Recently, I wrote about assisted living facilities for people with memory issues, but the reality remains that most people want to or have to remain at home for their care. As we age, our needs for custodial care may increase, especially among those with chronic illnesses like Parkinson’s, stroke and Alzheimer’s disease.

There are some important details that have to be considered before making the decision to provide care for a loved one on you own versus hiring an outside caregiver, foremost among them is often the cost. Because Medicare does not pay for long-term in-home custodial care, I’ve been a big fan of early acquisition of long term care (LTC) insurance. But even with a long term care policy, it’s important to clearly understand under what circumstances your LTC policy will pay for services.

Research has provided us with some sobering statistics about family members assuming the role of primary long-term caregivers for a spouse or other family member. In more than 60 percent of the cases involving seniors, the family caregiver, usually the spouse will predecease the patient.

It’s true that in many cases, the patient outlives the caregiver who actually dies of stress-related illnesses associated with caregiving. There is also strong research evidence that has shown that after the intense caregiving period is over, within six to 18 months, a high majority of caregivers will themselves become very ill – think of this as a post-traumatic stress-related illness, and another cost of caregiving.