When I was young, I didn't understand why I constantly felt stressed out, or why I attempted suicide at age 16 after feeling extremely worried about failing school and disappointing my parents. At age 29, when I entered rehab for alcohol use disorder, I was also diagnosed with generalized anxiety disorder. 

This came as a massive shock to me at the time. Didn't everyone always worry about everything and have ruminating thoughts about the worst things that can happen? Apparently not. I sought treatment for my anxiety and continue to see a therapist to this day. But it still felt like maybe that wasn't the whole story. I still struggled in different, non-anxiety-related ways—which can happen even if you don't have a mental illness. And yet… I wasn't so sure. 

It all came to a head this summer when I experienced the worst anxiety I had ever felt—and this comes from someone who had already experienced terrible perinatal anxiety during pregnancy and then gave birth at the start of the pandemic.

Due to some significant life changes, like moving from Florida to Colorado, my husband and I had taken on some additional financial burdens. The financial anxiety left me overwhelmed, burned out, and completely unable to focus on my job for weeks. I thought that maybe I just needed an increase of my anxiety medication, which I had begun to take after giving birth, but found myself instead walking away with a diagnosis for Attention-Deficit/Hyperactivity Disorder after meeting with my doctor. 

RELATED: 6 Women Get Real About Their Postpartum Anxiety

Later-in-life ADHD diagnosis

I was 29 years old when I received my anxiety diagnosis and 35 years old when I received my ADHD diagnosis. After talking with a few friends who also have this diagnosis, I realized that I was unfortunately not the only one to be diagnosed well into adulthood.

"For most people, ADHD symptoms arise during childhood," David Mou, MD, MBA, a part-time lecturer at Harvard Medical School and the chief medical officer at online mental health company Cerebral, tells Health. "Though increasingly, research is beginning to suggest that some won't get symptoms until later in life. Additionally, not all children with ADHD are correctly diagnosed and treated, so it is possible that you've had symptoms of ADHD your entire life, and only later after a crisis did the symptoms worsen." 

When I think back to my childhood, it's challenging to figure out if I had ADHD symptoms or not. The official DSM-5 diagnostic criteria for ADHD states that symptoms must be "present prior to age 12 years" to make it an official diagnosis. But my poor memory of my childhood doesn't necessarily indicate that I have a wrong diagnosis. Instead, it may suggest that I developed coping mechanisms throughout my life without knowing what I was doing.

"There are many intelligent, capable people with ADHD who have managed their symptoms alone with strategies developed over time," Christy Duan, MD, a private practice psychiatrist in New York City, tells Health. "A crisis or breaking point can overcome the strategies someone with ADHD has relied on for most of their life. When someone with ADHD reaches this point, they might seek out professional help and be diagnosed after a careful evaluation."

RELATED: 7 Things People With Adult ADHD Want You to Know

Although I didn't go to my doctor because I suspected ADHD and wanted an evaluation, some of the struggles I've had as an adult sound pretty typical of those of a person with this neurodivergent condition.

"In adulthood, clients seek therapy with stories of having difficulty maintaining employment or having persistent interpersonal difficulties," Michelle Hintz, PsyD, MT-BC, a licensed psychologist, board certified music therapist, and owner and executive director of the Cadenza Center for Psychotherapy & the Arts, tells Health. "Some struggle with time management, such as being on time, meeting deadlines, and generally being as productive as expected. Others struggle with completing tasks with sufficient attention to detail, have difficulty being direct during conversations, and frequently misplace or lose things. And, let's not forget about the high level of distractibility and wasted time doing meaningless tasks." 

She lists inhibition—the inability to stop ourselves from distractions—as another struggle for adults with ADHD. She points to things like pulling out your phone when stopped at a red light (which even those without ADHD struggle with) as a common sign. 

As someone who has always struggled with inhibition and impulse control (another ADHD symptom), getting a diagnosis felt like making sense of so many issues I've had in the past. But why wasn't I diagnosed sooner? 

Why do women go undiagnosed?

It turns out that the answer is, unfortunately, sexism. "Parents, educators, and clinicians also have a harder time recognizing ADHD symptoms in girls," says Dr. Duan. "Girls and women have more symptoms of inattention, which are harder to spot than symptoms of impulsivity and hyperactivity. So, for example, kids who keep getting out of their seat and running around the classroom are easier to spot than kids who have more inattentive symptoms."

Leah Kaplan, a licensed professional counselor and certified life coach who runs a private practice in Boulder, Colorado, tells Health that a few factors may lead to more women getting a diagnosis later in life—such as ADHD typically presenting differently based on sex at birth, women exhibiting less traditional hyperactive behaviors (like trouble sitting still and disruptive behaviors), and the fact that women are more likely to be misdiagnosed with depression or anxiety. 

"Some well-meaning but uninformed doctors and even psychologists will write off general life struggles as anxiety and/or someone just needing to try harder (make a list! read this book so you can get organized!)," Kristen Carder, a certified life coach and host of the I Have ADHD podcast, tells Health. With her later-diagnosed clients, an ADHD diagnosis often comes after a significant decline or life stressors such as infidelity, financial crisis, deep depression, an inability to keep a job, or "shit hitting the fan in higher academics, like a bachelor's or master's degree," Carder explains. 

For me, that proverbial shit hit the fan after becoming a mom during the pandemic and experiencing extreme financial stress, which Carder says "makes so much sense." 

RELATED: ADHD Time Blindness Contributes to My Impulse Spending

"There is so much executive functioning and multitasking needed to be a mom," says Carder. "You go from having to manage yourself (hard enough) to now having to manage other people, as well. Time management, sustaining focus, emotional regulation, organization, prioritization, planning, and working memory are all key skills in running a 'successful,' smooth, happy household." 

Hintz agrees. "As adults, women who have ADHD report to me that they often feel 'scattered' and anxious by competing demands and constant interruptions," she says. "My adult female clients tell me that one of the most difficult things about ADHD is the belief that they should be experts at multitasking, yet most of us struggle with this."

Additionally, Hintz says that the societal expectations on women—to simultaneously build an amazing career while being an accomplished homemaker and wife and an engaged mother—can be a huge challenge for women with ADHD. 

For me, becoming a mom has been all-consuming and easily overwhelming. Before my diagnosis, I thought I was just bad at mothering. But now I realize that many things I struggle with in my parenting are mainly due to my formerly undiagnosed ADHD. "Think about all of the planning, organization, memory, focus, and time management it takes just to make a meal or get your kids to school on time," says Carder. "Unfortunately, ADHDers are deficient in every single one of those skills needed to keep our house and our kids happy."

Hintz points to this cycle of adult women with ADHD who are mothers feeling "two steps behind" as yet another reason we feel chronically distracted by worries that we are not good enough—something I experience quite often myself. "As expected, the prevalence of anxiety, depression, and low self-esteem is much higher for women with ADHD than those without," Hintz adds. 

What comes after diagnosis?

There's no way for me to know if my ADHD or anxiety came first. However, I do know that I do not want ever to feel the fear I felt just before giving birth or the burnout I experienced just before getting my ADHD diagnosis. This is why I am currently on medication for both my ADHD and my generalized anxiety disorder. But medication is a very personal decision. 

For some with an ADHD diagnosis, supplements, lifestyle changes, and working with an ADHD coach can be the right call. Elizabeth Brink, a neurodivergent coach at Thriving Sister Coaching, suggests working with a therapist trained in somatic (body-based) modalities, talk therapy, or individual or group coaching.

"Specifically, ADHD coaches are trained to help people understand their neurobiology and guide in exploring ways to support themselves based on their unique needs," she tells Health. "In my experience, individuals who have done some work in therapy usually get more out of the coaching partnership in furthering their self-discovery and acceptance."

But ultimately, no matter what course of treatment a person seeks, just getting a diagnosis can be a huge win. "I was finally diagnosed with ADHD in my mid-20s, after struggling for many years to adapt to the expectations that came with adulthood," Sam Dylan Finch, an ADHD coach and writer who believed they were "bad" at adulting before getting their diagnosis, tells Health. "Chaos was the name of the game as an adult with undiagnosed ADHD. It was so frustrating and isolating to feel like I was just lazy, or incompetent, or both. It was a huge relief to finally have my diagnosis and realize that others were struggling with the same things." 

Like Dylan Finch, I very much felt the same after my diagnosis—a huge relief to finally have an answer as to why certain things are just so damn difficult for me. But I'm working with my doctor and my therapist to understand my ADHD better and trying to accept who I am now that a piece of the puzzle has been answered.

As Dylan Finch says: "I have to adapt to the brain that I have, rather than the one that I'd like to have, which means radically embracing the quirky, annoying, and even frustrating parts of having ADHD." 

And most of all, I'm being gentle with myself as someone who's still figuring things out. 

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While it is true that demographic shifts (more on those in a minute) will cause the social security trust fund to be cash-strapped in the future, the reality, as always, is a little more complex. 

What is social security?

Back story first: In 1935, as part of the New Deal, President Franklin D. Roosevelt signed the Social Security Act. The idea was to give retired workers a source of income and "promote the economic security of the nation's people." According to the Social Security Administration (SSA), the arm of the federal government that oversees the plan, in 2019 more than 63 million people received benefits. About 47 million of those were retirees and their dependents. About 10 million were disabled workers and their dependents. The rest were survivors of deceased workers. 

RELATED: How to Qualify for Medicare Disability Benefits

Money for social security is collected through taxes and placed in a trust fund. (Technically, there are two trusts, one for old age and survivors and one for disability insurance. For the purposes of this explainer, we're focusing on the former.) Even if you haven't been aware of it, you've been paying into this fund as you paid your payroll taxes. If you work for someone else, they pay a 6.2% tax into social security on your behalf, and you pay 6.2%. If you are self-employed, you pay the whole 12.4% (and then deduct some on your tax return).

Is social security really going bankrupt?

People live longer now than they did generations ago; life expectancy is 79 years in 2019 as compared with 62 in 1935. This means that when you retire, you will join the largest-yet (and most expensive, given the medical expenses that tend to come with old age) generation of retirees. Because of this—and because demographic trends mean more people are retiring each year (about 10,000 people turn 65 every year, according to the US Census Bureau)—the amount of money in that social security trust fund is decreasing. 

Economists do predict that the social security trusts will run out by 2037, but that doesn't actually mean the pot will be totally empty by the time you're ready to retire. Despite the hubbub in the media, social security is not going bankrupt—not technically.

There are a few reasons for the misconceptions: Even when the trust fund is spent, younger workers will be continuing to pay taxes, and that should cover 76% of scheduled benefits to those who will have retired by then. By 2083, it dips to 73%. Of course, that's not exactly good news, but it's not zero dollars either. 

How to plan for your retirement, considering

Linda Grant-Smith, CFP, senior financial planner at at Robert W. Baird & Co. in Nashville, recommends that her clients start their retirement planning by logging into the SSA website and seeing what the SSA has calculated as their earnings to date. You will have to create an account to get started.

The SSA calculates what your benefits will be based on your earnings. (Hot tip, self-employed folks: Grant-Smith says she sees more errors in the SSA reports for the self-employed than for those who have an employer, so it is worth checking those numbers against your tax returns when you log in.) Once you have worked about 10 years, you'll qualify to receive benefits on your retirement. 

RELATED: 6 Ways to Invest Your Tax Refund Into Your Health

In today's economy, social security is intended to replace between one-third and one-half of the income you made pre-retirement. The actual amounts estimated vary depending on how much you earned over the course of your career. And remember: You're eligible for social security benefits starting at age 62, but you're better off waiting until age 67, when you'll be eligible for larger payments.

In 2021, the maximum is $3,895 per month for someone who starts filing at age 70 and has made among the top earners over the course of their career (the maximum wage taxable by social security for 2022 will be $147,800). The lowest is $628 a month for someone who starts filing at age 62 and had lower income over the course of their career. The SSA uses your top 35 years of earnings to calculate your retirement benefit—so don't panic if you had a bad financial year in 2020 or took a few years off to stay home with kids. 

Benefits do adjust for inflation. For 2022, benefits will increase 5.9%, due to the overall increase of cost of consumer goods. Even if inflation abates and prices go back to pre-pandemic levels, that increase will stick around for the whole year. 

RELATED: What Does Medicare Cover? Not Everything You Need

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When he was in his 20s, Brian Walsh did just that. He rode a motorcycle at the time, and he knew that activity came with inherent risks. He also knew that if he did have an accident, it would be stressful and upsetting enough for his wife without her having to guess whether he would want to be put on a ventilator if he were unable to breathe on his own. So Walsh had this unpleasant conversation with his wife. They talked about his wishes, and he got a living will.

Walsh, now a CFP at SoFi, an online personal finance platform (and, BTW, no longer a motorcycle rider), encourages people in their 20s, 30s, and 40s alike to create a living will—and to think of it as a gift they give their loved ones.

RELATED: Your Estate Planning Checklist: How to Make a Will and Where to Find Expert Help

At its most basic, a living will is a legal document that outlines your wishes in case an accident or illness prevents you from speaking on your own behalf. It may outline your feelings about artificial respiration, hydration, nutrition, and CPR. It should not be confused with a last will and testament, which is the legal document that explains what you want to happen after you die; a living will covers events while you are still living. Because living wills help you if you have an accident, they are not just for those with chronic illnesses or are of advanced age. Most experts say anyone over the age of 18 should have one.

While a living will outlines your wishes, it doesn't necessarily empower another person to act on your behalf. For that, you'll need a power of attorney. In some states, these two documents can be combined together into an advance health care directive. If you don't have a living will and you need to go under anesthesia, your hospital may have you sign a document specifically asking you whether or not you wish to be resuscitated if something goes wrong. Unlike a living will or power of attorney, which are good until you change them (more on that later), these orders are generally only good for 30 days or sometimes just for that particular hospital visit.

A living will gives the person you trust to make decisions on your behalf the information they need. It can also help prevent arguments if family members disagree on how to handle such an emergency.

RELATED: 10 Things You Should Never Say to Someone With a Chronic Illness

While such documents are generally designed to last for a long time, it is worth revisiting it to update when your circumstances change, such as if you marry or get divorced, or your sister, who was listed as your power of attorney, moves across the country. It is not a bad idea to have a plan B, either. If you list your spouse on power of attorney and you are both in an accident, perhaps it is your brother who will then act on your behalf.

How to make a living will

Okay, you're convinced you need a living will. You can have an attorney draw one up, and it might not be particularly expensive if you have other estate planning documents, like a will, done at the same time. But free and low-cost online forms are available for download, and one of those, which you then sign and have notarized, may be sufficient.

Once you have a living will, don't just keep it in your desk drawer. It doesn't do any good if no one knows it exists or what it says. You need to have that conversation Walsh had with his wife. The person who you are giving the power to speak for you must know what you want, and the hospital should know who to call as your emergency contact.

RELATED: How to Avoid the Financial Pitfalls of Being a Caregiver

As is the case with most legal documents, specifics vary by state. Depending on where you live, there may be some variation concerning what needs to be included or what cannot be included. Some states honor living wills from other states, others do not. Some states may have laws that invalidate living will directives during pregnancy. If you have state-specific concerns, working with a local attorney is a good choice.

"Many people neglect this planning, because death is a topic in our society that is avoided," Timothy Jordan, a professor of public health who teaches about death and dying at The University of Toledo, tells Health. "By filling out these documents, some feel that they are 'jinxing' themselves… Thus, many just deny the reality of death and never complete their advance directives."

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"In many countries, such as the United States where there is no single-payer or universal care system, individuals have to understand that health-related decisions and strategies are closely tied to financial outlook," says Jagdish Khubchandani, PhD, a professor of public health at New Mexico State University. "And knowledge of both is a must and should complement each other." 

Wellness and money experts tell us the biggest financial mistakes they see people make when it comes to spending—and saving—on their health. 

RELATED: Best Medicare Advantage Plans 2021

TK-Mistakes-You're-Making-When-Spending-On-Your-Health-GettyImages-514515397 that provide premium discounts and other perks for enrolling and participating in their wellness programs," says Karen Condor, a health insurance expert with Clearsurance. Wellness program participation might provide discounts on gym memberships, fitness gear, or equipment. Or you could even receive money to use toward out-of-pocket expenses, Condor explains.

"It is advisable to compare prices, features, coverage, deductibles, prescription benefits, and provider networks to enable you to identify the most affordable health care plan available," says Daniel Boyer, MD, of Farr Institute.

When shopping for a health insurance plan, either through the Marketplace or choosing a tier on your employer-sponsored benefits, you might become hyper focused on choosing a plan with the lowest premium. But often lower premiums equal higher deductibles and vice versa. A lower premium will mean you'll have a lower monthly fee for your health insurance. But the higher deductible will mean you'll be paying more out of pocket for services each year. 

A high deductible health plan can be a financial drain on people with preexisting conditions who need to see their doctors more often. But if you're relatively healthy, the lower premium option might be the better choice.

RELATED: 23 Health Insurance Terms You Should Know

"Many people are jumping on board to buy expensive products that they may not need," says Meg Mill, PharmD, a functional medicine health consultant. "For example, I have seen patients claiming to do a monthly parasite cleanse without knowing if they even have a parasite. Not only is this expensive, it can also put undue stress on your body." 

Focus on diet as a source of nutrients, rather than supplements, adds Jinan Banna, PhD, a registered dietitian and professor of nutrition. "Supplements should be used when the diet is not adequate to meet needs and shouldn't be the primary source of nutrition," she explains. When in doubt, consult your healthcare provider about whether you have nutrient deficiencies or special dietary needs and how to address them. 

Only going to the doctor when you are sick

"Not seeking preventive care or screenings and rushing to the ER when a problem occurs is expensive for health systems, individuals, and families," Khubchandani says. Get established with a primary care physician (PCP) if possible and obtain all routine screenings, such as annual physicals. 

You should go to the emergency room if you are experiencing an emergency, of course. But a PCP should act as your general health home. Your provider should maintain a detailed record of your medical history and help you navigate health issues if they crop up. That may mean directing you to a trusted specialist if necessary. 

PCP (and other provider) copays are generally cheaper than emergency room copays. And often health plans waive copays for a certain number of PCP visits per year. Plus, under the Affordable Care Act (ACA), all non-grandfathered health plans in the US have to cover preventive care benefits at no cost to you, as long as you're seen by an in-network provider. That means you won't pay a deductible, coinsurance, or a copay for many routine screenings with your PCP. And preventive care could save you money down the road.

RELATED: Go to the ER if You Have These Symptoms—Even During the Coronavirus Pandemic

Not accessing free or low-cost services

Even if you don't have access to a health plan, you can still get preventive care. "For many, the lack of situational awareness or general knowledge about free or inexpensive community-based resources can end up costing out of pocket," Khubchandani says. 

Federally qualified health centers (FQHCs) receive funds from the Health Resources and Services Administration (HRSA) to deliver primary care to patients on a sliding-fee scale. And other free clinics offer services either pro bono or at a low cost. 

Not utilizing hospital financial assistance programs

Nonprofit hospitals must offer financial assistance programs. These programs provide a discount or even free care based on a sliding scale. "Don't assume you earn too much to qualify," says Michael Waterbury, CEO of Goodroot. "Depending on the poverty rate in your state and your family size, you can make six figures and still be entitled to a discount of 25% or more. Many people suffering with medical debt were eligible for financial assistance but didn't know to ask." Check with the hospital's financial department before paying your bill, he recommends.

With a little extra legwork on healthcare spending and saving, you can keep your finances—and yourself—in relatively good health. 

Also according to the American Dental Association, one of the first signs of a wisdom tooth that needs removal is pain, swelling, and stiffness of the jaw. This pain occurs because the wisdom teeth that have partially come through the gums can give bacteria a place to enter the gums and cause an infection. The wisdom teeth can become completely or partially impacted (trapped). This makes the impacted tooth difficult to clean, which increases the chances of dental cavities or a localized gum infection occurring  in the area. This situation can also lead to pain, swelling and cyst formation as well as damage to other teeth.

RELATED: Affordable Alternatives to Dental Insurance You Never Knew About

What does your dental insurance cover?

Dental coverage is an essential health benefit for children, but not adults. This means that health insurance plans are not mandated to provide dental coverage as part of plans for anyone over 18 years old. According to the 2019 enrollment survey by the National Association of Dental Plans, since most wisdom tooth eruption and corresponding complications happen after the age of 18, and since about 25% of American adults are without dental insurance, over 33% of patients seeking wisdom tooth removal are left to shoulder this unexpected expense themselves.

Depending on the severity of the oral surgery needed to remove the wisdom tooth or teeth, your medical (rather than dental) insurance can possibly be billed—but this is dependent on which insurance codes are used when the claims are filed. Medical insurance will only help cover the cost if the oral surgery is deemed "medically necessary" for your overall health and wellness. The key here is the correct use of Current Dental Terminology (CDT) as established by the American Dental Association for identifying procedures provided to patients for oral treatment. It's possible that insurance will cover wisdom tooth removal as well as pay for any hospitalization and/or general anesthesia for the surgery—but it's also possible it won't. According to the Canada Dental Association, medical plans will not pay for treatments billed as CDT procedures.

The advent of the Affordable Care Act has allowed for many essential services to be covered under dental, but unfortunately wisdom tooth removal isn't considered in this lot. Most dental plans purchased through the Marketplace will cover 100% the cost of preventative care—such as cleanings, check-ups and x-rays. They will also cover 80% of basic treatments like fillings and 50% of more complex procedures such as root canals and crowns.

RELATED: 14 Reasons Your Tooth Hurts

But with the known complications that can arise from untreated wisdom teeth, it's unfortunate that policy has yet to meet this medical necessity. Dr. Davis explains that an untreated impacted wisdom tooth can "lead to serious complications such as a swelling of the jaw and face that compromises breathing and requires hospitalization to treat, and infection spreading to your brain and to your bloodstream, which both can lead to death. It is important to note that this risk exists even if the pain subsides."   

Low-cost oral surgery options

Dental HMO insurance plans will cover wisdom tooth removal in younger patients when recommended by a dentist. The catch is finding an oral surgeon who accepts your health insurance. In my son's case, the same state-subsidized dental coverage that covered his braces was almost useless for wisdom tooth removal. I spent an entire day calling every oral surgeon in NYC before I found one that would take his health insurance—but the earliest appointment was weeks away.

Ultimately, I paid $900 out of pocket to have my son's wisdom tooth removed. I decided against having him fully sedated because of the additional cost.

Registered dental hygienist Alwaine Fenton tells Health that there are numerous training facilities and care credit companies that offer affordable rates for dental care. Since routine cleaning and dental care for minors is easier to find, we asked Fenton specifically about reduced cost oral care and surgery options for adults. Fenton recommends the more popular options of using federally funded community health centers, and also United Way. United Way is seen as a one-stop shop for many social services, including dental care.

Fenton, however, is a big advocate for getting dental care, including wisdom tooth removal, from dental schools. He believes this is an excellent option because "even though students are practicing or training and may work slower with procedures taking longer to complete, there is reduced cost for dental treatment and students are closely supervised by licensed dentists."

When asked what disadvantages exist with using dental schools, Fenton mentioned that anyone needing emergency treatment would be inconvenienced because the wait time for appointments is usually long. Fenton reiterated that "an accredited dental school or dental hygiene school for quality and low-cost dental treatment is great because they are held to high treatment standards of the American Dental Association (ADA) and the American Dental Hygiene Association (ADHA)."

Another option for wisdom tooth removal is clinical trials. Some people hear the term "clinical trials" and assume increased risks—but that's not necessarily true. Based on FDA regulations, clinical trials are held to the strictest standards regarding compliance, as this is the basis on which many of their results are validated. The FDA published a draft guidance in 2013 that gives specific guidance to how a study sponsor must meet obligations to monitor or oversee a clinical study.  Accredited medical organizations like the National Institute of Dental and Craniofacial Research perform clinical trials before a drug or therapy can be made available to the general public.  

RELATED: Why Some People Get Depressed After Surgery—Even if They've Recovered Just Fine

With most medical procedures, in the absence of excellent health insurance coverage and a big budget, access to information is your best bet. While not everyone will need wisdom tooth extraction, it is good to know (and explore) your options so that you can plan ahead in case you do.  

"It takes a special type of heart and selflessness to be a caregiver for a loved one," says Neel Shah, a certified financial planner and estate planning attorney with Shah Total Planning in Monroe, New Jersey. "But sometimes the best intentions can backfire."

How-To-Avoid-the-Financial-Pitfalls-of-Being-a-Caretaker-GettyImages-1074897188 are unpaid family caregivers to an adult with health or functional needs, according to a recent report from the National Caregiving Alliance (NAC) and AARP. Although you can be a caregiver to an adult of any age, the number of caregivers is expected to grow as America ages. US Census Bureau data shows that about 20% of people in the nation will be 65 or older by the end of the decade. More women (61%) are caregivers than men (39%). More than 60% of caregivers work in addition to their caregiving responsibilities. And about 45% of caregivers have experienced a financial impact from their caregiving situation. But the following tips, including how to get paid to be a caregiver, can help you keep caregiving from derailing your personal finances.

RELATED: 5 Common Challenges Caregivers Face, and How to Handle Them

How to become a caregiver

"Planning for an aging parent's future financial needs begins with ascertaining what size of nest egg the parent has saved, where those savings are held, how much income is still being earned, and how much the aging parent still owes to creditors," says Rick Lauber, author of two guidebooks on caregiving.

If the person you're caring for still has assets, they can add you as a signatory on a bank account for paying bills and other expenses, such as for medication copays. Additionally, they can add you as a power of attorney, Lauber explains, so that you can make financial decisions for them once they are no longer able to do so. 

Shah agrees that a conversation, if possible, is necessary. "One of the pitfalls I see with caregivers is the commingling of assets," he says. "It's common for the caregiver to pay for groceries or pay out of pocket for certain expenses for a loved one with the expectation that it will all balance out in the end." 

Assumptions, Shah explains, can lead to issues or misunderstandings later, whether with the person you're caring for or with other family members after the person is no longer living. Ultimately, if you're paying out of your own pocket, don't expect to be reimbursed out of an estate or otherwise unless that has been explicitly stated and documented.

RELATED: 3 Money Tips for Navigating a Financial Emergency

"If another family member is in a better financial situation than you," says Steffi Gaines, president of A Better Way in Home Care, "yet you are the only one footing the bill and carrying the physical, emotional, and financial burden of family caregiving, you need to make your voice heard and try to get other family members to pitch in."

Caregiving can absolutely be a joint effort, and financial support is just one branch of the tree. According to Pew Research Center, "sweat equity" is a common type of caregiver support. That includes running errands, performing household chores or repairs, and more. And emotional support is also a big need. Maybe that's helping someone navigate a medical crisis or offering solace during a period of grief. With a group of family and friends contributing where and how they're able, you can potentially cobble together a support network that meets your loved one's needs. 

Also check to see if the person you're caring for qualifies for certain home health services under Medicare or for home- and community-based services under their state-based Medicaid program. Even when a government program does cover services, it may not meet all a person's caregiving needs. But Medicare or Medicaid could ease some financial strain.

RELATED: How to Compare Medicare Part D Plans

How to get paid to be a caregiver

You may even be able to get paid for your caregiving duties, depending on various factors. Some state-directed Medicaid programs allow beneficiaries to hire their own in-home caregivers, including family members, through self-directed care programs. Not all states allow for this, and those that do sometimes exclude a spouse, legal guardian, or people who live under the same roof. To find out if you can get paid to be a caregiver, reach out to your state's Medicaid program. 

If the person you're caring for is a veteran, check whether they're eligible for Housebound Benefits, Veteran Directed Care, Aid & Attendance Benefits, or the Program of Comprehensive Assistance for Family Caregivers (PCAFC). These four different Veterans Affairs programs offer a variety of stipends, supplemental aid, or the option for the veteran to hire their choice of a caregiver, including a family member. Aid & Attendance may also be available to surviving spouses of some veterans.

"My advice to family caregivers is not to shy away from using all the resources at your disposal," Gaines says.

Average Cost of COVID Hospitalization , Patient lies in hospital bed attached to medical oxygen, copy space above. on COVID hospitalization costs by the Peterson-Kaiser Family Foundation Health System Tracker estimates that the average cost of getting treated in a hospital for COVID is $20,000, although data for all types of payers and hospitalizations are currently not available to the public. While COVID cases and new hospital admissions have decreased since mid-September according to the latest CDC data, there are still more than 57,000 people hospitalized for COVID, US News reports.

Here is what you need to know about the factors contributing to hefty medical bills that come with COVID hospital admissions, insurance coverage, and ways to potentially keep your costs down.

Length and severity of the case are among the multiple factors that increase the cost of COVID hospitalization

The length of a person's stay varies depending on the severity of their case. That and the resources required to treat a certain patient are two of the biggest factors impacting the bottom line, says Suneet Singh, MD, an ER doctor and medical director at digital health tech company CareHive Health.

"Ultimately, the overall costs of COVID hospitalizations are driven by long stays, the need for multiple types of health care providers working together in comprehensive care teams, the various medications utilized, and the advanced nature of the durable medical equipment required," says Dr. Singh. He adds other medical conditions a patient may have, such as hypertension, diabetes, heart disease, or compromised immunity also increase the chances of hospitalization—and come with their own additional costs.

"As resources and lengths of stay increased due to severity of disease, the use of equipment such as ventilators and the processes surrounding advanced respiratory care drove the averages up to $49,441 and 17.1 days," explains Dr. Singh. These numbers are from an August 2021 study published in medical journal Annals of Internal Medicine.

Other factors that contribute to total hospitalization cost include whether the hospital is in-network or out-of-network, explains Molly Moore, chief health plan officer at health insurance start-up Decent. "Costs also vary per hospital—some hospitals charge more than others," she adds.

RELATED: Mother of 8 Dies From COVID in Ohio Hospital: 'They Keep Asking for Mom'

Many health insurance providers are no longer waiving cost-sharing for COVID treatment

While public and private health insurance providers initially covered much of the costs of COVID-related expenses, insurance companies are now expecting patients to share more of the cost. A study by Peterson-KFF from November 2020 found that 88% of those enrolled in fully insured private health plans would have any out-of-pocket costs waived if they were hospitalized for COVID; that's no longer the case.

"These cost-sharing waivers…started to be phased out in November 2020," says Dr. Singh. An updated Peterson-KFF analysis on COVID insurance coverage reported that as of August 2021, 72% of the two largest health plans in each state (102 plans) are no longer waiving out-of-pocket COVID costs.

The reason? The availability, safety, and effectiveness of the vaccine makes most hospitalizations completely preventable. "Health insurance providers are now asking patients who are hospitalized due to COVID, and declined to get vaccinated, to share the cost of treatment, which can get expensive if it requires a lengthy hospital stay," says Moore. Between June and August 2021, preventable COVID hospitalizations of unvaccinated adults cost over $5 billion.

Vaccines, masks, and social distancing are ways to avoid hospitalization and expensive medical bills

Unfortunately, there is not much that can be done to lower medical bills once you are hospitalized for COVID—but there are measures to take to prevent or significantly decrease the chances you will be. "The best way to stay out of the hospital with COVID (and avoid big bills) is to get vaccinated," says Moore. The vaccine is free, regardless of insurance.

"The CDC cites a tenfold protective effect of the vaccine against hospitalization needs compared to a matched unvaccinated cohort," says Dr. Singh.

RELATED: The CDC Urgently Recommends COVID-19 Vaccine for Pregnant People in New Health Advisory—Here's Why

"Perhaps the most troubling trend of shopping addiction," says Kristin Roelofson, MSW, LSW, at Thriveworks in Pittsburgh, "is when one's personal finances run out and the person seeks loans, begs to borrow money from others, steals cash or credit cards, sells household items, engages in precarious behaviors to acquire money, or steals items."

RELATED: Why Drugstore Shopping is Like Therapy for Me

6 Signs Your Impulse Buying Is a Shopping Addiction and How To Get Help , High angle view of woman with shopping bags sitting on blue background professionals often use an evidence-based tool for gauging whether shopping habits have become something more insidious. You can take this 28-item questionnaire to gain an assessment. The questionnaire evaluates six signs of shopping addiction:

1. Constantly obsessing about shopping
2. Shopping to improve your mood
3. Buying more items to achieve the same previous levels of satisfaction
4. Shopping so much that it impacts your daily responsibilities
5. Buying to the point that it affects your well-being
6. Trying to cut back on shopping but not having success

"The presence of a shopping addiction is likely among individuals that demonstrate four or more of the aforementioned indicators," Roelofson explains.

Recognize the four stages of shopping addiction 

Shopping addiction is also called compulsive buying disorder (CBD), according to research published in the journal World Psychology. CBD is characterized by four stages that occur before, during, and after you make your purchases. If these stages feel familiar, that could be an indication that your buying is less of an occasional fancy and more of a compulsion.

The first stage is anticipation. During anticipation, you might have a preoccupation with obtaining something specific or the act of making the purchase. The second stage is preparation. Roelofson describes preparation as "planning one's personal shopping experience, including researching a specific item, seeking out sale prices, and determining how and where to shop—in store versus online." 

Next comes the actual shopping stage, which can provide a euphoric "shopper's high," Roelofson says. Finally, the last stage is spending. "The shopper may experience the excitement in anticipation of receiving the new item purchased," she adds, "and/or disappointment with oneself for spending again."

Help for shopping addiction

Support groups such as Debtors Anonymous and Spenders Anonymous, as well as individualized therapy, can help with shopping addiction. "In therapy," Roelofson says, "'the person has the opportunity to work with a professional to acknowledge the problem, assess its severity, and identify causes, triggers, and risk factors." 

A therapist will develop a customized treatment plan based on your personal needs. One common way to treat shopping addiction is through cognitive-behavioral therapy (CBT). Through CBT, you and your therapist counteract problematic thought processes. Roelofson gives the following example of a problematic belief surrounding shopping: "I can buy this now and figure out the money later on." 

RELATED: 7 Ways Debt is Bad for Your Health

Curbing impulse buying

Even if your buying behaviors are based on impulse rather than compulsion, you may still want to cut back. Maybe your home or closet is cluttered with things you really don't need or want. Or maybe you've decided your credit card could use a rest while you pay off a balance. Roelofson offers a few tactics for curbing the urge to add to cart.

• Unsubscribe from store email newsletters. 
• Wait a day longer before making a purchase you've had your eye on.
• Practice gratitude for what you have.
• Make a budget and stick to it, while allowing for some "fun money."
• Try a "no spend" challenge for a specific period.
• Create and maintain a savings account that makes it harder to withdraw money.
• Avoid paying with credit cards.
• Remove stored credit cards from digital devices.

RELATED: Bipolar Disorder Destroyed My Credit

Keep in mind that impulse buying can sometimes be about a fear of missing out (you know, FOMO). So if that's a root cause of racked-up charges, give a wish list a try. When you "favorite" something or add it to an online shopping cart, but don't buy it, you know it's there and you can always go back to it later if you truly, truly decide you can't live without it. Many times, the feeling will pass—and you'll have saved a dent in your budget.

"Let your emotions subside before you decide," Roelofson says.

Here's a look at what families often pay out of pocket, which services cover long-term care, and how to plan.

RELATED: In-Home Senior Care: Warning Signs Your Aging Parent Needs It

Nursing-Home-Costs-What-You-Need-to-Know-GettyImages-755651237 shows a 62% increase in the price of a private room in a nursing home and a 79% increase in the cost of care in an assisted living facility. Collectively, Americans now pay more than $60 billion in long-term care costs, according to the Congressional Research Service (CRS). 

Fees vary by region and facility. But on average, a person now turning 65 in the US will incur $138,000 for future long-term care services. And they, or their loved ones, will pay about half of that cost out of pocket, according to the Office of the Assistant Secretary for Planning and Evaluation (ASPE). But about one in six people will pay more than $100,000 out of pocket. Many will incur costs above this if medical care is also needed, though health insurance policies may offer some relief. However, most long-term care benefits only cover help with daily living tasks, such as eating and bathing.

For 2018, the median income of households headed by someone 65 and older was about $64,000, according to a report by the Administration for Community Living. And in 2017, more than 7 million seniors 65 and older had incomes below the Supplemental Poverty Measure, according to KFF. So nursing home care can be unaffordable for many people and their families.

Does Medicare or Medicaid pay for nursing home care?

Medicare typically does not cover long-term care in a nursing home. However, basic Medicare does cover some medically necessary short-term care in a skilled nursing home facility for an illness or injury. 

Medicaid does provide coverage for eligible individuals in homes that are licensed as Medicaid Nursing Facilities. In 2017, Medicaid covered about 6 in 10 nursing home residents, according to KFF. And in 2019, Medicaid paid a collective $192 billion in long-term care costs, reports the (CRS). For nursing home coverage, individuals must undergo a review that demonstrates the need for care, and they must meet low-income requirements. The American Council on Aging lists income thresholds for seniors by state.

Those who don't meet the income requirement for Medicaid have the option to "spend down" income and assets. Medicaid typically does not count a person's home as an asset when determining income eligibility. But Medicaid estate recovery programs allow states to then sell the home to recoup costs after a person's death. So consult an elder law or Medicaid lawyer to help you determine options. You may wish to transfer assets or set up a trust in advance of applying for Medicaid coverage if you wish for property to be passed to a loved one.

RELATED: What Does Medicare Cover? Not Everything You Need

The Veterans Health Administration paid for roughly a quarter of long-term care services in 2019, totaling nearly $7 billion, according to the CRS. Beneficiaries must be signed up for VA Health, have a need for care, and meet other requirements. You can find out if you qualify or learn more by calling the VA hotline: 877-222-8387.

Planning for nursing home care 

If possible, long-term care planning should start early, well before retirement age. You can purchase private long-term care insurance to help pay for a potential nursing home stay down the road. Premiums are often lower the earlier the policy begins. 

RELATED: Medicare Eligibility: Everything You Need to Know

Plus, purchasing a long-term care plan has some benefits beyond the actual coverage. If you itemize on your taxes, you can deduct all or a portion of your premiums as a medical expense if they meet the threshold. Such deductions can help reduce your tax burden. Additionally, some states have what's called a partnership program that links qualified long-term private policies with Medicaid. If you purchase a partnership policy under such a program, then you might qualify for Medicaid benefits without having to spend down as much of your assets when your long-term care policy benefits run out.

And remember: Nursing home care may not be the only option for you or your loved one who needs assistance. The National Institute on Aging lists resources for aging in place and other money-saving alternatives. 

Financial Hardship Is a Major Risk Factor for Suicide, Experts Say , unhappy beauty girl having bad trouble and getting depression illness sitting on wooden floor daydreaming in money background is a mental health risk factor.

"Studies show that people who struggle with debt are more likely to suffer from depression and anxiety," psychiatrist Aniko Dunn, MD, tells Health. Both depression and anxiety, she adds, can lead to suicidal ideations or attempts.

RELATED: 3 Expert Tips for Dealing With Financial Stress

Of course, it's not recent news that a correlation exists between homelessness, joblessness, debt, financial stress, and suicide. A 2017 study by Aggrawal et. al. published in PLoS One found that financial crisis and what the researchers call "adverse economic sentiment" increased suicide rates after the housing market crash of 2008. A 2018 article from the Aspen Institute explains that "the potential of suicide increases among financially distressed individuals as debt levels become harder to manage."

A statement from the Pennsylvania Suicide Prevention Coalition revealed similar findings: "Mounting debt, losing a job, a home, or retirement income can be linked to a wide variety of negative health outcomes," the Coalition explained. "Such stressors may lead to thoughts of suicide or even to attempts and completions." And a 2020 study published in The American Journal of Epidemiology showed financial hardship can make people up to 20 times more likely to make (or take) an attempt on their lives.

"We studied homelessness, unemployment, debt, and low income," wrote Eric Elbogen, PhD, study author and professor of psychiatry and behavioral sciences at Duke University. "Our research… [revealed] that financial stressors play a major role in suicides."

In fact, the study showed that the risk of suicide grew with each added stressor—and those who experienced all four financial stressors were 20 times more likely to make an attempt.

"Economic stress plays a major role in suicides and needs to be recognized and applauded in light of the unprecedented economic instability resulting from the COVID-19 epidemic," adds Dr. Dunn. If not, both he and Dr. Elbogen fear we may see a "dramatic increase" in suicide rates moving forward.

"The financial conditions [we studied] are being magnified by this COVID pandemic," says Dr. Elbogen in a U.S. News piece. "Given those realities, it's going to be really important for clinicians, policymakers, and the public to keep in mind the link between financial strain and suicide." In fact, noting (and addressing) the relation between the two is of the utmost importance.

RELATED: 10 Things Suicide Attempt Survivors Want You to Know

That said, individuals struggling with debt, homelessness, joblessness, and feelings of hopelessness should know they are not alone—there is both help and hope. 

"Many companies offer free counseling to solve financial problems, be it debt management, budgeting and commitment, finding work, communicating with lenders, or claiming benefits or financial assistance," says Dr. Dunn. "Whether you have a friend or loved one to talk to for emotional support, it is always a good idea to take practical advice from an expert. Reaching out is not a sign of weakness and does not mean you have failed as a provider, parent, or spouse. Rather, it means that you are smart enough to recognize that your financial situation is putting you under stress and that you need to address it." 

"Speaking about debt with a trusted person can also help ease the weight," adds Romanoff, "as it will help you gain insight into ways to manage it and create a plan to which you can be held accountable."

It's also important to take a multifaceted approach, i.e. join a support group. There are numerous programs which help individuals navigate financial hardships and burdens. You can (and should) seek counseling, for both your mental needs and your financial ones, and taking financial management classes can be helpful as well. Journaling and making a realistic budget can help you organize your thoughts and stay on track.

"Income support might help, but if people misuse their money, if they haven't gotten financial education, they could still go into debt, risk becoming homeless—and the current study shows that would increase risk of suicide attempts," says Elbogen. For that reason, "health professionals can, in addition to psychotropic medications and psychotherapy, consider job retraining, vocational rehab, housing assistance, financial support systems, financial education, [and] debt management."

RELATED: What Is Suicidal Ideation?

If you or someone you know is having suicidal thoughts due to stress of debt or monetary hardship, seek emergency help—call the suicide hotline below, 911, or get to your nearest emergency department. Also, call a friend, co-worker, or clergyperson. 

The first step to coping is getting help. Talk to a mental health professional about the thoughts or anxiety symptoms you may be experiencing. Very often, what feels like an overwhelming catastrophe really isn't, and processing this with a therapist or counselor can help you learn ways to control those unwanted thoughts. Also, consider calling a financial advisor or counselor to strategize potential solutions or options going forward, once the immediate risk of harm has passed.

If you or someone you love is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741-741.