibilities to reduce stress and take care of yourself. 

Elderly woman talking with a doctor while holding hands at home and wearing face protective mask. Worried senior woman talking to her general pratictioner visiting her at home during virus epidemic. Doctor explaining about precautionary measures during virus pandemic to old lady and takes care of her.

Respite care can be formal or informal. Formal care would be provided by a paid professional, community program or facility. Informal care might be provided by a friend or family member. There are different ways that families can approach respite care. First, determine if you need a one-time break, to get a weekend away, or if this is an ongoing need. Then determine if you have a friend or family member who is willing and able to provide the care he will need, without you in the home. Sometimes respite care is a combination of both formal and informal care. For example, your adult daughter offers to stay at your home with her dad, so you can go visit a friend for a few days. However, your daughter also works and will need a paid caregiver to come in during the day until she returns home in the evening. The combination of the two sources would provide him the support he needs and you the time away. 

In a non-COVID world, facilities and adult day centers also offer options for short term respite care. For example, if you are going away for a week, he could visit one of the local Assisted Living Facilities (ALF) for the week. This can serve as a trial period to see how he does in this setting and provide you with reassurance that he is being cared for while you are gone. A respite stay in a facility requires an available bed, and paperwork the facility will need from the physician. This is more difficult now, as most will have restrictions in place that may make a short-term respite stay more challenging to coordinate. It would also likely require a quarantine period once in the facility. This may be more than you want to put your husband through if it is only temporary. However, if you are looking at an extended respite stay, such as a month, it might be an option worth investigating. 

The majority of respite care occurs in the home and is an out-of-pocket expense. The National Institute on Aging states, “Respite services charge by the hour or by the number of days or weeks that services are provided. Most insurance plans do not cover these costs. You must pay all costs not covered by insurance or other funding sources. Medicare will cover most of the cost of up to 5 days in a row of respite care in a hospital or skilled nursing facility for a person receiving hospice care.” Some individuals might have a long-term care insurance policy with a respite benefit as well. Each policy is different and would need to be reviewed. There are also a few community grant programs that might provide assistance with the funds needed. AOS and Friends Care, Duke Family Caregiving Program and Dementia Care Alliance of NC are just a few that come to mind. 

If you decide to pay for a caregiver to come into the home to provide care for him, you will need to determine if this is something you want weekly (every Monday from 1 to 4, so you can go grocery shopping) or for a predetermined period of time (for the weekend so you can spend a weekend at the beach). Either way, once you know what hours or days you need care for, then you will need to figure out what skillset the caregiver needs to have? What are his daily needs and what will the caregiver need to do for him? This will help you choose the care provider that is the right fit. You can hire a private duty caregiver or seek care through a home health agency. You will need to make a few calls to see who has the ability to meet the criteria you have outlined and what the cost will be. They should be able to provide you with an estimate, based on what you have requested, and provide you with some options and guidance. 

Respite care takes some planning, but it is essential that you get a break and pay attention to your own needs. If you find yourself overwhelmed by the process or are not sure what you need, seek out a social service professional or Aging Life Care Manager who can help you accurately assess the situation and help provide you with resources. You are not in this alone. Reach out and get the support you need to enable you to be the best care partner to your husband that you can be. Taking the time to take care of yourself will be worth every penny!

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Ask The Expert: Kate Pomplum was last modified: June 21st, 2023 by Sprout Media Lab Testing