In many instances, families end up deciding to try to care for their invalid or elderly loved ones themselves rather than commit them to an impersonal — and often very expensive — institution. While this choice can be made either out of love or perceived necessity (or both), the expense of providing care for someone at home can be much higher than what you have estimated.

Home caregiving comes with several hidden costs that you will need to factor into your plans in order to successfully manage this arrangement. (For related reading, see: How to Find the Right Retirement Community.)

A recent study done by MetLife, Inc. (MET) indicates that there are almost 10 million adult children caring for older relatives and loved ones in their homes in the U.S. today. The study also revealed that women constitute about two-thirds of family caregivers in America. A large percentage of them are middle-aged and have their own children living with them.

Of course, many of them are in this position because there is no alternative, as the cost of managed care today comes in at a national average of roughly $42,000 a year. A private room in a managed care facility runs about twice that amount. Therefore, someone who resides in one of these facilities for two and a half years could easily rack up a managed care bill of $100,000 to $200,000 — a sum that could leave many families virtually bankrupt.

Another recent study conducted by the AARP shows that more than half of all caregivers also work another job either full or part-time, and many have had to either miss work or make adjustments to their work schedules in order to care for their loved ones at home. Those who play this dual role are frequently faced with having to take time off for medical visits or to provide care services at home that must be done at certain times. (For related reading, see: Beware of These Reverse Mortgage Scams.)

Caring for a loved one at home is certainly a commendable choice, but be sure to count the real cost of this before you commit yourself, so that you can make adequate adjustments to your budget and work schedule if necessary.

There can be obvious expenses to begin with, such as the cost of finishing a room or basement to accommodate the new guest, or other modifications or medical equipment that may need to be installed. In many cases, these expenses can either be added to the cost basis of the house or deducted as medical expenses for those who qualify.

But the key factor to understand here is that the real cost of caring for someone at home lies in the wages and earnings that you and/or your spouse may forfeit by doing this. The MetLife study revealed that the average woman who dropped out of the workforce to care for someone at home forfeited nearly $145,000 over the course of the obligation, which usually averages a length of around five years. But that number almost doubles when the growth that is lost from retirement plan contributions is coupled with reduced Social Security benefits and pension payouts.

And while these numbers are alarming, they still don't factor in the reduced employee effectiveness that the caregiver may experience as a result of their absence, as well as lost promotions, raises and bonuses. And the effort that it takes to try and meet both of these obligations at once for an extended period of time can also be physically taxing on the caregiver and thus possibly increase the cost of their own current health care as well as the odds that that person will also need to be cared for one day. (For more, see: The Importance of Healthcare Risk Management.)

The final cost that potential caregivers need to keep in mind is the emotional ramifications that may come with caregiving. Will both the caregiver and the recipient be comfortable with issues like needing assistance with bathing and toileting? In many cases, the recipient may prefer that these tasks be performed by a detached professional outside the family if this is at all possible.

Perhaps the most staggering numbers that have come from these studies are the ones that show that the aggregate cost of the unpaid wages that would be due to caregivers if they were paid for their work. It came to a whopping $470 billion in 2013. This number is based on what caregivers would make if they were paid a paltry $12.51 cents per hour for providing 18 hours of care per week! To help put this in perspective, this number exceeds the total amount spent by Medicaid for that year. This amount is also increasing at a rapid pace, as a study by Indiana University showed that the aggregate cost was roughly $375 billion in 2009.

Of course, providing home care for loved ones is still the best — or only — choice for many grown children who must care for their parents or other elderly folks. There are some lobby groups that are pushing Congress to offer tax credits and other financial incentives for those who provide home care services. Others would like to see corporate America make more of an effort to cater to those who face this dilemma with flex time and more tolerant working schedules. Other ideas include preserving and expanding the Family and Medical Leave Act, compensating family caregivers with Medicaid funds and increasing the funding for the National Family Caregiver Program. (For related reading, see: A Quick Guide to Healthcare ETFs.)

But for the moment, caregivers must face the reality that they will be the primary bearers of the expenses that come with their duty.

Statistics show that nearly three-quarters of all adults today expect that their families will take care of them in their old age, and many younger adults also anticipate that they will have to shoulder this burden to some extent. And while this might be an unavoidable choice, these same figures also show that most caregivers did not realize the true extent of the burden that would be placed upon them in many ways. If you are contemplating whether this choice is right for you, don't hesitate to follow your heart, but be sure to consult your financial advisor as well as perhaps an eldercare attorney and a few other experienced caregivers in order to help prepare yourself. For more information on caring for a loved one in your home, visit the AARP website at www.aarp.com. (For more, see: Estate Planning Tips for Your Elderly and Passed Clients.)