Stankovich: Bay Area family caregivers face financial hurdles 

Family caregivers are the unsung heroes of our health care system, yet their struggles often go unnoticed.

In the Bay Area, the cost of living is astronomical, making caregiving an expensive endeavor. Our family caregivers face immense challenges, from financial strain to emotional stress, and it’s time we address these issues with the urgency they deserve.

One of the primary challenges family, friend and family of choice caregivers in the Bay Area face is the high cost of living. Caregiving agencies must keep up with these expenses, which makes their services costly. At rates of $40 to $50 per hour, many families cannot afford professional care. This forces people to take on the role of unpaid caregivers, often causing them to leave their jobs. The financial burden can be debilitating, creating a vicious cycle where family caregivers are unable to contribute to the local economy because they are wholly focused on their caregiving responsibilities.

In California, if an individual is over the monthly income limit for free Medi-Cal, the individual must pay a shared cost or deductible before Medi-Cal pays for services. The Maintenance Need Level, which calculates the share of cost, is the amount of money it should take to cover food, clothing and shelter. This amount is only $600 and has not been updated since 1989. For a single person who is just $20 over the income limit of $1,732, the individual would have to pay their first $1,152 of care each month.

This outdated policy is a stark reminder of the financial hurdles many unpaid caregivers face. While there have been some positive changes, such as no longer considering assets to qualify for Medi-Cal, the system still leaves many falling through the cracks. For instance, youth in Santa Clara County have higher income thresholds for Medi-Cal eligibility, but there’s no similar provision for older adults, leaving many without the support they need.

According to the Family Caregiver Alliance, 40% to 70% of caregivers have clinically significant symptoms of depression, and the “unpaid labor force is estimated to be at least $306 billion annually, nearly double the combined costs of home health care ($43 billion) and nursing home care ($115 billion).” According to a new AARP study, family caregivers saw an annual average of $7,242 in out-of-pocket costs related to caregiving.

However, there are still significant gaps in services. Many caregivers start without knowing about available resources, believing they can manage independently. The emotional toll is immense, with 99% of caregivers in our program alone reporting stress levels of six or above. Many are experiencing stress levels between eight and 10. This stress often stems from caregiving responsibilities combined with financial concerns.

Family dynamics can further complicate caregiving. Care recipients may resist help, leading to strained relationships. Trust is critical. Sometimes a third party is needed to mediate and ensure the care recipient gets the help they need. The lack of adequate aid for family, friend and chosen family caregivers affects society’s overall well-being. Without proper reinforcements, family caregivers are at risk of worsening health problems compared to their non-caregiving peers. This not only impacts their quality of life, but also places additional strain on the health care system.

The community and government can play a significant role in alleviating these burdens. Policies need updating to reflect current economic realities, and more programs should be available to provide respite care for unpaid caregivers. It’s also crucial to educate these caregivers on practical and self-care techniques. My agency, which has no financial or diagnosis requirements for support for those 60+, emphasizes the importance of self-care, respite and education in managing caretaking responsibilities. While we have made great strides in our agency to address this with effective programming, more work is needed.

Some cities in the Bay Area are taking aging services seriously. Campbell, for example, is a designated Age Friendly City, working on addressing service gaps and seeking solutions to nurture their aging population. And free events like the Caregivers Count! Conference are so important to reaching and helping family caregivers. Through a four-event series, the conference brings leaders in the field to share skills, provide resources and, most importantly, respite for those dedicating their lives to caring for their loved ones. It’s heartening to see agencies and cities recognizing the importance of supporting caregivers and their loved ones.

Together, we can build a future where family caregiving is not a burden, but a sustainable and needed role in our society.

Adrianna Stankovich is a supervising care manager with Sourcewise.