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Benefits of Structured Family Caregiving

Kimberley Fowler
By Kimberley FowlerSeptember 16, 2016

What began in 2013 as an innovative alternative to traditional nursing homes has proven a cost effective solution that’s being adopted by more and more states across the country. Structured family caregiving is a caregiving model being used by states like Indiana to provide financial and supportive services to seniors and their families.

Learn more about the benefits of structured family caregiving.

Benefits of Structured Family Caregiving

In Indiana, structured family caregiving “empowers caregivers to care for seniors and those with disabilities who wish to remain at home, or in the home of an approved caregiver, rather than become institutionalized into a nursing home,” explains the American Elder Care Research Organization’s Paying for Senior Care website.  In Indiana, Structured Family Care is not a standalone program — it’s a benefit associated with Indiana’s Aged and Disability Medicaid Waiver and the program is successfully providing seniors and their families with a cost saving alternative for senior care.

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According to the Indiana Family and Social Services Administration, the primary caregiver is responsible for providing “personal care services, homemaker and chore services, attendant care and companion services, medication oversight (to the extent permissible by Indiana law), transportation, activities that are therapeutic in nature or assist with maintaining natural supports, assistance with correspondence and/or bill paying and other appropriate supports as outlined in the plan of care.”

Indiana isn’t the only state using a structured family caregiving model. Although it’s branded differently from state to state, the concept has been successfully implemented in six states to date, including Connecticut, Indiana, Louisiana, Massachusetts, Ohio and Rhode Island. According to Stephanie Bouchard, a contributor to HealthCare Finance, “in Massachusetts last year, Medicaid savings reached between $130 million and $140 million because of its structured family caregiving program.”

How Does Structured Family Caregiving Work?

Although the specifics vary by state, the American Elder Care Research Organization describes structured family caregiving as a scenario where a caregiver moves into a senior’s home to provide care, or an elderly person moves into the caregiver’s home to receive care. The caregiver is financially compensated for providing care to the elderly individual who would otherwise require care in a nursing home.

It’s important to note that in most states, like Indiana, the structured family caregiving model defines the principal caregiver as a non-family member or family member who is not the participant’s spouse, parent or legal guardian. The American Elder Care Research Organization explains that with the structured family caregiving model “caregivers can be related to the care recipients. Commonly it is the adult children who become the paid caregivers. However, there is no requirement that care recipient and caregivers be related. Sometimes, a friend, in-law or neighbor becomes the caregiver. Spouses and legal guardians are prohibited from participating in this program as compensated caregivers.”

The benefit to this care model is that “the adult children of aging parents receive compensation for having their aging parent live with them and being their primary caregiver,” which provides much needed financial relief to families across America.

Model Based on Providing Caregivers with Support

Family caregivers who face the financial burden of caring for a senior certainly benefit from the financial support that the program provides. There are also cost savings to each state. According to Bouchard, Rhode Island saved “$1.5 million last year because paying home caregivers cost about half as much per day as a nursing home bed.” About 60% of the Medicaid dollars paid by the state to for-profit providers of structured family caregiving models like SeniorLink “are given to caregivers as a tax-free stipend, equating to about $17,000 a year,” Bouchard reports. “The rest of the money goes toward paying the clinical care team and operating costs… It’s not a lot of money… but the vast majority of people participating in the structured family caregiving model are from low-income families, many of whom, when they were in the workforce, made about the same amount.”

However, the benefits of the structured family caregiving program extend beyond finances.

Caregivers “get compensation that allows them to do the work, keep their family together, and give back to their mom in a way that she took care of them at the other end of life,” Tom Riley, president and chief operating officer of SeniorLink, tells Bouchard.

Not only does structured family caregiving help keep families together, it provides family caregivers access to a clinical team that includes nurses and a licensed social worker who provide training and support in creating a care plan with the caregiver. This supportive approach helps protect seniors by ensuring they get the best possible care, while also providing their caregivers with vital information and access to local support networks and adult day cares that help reduce the worry and stress involved in caregiving. Not only does the model ensure that caregivers are trained, they are also expected to report to the clinical team, who conducts regular visits.

Sue Burman, a nurse working with Rite @ Home, Rhode Island’s structured family caregiving program, tells Bouchard that “caregiving can be stressful and lonely… but the nature of the model creates a support network for caregivers. In addition to being able to talk to members of the clinical team, caregivers are given $3,000 a year for respite services so they can get a break occasionally.”

As the structured family caregiving model continues to provide benefits to the states who have adopted it the expectation is that more and more states will jump on board. Next Avenue’s Beth Baker reports that SeniorLink hopes to expand the program to two states per year. This is certainly a worthwhile goal, considering that states who adopt similar models will reduce the cost involved in caring for an aging population while also providing much needed assistance to family caregivers, who may be carrying the responsibility of senior care all on their own.

Do you and your family have experience with structured family caregiving? Share stories about your experiences with us in the comments below.

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