Long-Term Care

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.

Most Americans aren't aware of the costs of long-term care and mistakenly think that Medicare pays for more than it does. With the demographic shift occurring in the U.S., the need for long-term care -- whether in a nursing home, assisted-living facility, or at home -- will only grow, with an estimated 12 million Americans needing care by 2020. That's why government, individuals, and the private sector need to work together to make a wider variety of affordable long-term care options available.

Long-Term Care Is Expensive

One of the greatest fears of aging is the loss of independence. With help, many long-term care patients can thrive at home. But, Medicare doesn't cover most long-term care expenses and Medicaid only helps after patients exhaust their financial resources.

• The average annual cost of skilled care at a nursing home is about $78,000 for a private room and $69,000 for a semi-private room.
• Assisted-living residences cost an average of about $36,000 per year.
• The average rate for an in-home health aid is $19 an hour.
• Adult day services average about $16,000 annually if care is provided five days per week.
• 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. Private long-term care insurance exists, but premiums are too expensive for most families. Affordable financing options for long-term care are a necessity.

Families Are Often Left On Their Own

The cost of nursing homes and assisted-living facilities and lack of community-based options means that many older Americans must rely on family and friends to provide care at home. Most long-term care (about 80%) is provided in the home by unpaid family members and friends. Family caregivers are the backbone of long-term care in the U.S, providing unpaid care at an estimated value to the U.S. economy of $350 billion in 2006.

Caregivers, particularly women and members of low-income families, are faced with tremendous stress. Families and friends who provide this unpaid care often do so at the expense of their own health and financial well being. U.S. business productivity losses related to family caregiving have been estimated as high as $33.6 billion per year. 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.

We need to work on multiple solutions to help family caregivers help the ones they love. Family friendly workplace polices and government programs like respite care are a few examples of how we can help caregivers.

An Innovative Model of Community-based Care

Beacon Hill Village of Boston is a new, all-encompassing service created by residents who want to stay in the homes they have lived in for years. The village links members to carefully-reviewed, fee-for-service personal assistants, 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.

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 other kinds of care. 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.

This example of a private, non-profit response to the needs of a community's residents should encourage businesses and governments to rethink their approaches to long-term care.

Share Your Experience

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.