Think about longterm care for your elderly relatives now

Published 1:11 am Sunday, March 9, 2008

With maturing Americans living longer, more vital lives, how will they afford the growing cost of healthcare — especially for situations involving long-term care? While various forms of insurance typically cover routine doctor visits and emergency medical situations sufficiently, coverage for ongoing long-term healthcare needs if often limited and restricted. And, paying for long-term care needs can quickly deplete even substantial savings.

Long-term care: Not just for the elderly

This year, about 9 million Americans over the age of 65 will need some form of long-term care, and that number will reach 12 million by 2020. Typically, the majority of people who require long-term care are over the age of 65. But a substantial 40 percent of those requiring long-term care are between the ages of 18 and 64. Consequently, everyone should have reasonable provisions for healthcare financing in place.

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Long-term care covers a range of services and supports, both medical and personal, to help individuals over an extended time with a chronic illness or disability (including cognitive impairments such as memory loss, confusion, or disorientation). The bulk of long-term care involves non-skilled personal assistance with performing “activities of daily living” (ADLs), such as bathing, dressing, toileting, getting around the house and eating. Another category of assistance, “instrumental activities of daily living” (IADLs) includes preparing meals, shopping, bill paying and managing money, cleaning and other household chores, using the telephone or computer, and taking medication.

The chances of needing long-term care are higher for women:

Female nursing home residents are generally older, with more than half aged 85 and over. This may be due to longer life expectancies and longer disability-free lifetimes.

After entering nursing homes in old age, women tend to stay longer than men do. The average stay in a nursing home is 26 months for women, 19 months for men.

Older women’s long-term health care needs may be greater, yet their ability to accumulate assets is less and they typically need those assets to last longer.

(Source: U.S. Census Bureau, “65+ in the United States: 2005.”)

The chances also increase with age. For those 65 years and older, 60 percent will require at least some type of long-term care services during their lifetime and 40 percent will need care in a nursing home for some period of time. On average, older people today will need some long-term care services for three years (3.7 years for women, 2.2 years for men).

However, one in five will need this care for more than five years. Long-term care needs often develop gradually and may include: home care from nurses, aides, therapists; community-based services; and care in a variety of long-term facilities.

Assistance from family, friends and community

Perhaps the most important aspect of what you will want from long-term care is the ability to continue an active lifestyle with the greatest degree of independence as possible. While the above paid services can be extensive and partly or wholly covered by your insurance, most people also rely on help from family, friends and community. Case managers, typically nurses or social workers, can assist you and your family in designing a practical regimen for long-term care needs.

The trend today is to help older people stay within the community, preferably living at home (or in a family member’s home). Many communities offer adult day service programs, volunteer visitor/companion services, meal programs, transportation services, senior centers, and respite care — to give family members necessary relief to avoid caregiver “burn-out.” Home care may also include emergency response systems, and great advances in technology can now help family members monitor and older person’s daily regimen while preserving a high degree of independence.

Bill Byrne is a financial advisor with Smith Barney located in Natchez.