Part 2 – LTC The Problem

Due to advances in our medical technology, our society has been blessed with an increasing average life span. Today, we are living almost twice as long as our ancestors did only 100 years ago. Unfortunately, along with this comes the drawback that the longer we live, the more likely we may need long-term care before we die. 

This section addresses the risks of needing long-term care as well as the average length of time that people may need long-term care. It also covers how our aging population increases the need for long-term care and how families are not equipped to handle their needs. In the next 30 years projections of the number of seniors needing long-term care exceed 6 million, with family and other informal caregivers providing much of this care. 

Who will care for each of us? America’s coming health care crisis. - UIC Nursing Institute, 2001

“What are my odds of needing long-term care?” 
It is human nature to think that YOU will never need long-term care. After all, things like that happen to OTHER people, right? That is what most of us would like to believe. Because we don’t think it will happen to us, we are often reluctant to plan ahead for future long-term care needs. The reality is that there is a strong possibility that you will need some type of long-term care at some point in your life. “While the general population perceives the risk of needing long-term care services to be less than 25%, the actual risk for needing long-term care (either home care or nursing home care) is greater than 50%.”

LifePlans, Inc. January 2002

“Who is at risk for needing long-term care? Isn’t it just older people? “ 
While many older people need long-term care, it is important not to overlook that young people can need long-term care too. It is never too early to plan for your future long-term care needs. Some common reasons that young people can need long-term care are: strokes, Parkinson’s disease, cancer, multiple sclerosis, and accidents to name just a few. Over 40% of Americans receiving long-term care are under 65 years old.

Long-Term Care Chart Book: Persons Served, Payers, and Spending, The Urban Institute in Collaboration with the Congressional Research Service, May 5, 2000

“I can’t see myself in a nursing home. I’d rather jump off of a bridge or shoot myself!”
People may have a hard time admitting that they could need long-term care because they associate long-term care with nursing homes. None of us can imagine ourselves being in nursing homes. In fact, we may live our lives promising our parents that we will NEVER put them in a nursing home. A nursing home is the LAST place we would like to receive care. 

The good news is that a nursing home is probably the last place you will have to go. Today, there are so many more options that weren’t available before. Now it is possible to stay at home or live in an assisted living facility, rather than go to a nursing home. Many people are more realistic about seeing themselves needing long-term care in their home. 82% of long-term care takes place in the home, adult day care centers, and assisted living facilities. 18% of long-term care takes place in nursing homes.

Agency for Health Care Research and Quality Sept. 2000

Unfortunately, no one has a crystal ball so you can never be sure how long you could need long-term care. We can look at some statistics to see what some of the nursing home “averages” are, but that is no guarantee that if you needed long-term care you wouldn’t be ‘above average’, or ‘below average’.

There have been a lot of studies on the average length of stay in a nursing home, but it is difficult to get studies that show how long people need care in assisted living facilities or in their homes. 

An important point to note is that long-term care usually starts out in the home. Therefore, it is important to consider the length of time you may need care at home BEFORE you entered a nursing home and not base your planning on only nursing home statistics. The average caregiving time in a national survey was five years. 

Health Spending Projections For 2001-2011: The Latest Outlook, Office of the Actuary, Centers for Medicare and Medicaid Services, Health Affairs, March/April 2002

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America’ Future Long Term Care Needs

Long-term care is more of an issue now then it ever was in the past due to our aging population. We are living much longer now than we ever did before. Along with living longer, our odds for needing long-term care may increase. Many times people wrongly assume that because no one in their family needed long-term care, they won’t. What people forget is that in the past their family members probably didn’t live long enough to require long-term care! As we live longer, our odds for needing long-term care increase. 

“The 65+ age group is the fastest growing segment of the population on a percentage basis – with each calendar year that passes there is an increase of one million 65-year-olds in the U.S. This cross-section of the population tends to focus upon health concerns, estate planning, and survivorship issues. Long-term care coverage should be a vital component of their long-range planning.” Conning’s Industry Insight, Long Term Care Insurance, Issue #4, June 2002

“At least 6.4 million people aged 65 or older need long-term care, with one in two over the age of 85 requiring such care. It is estimated that 6% of all persons aged 65 and over are living in a nursing home. After the age of 85, half of us will need help with the ordinary activities of daily living (ADLs).

About 1 in 10 individuals over 65 and almost half of those over 85 will get Alzheimer’s disease.” Planning for Long-Term Care, United Seniors Health Council, Washington, D.C. 2002

Protect your family from the toll of Long-Term Care

When we look into the past at our parents, grandparents, or great-grand parents, long-term care didn’t seem to be as big of an issue as it is today. This could be due to the fact that families were able to take care of their loved ones if they lived long enough to need long-term care. Our families have changed a lot over the years, making it more difficult for families to take on the responsibility of care giving. There are many challenges that families face that make it difficult to take care of their loved ones.

Two Family Incomes – Women in the Workplace

In the past, women did not always have to work and were able to care for their parents, or their spouse’s parents. Now, in order to survive in today’s world, many times both the husband and wife need to work. If the wife is working it makes it very difficult, if not impossible, for her to be the primary caregiver. If she tries to accomplish both, often her work will suffer which can result in substantial financial losses.

Divorce

In America, there has been a tremendous increase in the number of divorces. Divorce leaves a lot of single-parent families. These single-parent families may face a difficult job raising a family on their own while trying to work a full-time job to support their family. Imagine if they were also providing care to a loved one as well!

Fewer Children

In the past, people had more children than we are having today. It was normal to have three, four, or more children. If a parent needed long-term care, there was a greater chance that at least one of those children could provide care. In today’s world we are not having as many children, thereby decreasing the odds that one of them would be available to provide long-term care.

Geographical Separation

In the past, families usually lived in the same communities, or not far away. If a parent needed long-term care there was usually a family member living nearby that could step in and help out. In today’s world, our families are spread out across the country. If Mom and Dad live in California and their children live in Florida and New York, you can see how difficult it would be for the children to participate in the care giving without having to pick up and move and leave behind their current lives.