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UNDERSTANDING LONG-TERM CARE
The italicized section below and throughout is an example of a women named
Martha and how she came to realize how little she new about not being covered
for LTC.
When Martha was 50 years old, she never dreamed she would be in this
predicament. But, here she is at 82, lying in a nursing home with a broken hip.
She has already been here for three weeks, and her doctor is not very optimistic
about a complete recovery.
Martha has always been a saver. She planned for emergencies. She thought
Medicare would pay most of the costs; she even purchased a Medicare supplemental
policy. Now, she has learned that in her case, Medicare will only pay for the
first 14 days. Apparently, there's a rule about needing to receive therapy
daily, not just once or twice a week. At $120 a day for nursing home expenses,
her savings will be used up quickly. And then, what will she do?
Most of us would like to be able to look into a crystal ball to see what our
lives will be like ten, twenty or thirty years from now. Will we be healthy, or
will we need care and assistance from others? Will we spend some time in a
nursing home, like Martha? Will we need long-term care?
Of course we don’t know. People criticize agents for mentioning that most
of us carry auto insurance and home insurance. Why? No one knows if we will ever
use those coverages either. It just becomes more likely as we age that we will
use Long Term Care. Why stop protecting ourselves now.
What Is Long-Term Care?
Long-term care is the kind of assistance you need when you need help with
personal care. The need for this assistance usually results from a disabling or
long-term medical or physical condition. Long-term care services can include
in-home care, as well as nursing home or community- based care.
Let’s start realizing now that Long Term Care can be delivered in the home.
Most Long Term Care is delivered in the home. Most associate Long Term Care with
a Nursing Home. Long Term Care is giving assistance to those with a chronic
condition in a setting that is appropriate and desirable for that person
receiving the care.
Martha is now receiving long-term care in a nursing home. As she improves,
she may be able to have services brought to her home - such as home-delivered
meals, choreworker services or, perhaps, physical therapy.
Will I Need Long-Term Care Services As I Get Older?
Anyone may need long-term care services. An accident or a sudden, serious
illness can create a need for services, as can the slow progression of chronic
diseases such as rheumatoid arthritis, Alzheimer's disease or Parkinson's
disease. Age or frailty may also be contributing factors. People who live to be
very old are more apt to need long-term care services than those who die at a
younger age.
In addition to age and disability, there are other factors that determine the
likelihood of needing long-term care services.
I can’t stress enough as you read on how important it is to remember that
most Long Term Care is delivered at home. The reason you hear so much about
Nursing Homes is that a lot of that is paid by Welfare (Medicaid), Medicare, and
out of someone’s pocket. Which means that it is traceable. The Facilities are
documenting the expense. Thus statistics are available. If the majority of Long
Term Care is delivered at home and that care is unpaid and unreimbursed than how
can they possibly provide you with statistics on it. More than 22 million
families currently provide informal, unpaid care for an older parent or
relative. Please keep that in mind.
Gender
Women are more likely to need long-term care services than men. One reason
may be their longer life expectancy; women outlive men by about eight years. At
any given time, of those age 75 and over, 30 percent of women, but only 17
percent of men, need assistance with personal care.
Marital Status
Women tend to marry men who are older. Since women also have longer life
expectancies, they usually outlive their husbands. It is not unusual to find an
older man being cared for by his younger wife. When a woman needs long-term care
services, they are more often provided by a daughter or daughter-in-law, or in a
nursing home.
Only 25 percent of people who were married at the time of their death spent
some time in a nursing home.
In contrast, 40 percent of those who were widowed, divorced, separated or
never married spent time in a nursing facility.
Functional Limitations
Women have more chronic diseases that impair mobility, such as arthritis and
osteoporosis, than men. Men have more acute health episodes that lead to earlier
and quicker death.
Mental (Cognitive) Impairments
Mental impairment often leads to the need for long-term care. People with
mental impairments stay in nursing homes longer than those who only suffer from
physical infirmities. Also, some families have a genetic disposition toward
Alzheimer's disease, stroke or other mentally disabling conditions.
The statistics for those over age 80 developing a cognitive impairment are
staggering.
Family Circumstances/ Support Systems
Whether a person can remain at home is often dependent on his or her support
system. Many older people do not live near their children; their support system
consists of neighbors and friends who may not always be available. If an older
person does live near family, family caregivers may work full time or be unable
to offer as much help as is needed.
Yet the desire for us to stay in our home remains. Over 95% of the people I
speak with want to stay home as long as possible and they choose Long Term Care
Insurance that includes Home Care.
What Are The Risks Of Needing Long-Term Care?
Nursing home care
A study on nursing home use prior to death is shown below.
Home and Community Care
Only a small percent of people who need long-term care assistance live in
nursing homes. At ages 65 to 79, 17 percent of those living at home need
assistance; this number jumps to 28 percent for those 75 to 84 and almost half
(49 percent) at age 85+. The most common type of assistance needed is help with
walking. The chart on page 8 shows the activities of daily living limitations
for people over 65 who reside in the community.
What Can I Do To Reduce My Chance Of Needing Long-Term Care?
Some of us will need assistance with activities of daily living (ADLS) when
we are very old, no matter how well we take care of ourselves. Diseases such as
arthritis and osteoporosis affect mobility and may lead to dependence on other
people. However, recent research demonstrates that we are more in control of our
own aging than previously assumed.
Good nutrition and regular exercise are the key ingredients to a healthy and
active old age. And the earlier we get started, the better. High fiber, low-fat
diets decrease the incidence of cancer, heart disease and many other
"modern" ailments as well. And exercise may be equally as important as
nutrition in helping us to remain active through our lifetime.
Although our muscles decrease in size as we age, weak muscles are not a
normal part of aging. Elderly people who exercise have minimal deterioration in
muscle tone. Walking, combined with moderate stretching exercises to retain
flexibility, is by far the best exercise. Although illness or injury can affect
the muscles and joints, with good medical treatment, even this damage can be
greatly reduced. There is no magic ingredient that allows us to stay fit. It
takes determination, discipline, belief that good nutrition and exercise are
worth the effort, and a little bit of luck!
Of course, there are some things we cannot control. Alzheimer's and similar
diseases that affect the functioning of the brain and nervous system often lead
to the need for long-term care. Over half of nursing home residents experience a
cognitive impairment like Alzheimer's disease. Not only is this a devastating
condition, but currently there is no known cure.
And Cognitive Impairments and Alzheimer’s cause one of the longest average
stays in facilities today.
Read Chapter Three "Planning for Long Term Care"
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