MONEY family money

How to Ask Your Sibling to Chip in for a Parent’s Care

The financial burden of caring for an elderly parent is typically a large one: Family caregivers spend an average $5,500 a year, AARP reports.

That’s not to mention the physical and emotional toll. (Depression rates among working women caregivers over 50 are 2½ times higher than those of non-caregivers, one study found.)

So if your siblings aren’t sharing the load, you’re probably bearing some resentment. “Caregivers often don’t know how to ask for help,” says Gail Hunt of the National Alliance for Caregiving. “They just keep plugging away without realizing they’re burning out.”

Use this talk to get your brother to spare a dime and lend a hand.

The Ground Rules

Know your goals. In the short term you may want your brother to split the bills or take Dad on weekends. Also, deciding what you want long term, for you and your parent, helps put the situation in perspective, says Clare Fowler of Mediate.com.

Avoid finger-pointing. Stick to what’s happening now, not what your sis has failed to do in the past. “Blaming is not going to be helpful,” says family therapist Barry Sommer.

Have a fail-safe. Emotions can run high with siblings. When tempers impede progress, call a time-out.

When You’re Face to Face…

1. Opening gambit: “I wanted to talk about Mom’s care since she broke her hip. To start with, thank you for staying with her the last time I was away.”

Why it works: By acknowledging your sibling’s contributions, you’re setting yourself up as partners who will tackle the problem together — and preventing old rivalries from reemerging, says Vicki Rackner, author of Caregiving Without Regrets.

2. State the problem: “The home health aide has hastened her recovery. But paying $720 a week is straining our budget and putting us behind on college savings.”

Why it works: You’re laying out the costs straightforwardly, while providing enough detail of how this impacts your finances that he knows you’re not just being dramatic. “With family, it’s important to be direct or else you’ll sound disingenuous,” says Fowler.

3. Ask, don’t tell: “What do you think you could contribute?”

Why it works: You’re probably not fully aware of your sibling’s obligations and resources, so putting this question to him — rather than making a demand — will help you figure out a reasonable care-sharing strategy.

If you get pushback, figure out where it’s coming from and try to address his concerns. Should money be the issue, for example, you could suggest dividing costs based on income or having him spend more time with Mom so you can cut back the aide’s hours.

4. Split the jobs: “I’d like help thinking about what care Mom needs. Maybe we can start a list of duties — and figure out who should do what?”

Why it works: Collaborating on this list can help your sibling realize how much time caregiving requires. If he or she lives far away and any division of labor would leave you with a hefty load, you might ask your sib to share the cost of a geriatric-care manager to help you out.

5. Iterate a plan: “So we’ll split costs 60/40, with the option to revisit if our situations change. We’ll also Skype weekly to discuss Mom’s progress.”

Why it works: “You’re summing up the conversation and framing it so the goals are clear for both of you,” says Fowler. You’ll leave with a positive feeling and reminder of what must be done.

MONEY

5 Ways to Cut the Cost of Allergy Relief

Your health insurance is unlikely to cover an acupuncture session for treating allergies. Illustration: Gillian Blease

What you need to know about treating this common malady.

Looking for allergy relief? Prescriptions, rather than OTC remedies, are often more effective and cheaper in the long run.

1. Avoiding treatment can be costly

Nearly a third of adults have allergies. Suffer through the symptoms, and you could pay the price at work. During allergy attacks, one study found, employees lost more than two hours of productivity a day.

If you regularly take over-the-counter pills, get tested to pinpoint your allergens and fine-tune treatment.

The common skin-prick test is faster than a blood test and may save you a second office trip, says North Aurora, Ill., allergist Sakina Bajowala.

2. A prescription pays in more than one way

What your doctor prescribes may be more effective. For example, a steroidal nasal spray like Flonase beats an OTC spray, which shouldn’t be used for more than a few days because it’s habit forming, says Richard Madden, a physician in Belen, N.M.

Even when an OTC drug like Claritin or Zyrtec works fine for you, ask for a prescription anyway. That way you can pay for the pills with the pretax dollars in your flexible spending account.

3. Shots pay off over time

Your doctor may suggest immunotherapy — shots one or two times a week for up to eight months, tapering down to monthly over three to five years. A recent study in the Journal of Allergy and Clinical Immunology found that immunotherapy patients saw 38% lower treatment costs owing to fewer overall doctor visits and drugs.

“You put in your work and expense upfront and get all the benefit down the road,” says Bajowala.

4. An alternative treatment is on you

Acupuncture, biofeedback, hypnosis, and even eating local honey are touted as treatments, but there’s little clinical data to prove widespread effectiveness over the long term. While your insurance may pay for a $100 acupuncture session for back pain, allergies are less likely to be covered.

One homebrew that gets a thumbs-up from doctors: nasal irrigation. No need to spring for a $100 contraption — a $20 drugstore variety with distilled water is fine for most.

5. For gear, there’s no need to splurge

The best air purifier is your air conditioner, says Gaithersburg, Md., allergist Jacqueline Eghrari-Sabet. Just add a HEPA filter to trap pollen, dust, and mold spores. With no AC, a basic $50 HEPA air purifier works fine, especially in small rooms.

When you’re allergic to heavier allergens that settle quickly — like dust mites and cat hair — air purifiers may not help much, though. Get a HEPA filter for your vacuum and clean often.

MONEY health

DNA Testing: Crack Open Your Genetic Code

Genetic testing is getting cheaper and easier. What you should know before you use it.

For as little as $100, here are some secrets you can unlock from your DNA: Whether you could have inherited a risk factor for certain kinds of cancer. Or how much of your genetic makeup comes from Neanderthals.

You might also learn whether your genes raise your chances of getting diabetes — but your doctor will still probably be more interested in other, more obvious risk factors, such as your family history and diet.

In short, although technology is quickly making it cheaper and easier to get data about yourself, it’s not always clear which information is worth getting and which isn’t.

Here’s a guide to using, and paying for, genetic tests.

What you can find out — and what you’ll pay

Roughly, two kinds of tests are available.

The first is ordered by a doctor and will often involve finding all the variations in specific genes. Research has found some variations that point to a higher risk of diseases, including breast cancer and a kind of colon cancer.

A doctor might recommend a screen based on risk factors like family history or ethnic background. Other tests, says David Fleming, an internist and health ethicist at the University of Missouri, can provide clues to how you’ll respond to certain drugs or treatments.

The tests can cost $300 to $3,500. If your doctor recommends it, insurance will generally cover it like any other test. But call your insurer first: Some might require an advance letter from your doctor or a visit to a genetic counselor, a professional trained to help people use genetic information to manage their health.

The second kind of test is a home kit that lets you mail in a saliva sample and log on to a website to get results. It’s generally not covered by insurance. (The Food and Drug Administration has said it’s concerned about unregulated consumer tests but allowed companies to keep them on the market if they began the process of getting approval; none are yet FDA approved.)

One big player, 23andMe, has made a publicity splash by cutting its price to $99 for a report on up to 250 indicators, from that Neanderthal DNA to markers of health risk. This test may differ from one your doctor would order; it won’t read all the variations in a gene but looks for common markers.

For concerns about a specific disease, use a doctor, not a kit.

Why you shouldn’t face the serious stuff alone

Experts caution that the results of tests can be difficult to interpret on your own. That’s fine if you are looking for fun info on your ancestry. But discuss with a counselor or doctor in advance whether you should do a screen for a disease, and what a positive or negative result would mean.

You also need to think about what you’ll do if you get a worrying result.

A test can find markers of an elevated risk for late-onset Alzheimer’s, for example, but you can have them and never get the disease. And since there’s little to do now to prevent Alzheimer’s, you may feel better off not knowing.

Other screens, such as those for cancer, could leave you with difficult choices about how aggressively to respond. “The issue is when we make decisions based on fear rather than what we know,” says Fleming.

You’ll want professional help to sort through the facts. Visits to genetic counselors are often covered by insurers and billed like doctor’s visits. You can find a counselor at nsgc.org.

What tests don’t tell you

With some diseases, such as diabetes, it may be more accurate to simply look at your own family history, says Michael Dougherty, director of education at the American Society of Human Genetics. What’s more, he adds, “the genetic test doesn’t take into consideration all of the environmental factors.”

So it’s a good idea to eat right and exercise no matter what the result.

How safe are your records?

A law passed in 2008 prevents health insurers from using genetic information against you. Employers can’t use it either. But federal law doesn’t offer the same protection on long-term-care, life, and disability coverage. (Some states have stricter rules.)

“The concern is the insurance company could require you to show certain medical records,” says Harvard Medical School geneticist Robert Green. Or even just ask if you’ve been tested. It doesn’t appear to be happening yet, but it’s one more thing to keep in mind as you weigh whether you want to see what’s written in your DNA.

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