Long-Term Care
By: Source: AARP.org Date Posted: 2007-03-15 10:02:00-05:00
Americans should have choices when it comes to long-term care - allowing them to maintain their independence at home or in their communities with expanded and affordable financing options.
Few things matter more in life than being able to make your own choices everyday. But as health needs increase, many Americans are forced to move to nursing homes. There aren't enough products and services to help people live independently, remaining in their own homes and communities.
A need for help shouldn't mean leaving your home and living in poverty
One of the greatest fears of aging is being taken from our homes and communities. Many older Americans can thrive at home with help. Medicare doesn't cover most long-term care expenses. To qualify for help through Medicaid, the government often requires them to move into a nursing home and spend themselves into poverty.
- The average annual cost of skilled care at a nursing home is $74,000.
- Assisted-living facilities cost nearly $35,000 per year.
- In 2002, Americans spent $139 billion - 8.7 percent of our total health care spending - on long-term care for people of all ages.
- The need for long-term care is one of the two greatest health-related financial risks facing older Americans.
The existing assortment of public and private options to pay for long-term care is nearly impossible for most people to understand, let alone navigate. Insurance is available for individuals to purchase, but at premiums that are out of reach for most people. Affordable financing options for long-term care are a necessity.
Alternatives to nursing homes work and are in demand
Federal figures show, conservatively, that at least 20 percent of the nursing home population in this country wants to go back into their communities. Also, studies have shown home and community services are generally less expensive than nursing home care.
America's long-term care system has a built-in bias toward nursing homes. It wasn't until 1981 that the federal government allowed states to begin to develop alternative care for the elderly and the disabled. Without a significant investment in community programs, we will continue to place people in nursing homes when they really don't need or want that kind of expensive care.
Many people who qualify for a nursing home fully paid for by Medicaid, the Federal program for low-income people needing help with long-term care costs, would rather remain on waiting lists for Medicaid's home and community programs, even if that means doing without the care they need. Indiana, for example, has about 15,000 empty nursing home beds and more than 30,000 people wait-listed for home and community care services.
Family caregivers can face future economic insecurity
The cost of facilities and lack of community-based options means that many older Americans must rely on family and friends to provide care at home. Caregivers, particularly women and members of low-income families, are faced with tremendous stress. Many get caught in a difficult spiral. They are forced to take time off from work, forgo promotions, and maybe even drop out of the workforce altogether to care for elderly relatives. Consequently, they work less and earn less, which reduces the Social Security and pension benefits they receive. And women, who generally live longer than men, must stretch their meager resources much further.
Beacon Hill Village's shining example of community-based care
Beacon Hill Village of Boston is a revolutionary, all-encompassing concierge service created by residents who want to grow old in the homes they have lived in for years. The village links members to carefully-reviewed, fee-for-service personal trainers, caterers, house cleaners, plumbers and computer advisers, and it offers them a number of free benefits such as weekly car service to the grocery. Other free benefits include monthly lectures by notable Bostonians, exercise classes and special health clinics-all activities that take place in neighborhood churches, schools and a community center. The village's director claims it hasn't had a request it couldn't help fill, including picking up and delivering a hospital patient's betting slips at the track!
Membership costs $550 a year per person, $750 a year per couple and $100 a year for lower-income residents, who also get a $250 credit toward services. And the village has people who charge as little as $15 an hour for odd jobs.
In many cases remaining at home and using the village's a la carte services is much cheaper than assisted living. If, however, someone becomes ill enough to need 24-hour care or other expensive services, the total costs probably will equal those of a nursing home, but with one big difference: People are in their own homes.
People have a right to choose independence and home over institutional long-term care - without facing a long waiting list or poverty. Let's work to change the meaning of long-term care in America.
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Do you have an experience with our nation's leaders that will show them why America's families must achieve this dignified and reasonable goal? We want to hear from you.
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