Patient job, insurance, and money concerns for caregivers
Can the patient keep working during treatment?
The patient with cancer often wants to keep working through treatment. Work is an important part of many people’s lives, and often a way to maintain some stability and control. In some cases, it’s possible to work during treatment. In others, it’s not. There are many things to take into consideration when deciding whether to work through treatment. Talk to the cancer care team for advice. You can also see Working During Cancer Treatment to learn more about how to do this and the legal protections the patient has available. It also covers what can be done to keep health insurance coverage if the patient is unable to work or can only work part time.
What do we need to know about the patient going back to work after treatment?
As cancer treatment comes to an end and the patient begins to recover, at some point the patient may be given the “all clear” to go back to work. You may need to help get the letters from the doctor that will be needed to clear the patient for full work duties when the time comes. And even when your loved one starts working a more normal schedule, there may be days of extreme tiredness in which your help will still be needed. It may take some time to get past this phase, and you may still need your circle of helpers so that you, too, can start getting back to a more normal schedule.
Tips on how to manage this transition and the legal protections available are covered in Returning to Work After Cancer Treatment.
What do I need to do with the patient’s health insurance?
Cancer is a very costly illness. Even if the patient has health insurance, it surprises many people to learn how much they have to pay out-of-pocket for cancer care. And the patient is probably going to need help keeping track of it all, figuring out what’s covered and what isn’t, and paying deductibles and co-pays.
You or someone else will probably need to help set up a system for tracking costs, comparing insurance statements, and keeping careful records. Patients will need to stay in touch with their insurance plan in case there are reimbursement problems. The patient may need to give permission to the insurance company to talk about problems and disputes with the person chosen to help with insurance.
How do I deal with all the money issues?
For the person who has lost their income because they had to quit their job to be a full time caregiver, financial problems can become overwhelming very quickly. Contact us or visit our website for more information on dealing with money issues.
If you’re still working, the patient may need extra help – someone to check in on them while you’re at work. Some caregivers may be able to check in by phone as long as their loved one can do some of their own basic care. Or you can start pulling your family together to find people who can be there or call while you’re at work. If there’s a need for skilled nursing care, the patient may be able to get home health visits through their health insurance.
A few people are able to get paid for time spent caregiving. Some states have Cash and Counseling Programs that can directly pay some caregivers. You can find out whether your state has a program by contacting your local Medicaid office, social services, or health department.
It may be hard to talk about, but legal issues can be a huge source of stress for caregivers, patients, and families. Common worries include who will manage the person’s money and who will make important health care decisions if the patient is unable to do so. It’s important to bring these up with the patient while he or she is still able to make choices. This way, you and the rest of the family can be clear about what the patient wants.
If the person with cancer becomes unable to manage their own money
There are surrogate decision-making tools that may help you and the patient. One example is the durable power of attorney, which allows the patient to choose the person who can make financial decisions on behalf of the patient. (This is quite different from the durable power of attorney for health care, which is discussed below.) The durable power of attorney does not affect health decisions. If you are the health caregiver, you might want to consider asking the patient to let someone else make the financial decisions.
If the person with cancer becomes unable to make health care decisions
A durable power of attorney for health care has nothing to do with money or finances, only health care decisions. It allows the patient to choose someone to make health care decisions if he or she becomes unable to do so. The caregiver is a logical choice in many cases, given their knowledge of the patient and their condition. But it becomes more difficult when the patient and the caregiver have different goals and values. Contact us for more information on living wills and durable powers of attorney for health care, see Advance Directives.
Sagawa R, Akechi T, Okuyama T, et al. Etiologies of delirium and their relationship to reversibility and motor subtype in cancer patients. Jpn J Clin Oncol. 2009;39(3):175-182.
Yabroff KR, Kim Y. Time costs associated with informal caregiving for cancer survivors. Cancer. 2009;115(18 Suppl):4362-4373.
Last Medical Review: May 2, 2016 Last Revised: June 6, 2016