Caregiving: Where Clinton and Trump Stand

presidential election 2016

According to a recent AARP study, approximately 34.2 million Americans have provided unpaid care to an adult age 50 or older in the prior 12 months. Nearly half of these caregivers provide care to someone 75 years old or older (47%), and in most cases, the main reason their recipient needs care includes “old age” (14%), Alzheimer’s or dementia (8%), or surgery/wounds (8%). Caregiving each week typically exceeds 22 hours, and is particularly time-intensive for those caring for a spouse/partner (44.6 hours a week).

Caregivers help, on average, with 4.2 out of 7 Instrumental Activities of Daily Living (IADLs), including transportation (78%), grocery or other shopping (76%), or housework (72%). They also deal with Activities of Daily Living (ADLs), such as incontinence or diapers (40%), helping the recipient to and from the toilet (33%), and provide bathing/showering assistance (31%). Recent research revealed that, in addition to ADLs and IADLs, 6 in 10 family caregivers are increasingly performing tasks that nurses typically perform, such as administering injections, tube feedings, catheter and colostomy care, and many other complex care responsibilities (and only 14% of these caregivers had preparation or training to do so).

As you can see, caregiving is an issue that needs to be addressed by our country’s leaders. Let’s take a look at where the presidential candidates Hilary Clinton and Donald Trump stand on issues involving caregiving (excerpted from Next Avenue).

Issue Trump Clinton
Social Security, Taxes and Caregiving Trump responded to a question about Alzheimer’s at a campaign event by saying the disease is “a total top priority for me… That’s something that we should be working on and we can get an answer.”

 

One passage of the 2016 Republican Party platform refers to “homecare:” It says: “Our aging population must have access to safe and affordable care. Because most seniors desire to age at home, we will make homecare a priority in public policy and will implement programs to protect against elder abuse.” As for taxes, the Republican platform says, “We will be mindful of the burdens on families with children and the impact on an aging population. We will seek simplicity and clarity so that every taxpayer can understand how much of their income is consumed by the federal government.”

Clinton also announced last year that she would invest in the “caring economy,” as reported by the Associated Press. She favors a new tax break for individuals caring for aging parents or grandparents. Under the proposal, a family caregiver would be able to deduct 20 percent of caregiving expenses, up to a total of $6,000. That would result in a total tax savings of up to $1,200. (The proposal would not apply to those taking care of a spouse, however.) “The lost wages and the work that is sometimes given up are costing families — especially women, who make up the majority of both paid and unpaid caregivers,” Clinton told AP.
Respite Care for Caregivers Trump recorded a guest spot for an Alzheimer’s Foundation of America telethon in 2010 urging viewers to contribute to the foundation for its helpline, educational materials, hands-on care programs and “grants to families for respite care.” She favors greatly increasing the amount the federal government spends on its Lifespan Respite Care program, which provides money to states to give family caregivers a temporary break. It spent $2 million in 2015, according to CNN. Obama asked for $5 million for 2016, and Clinton proposes increasing funding to $10 million a year.
Paid Family Leave for Caregivers Fox Business Network’s Stuart Varney asked the Republican nominee last fall what Trump’s position was on paid family leave (he didn’t specify under what circumstances). Trump’s response: “Well, it’s something that’s being discussed. I think we have to keep our country very competitive, so you have to be careful of it, but certainly there are a lot of people discussing it.”

 

He has not talked specifically about paid leave for those taking care of older relatives.

Under the heading, “Supporting Working Families,” the Democratic Party platform states “…Democrats will make sure that the United States finally enacts national paid family and medical leave by passing a family and medical leave act that would provide all workers at least 12 weeks of paid leave to care for a new child or address a personal or family member’s serious health issue.

“Our work and family policies must also help family caregivers,” the platform continues. “We will ensure that family caregivers have the support, respite care, and training they need to support their loved ones. We will create a strong, stable, paid caregiving workforce to help meet families’ needs, by raising wages, improving access to training, and giving workers the opportunity to come together to make their voices heard in support of a stronger system. We will address the conditions that make it hard for workers with unpredictable or inflexible schedules to meet caregiving responsibilities… and support the millions of people paying for, coordinating, or providing care for aging relatives or those with disabilities.”

Long-Term Care The Republican platform mentions the issue once, in the context of Medicaid — which pays for nursing home care for people who have exhausted their assets. (PLEASE NOTE: There are dozens of legal and ethical strategies that our firm can use to re-arrange your assets in order to protect them while still meeting the strict guidelines and qualify for Medicaid benefits. Life Care Planning and Medicaid Asset Protection is the process of re-arranging / protecting assets from having to be simply “spent down” in connection with nursing home care or in-home care, while also helping ensure that you or your loved one gets the best possible care and maintains the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home.) The platform says: “As the dominant force in the health market with regard to long-term care, births, and persons with mental illness, [Medicaid] is the next frontier of welfare reform,” the platform says. “It is simply too big and too flawed to be administered from Washington.” The Democratic nominee states in a fact sheet: “Hillary Clinton knows that as baby boomers age, more and more families will need to provide care for or will need care from loved ones. In fact, the number of Americans needing long-term care and support is projected to grow from about 12 million today to 27 million by 2050, and nearly 7 in 10 people turning age 65 will need long-term care at some point in life.” That’s why she has proposed the tax break for caregivers and the Social Security adjustment, the fact sheet says. But those would not affect the difficulties many families face in paying for other types of long-term care, such as assisted living centers and nursing homes.

The Democratic platform includes a section titled “Ensuring Long-Term Care, Services, and Supports” that is low on specifics. It reads: “Our country faces a long-term care crisis that prevents too many seniors and people with disabilities from being able to live with dignity at home or in their communities. The vast majority of people who are aging or living with a disability want to do so at home, but face challenges finding and affording the support they need to do so…. Democrats will take steps to strengthen and expand the home care workforce, give seniors and people with disabilities access to quality, affordable long-term care, services, and supports, and ensure that all of these resources are readily available at home or in the community.”

The Status of the National Family Caregiver Support Program

In addition to the stances taken by the candidates, a recent study is bringing the National Family Caregiver Support Program into the spotlight. It finds that over the past 15 years, the program has accelerated the development of local services and supports to help caregiving families.

The NFCSP calls for states, working in partnership with Area Agencies on Aging and service providers in the community, to offer core services to family caregivers in five categories to help keep older adults living in their homes and communities for as long as they choose: 1) information to caregivers about available services; 2) assistance to caregivers in accessing supportive services; 3) individual counseling, support groups and training; 4) respite care to give family caregivers temporary relief from the daily stress of caregiving; and 5) supplemental services (such as installation of personal emergency response systems).

Progress is as follows:

● Before the NFCSP became law, only half the states reported providing respite care — one of the most pressing needs of families and friends who take on the caregiving role.  That has begun to change, although greater progress needs to be made.

● Before the NFCSP, less than half of the Area Agencies on Aging operated any programs for family caregivers in the community. Today, twice as many deliver respite care, more than three times as many offer caregiver support groups and education and training in the community, and more than nine times as many provide counseling to caregivers to help them cope and manage their own stress.

Demand for supportive services exceeds available resources. Hopefully, whoever is elected president will strengthen current programs and enact additional ones to provide much needed assistance for caregivers.

Where the Candidates Stand on other Senior Issues

Earlier this year, we did other articles on where the candidates stand, before Hilary Clinton and Donald Trump were the nominees. Please see “Where Presidential Candidates Stand on Senior Issues,” “Part 2: Where Presidential Candidates Stand on Medicaid and Veterans Issues,” and “Critter Corner: How Presidential Candidates Stack Up When it Comes to Pets.” We will continue to keep our readers updated on issues of interest as we get closer to Election Day.

Have you planned for your future and for your loved ones? Regardless of the election outcome or possible changes in the law, the need to plan in advance remains. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning (or had your documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please don’t hesitate to call us as soon as possible for a no-cost initial consultation:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

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About Renee Eder

Renee Eder is the Director of Public Relations for the Farr Law Firm, and gives the voice to the Critters of Critter Corner. Renee’s poodle, Penny, is an official comfort dog who she and her children bring to visit with seniors who are in the early stages of dementia at a local senior home once a month.

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