Our nationâ€™s senior population is expected to double in the next 25 years. Referred to as â€œthe Age Wave,â€ this boom in the over-65 population will lead to a dramatic increase in the number of adults needing long-term care. Long-term care is defined as the support services a person needs as they age. The activities associated with long-term care are handled through a wide range of individuals and facilities, from a person handling their own care, to family caregivers, to assisted-living facilities, in-home care and more.
The harsh reality is that only one third of older adults have a plan for long term care. In a Feldman Group survey conducted in June 2014 in Washington, senior issues and long-term care were ranked second from last in terms of priority issues â€“ below education, jobs, and taxes.
Meet Lon Cole of Puyallup. As somebody living with Alzheimerâ€™s disease and dementia, he knows firsthand the worry and fear that comes with figuring out how to take care of yourself as you age. He is relieved that his long-term care will be covered by the Veterans Administration. Through his volunteer work at the Alzheimerâ€™s Association, he knows plenty of people who do not have a plan â€“ nor the resources â€“ to pay for care as they age.
â€œI see people struggle financially and not know where to turn when it comes to long-term care,â€™ he says. â€œThe state really needs to make changes to help people.â€
Health care is expensive, and costs continue to grow
According to a recent survey by Genworth Financial, an insurance company with expertise in long-term care, in 2015, a month in a nursing home costs nearly $10,000. Assisted-living private rates averaged $4,625 per month, and homecare service rates were comparable.
If the average Washington citizen requires two years of support services, families face costs of between $100,000 and $200,000 or more in long-term care costs for a parent or loved one, regardless of where that care is provided.
Social Security doesnâ€™t begin to cover costs. And in 2015, the average Social Security benefit payment was little more than $1,200 per month. The average payment was half of that amount.
Long-term care insurance and Medicare donâ€™t solve the financial problem. The long-term care insurance market is on the decline in Washington, and families face spending themselves into poverty to qualify for Medicaid-funded care. Reimbursement rates are so low that access to Medicaid-supported care is still a challenge in assisted-living facilities.
Getting help from family strains relationships, resources
Unpaid caregiving in the form of help from family, friends and neighbors continues to be the most popular and rewarding form of long-term care, but it is not without its challenges. Unpaid caregivers provide an estimated 90 percent of long-term care for relatives. Seniors are relying on this support, but the number of caregivers is declining. According to the AARP Public Policy Care Institute, in 2010, the caregiver support ratio was more than seven potential caregivers for every person in the high-risk years of 80-plus. By 2030, the ratio is projected to decline sharply to 4 to 1, and it is expected to further fall to less than 3 to 1 in 2050, when all boomers will be in the high-risk years of late life.
Family caregiving takes a physical and emotional toll and often strains the relationship between adult children and their parents. Taking care of an aging parent is difficult work â€“ fraught with emotions on both sides. Caregivers may feel resentment and having to spend time and money supporting their family members. Seniors feel helpless, ashamed and angry at having lost their sense of independence and (they feel) dignity.
Nobody feels the rollercoaster of emotions of a family caregiver more than Erika Roden, a 31-year-old from the Seattle area. She and her sisters help with the caregiving needs of their mother who, at age 56, was diagnosed with early-onset Alzheimerâ€™s.
â€œMy emotions are all over the place,â€ says Erika. â€œAs a mother of a 2-year-old and expecting in May, I have a full plate. I work full-time. We never expected this to happen, especially at this age.â€
Economics plays a role, too. Almost 60 percent of unpaid caregivers had cut their own discretionary spending to help loved ones cover the costs of long-term care. According to Genworthâ€™s Beyond Dollars 2013 Report , 11 percent of caregivers actually lose their jobs, and another 10 percent report having to change careers â€“ both due to the conflicting responsibilities with care.
Hope for long term care financing options on the horizon
All is not lost. In 2015, the Washington Legislature passed a bill commissioning a study to explore state-supported options for long-term services and supports. The bill was endorsed by Washingtonians for a Responsible Future, a coalition of aging and disability advocates, long-term care providers, labor, and consumer-rights organizations seeking to protect the financial health and well-being of individuals and families who need long-term care. The study will be complete by December 2016, providing insight and recommendations to the Legislature for action. For more information on Washingtonians for a Responsible Future, visit responsiblefuture.org.
Dennis Mahar, who wrote this article, is chairman of the Washington Association of the Area Agencies on Aging and executive director of the Lewis-Mason-Thurston Area Agency on Aging, operating out of Olympia.