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Have you ever thought about what assistance you might need in your golden years? As the population ages at a rate of about 10,000 turning 65 every day, the sticker shock of long-term care is slowly coming to the forefront. The U.S. Census says that by 2050, the number of those aged 65 and older is expected to reach at least 86 million, while 19 million will be 85 and older. That means that the demand for realistic long-term care solutions will become much stronger in the coming decades.
That’s especially true for those who develop dementia. According to a study conducted by the New York Times, about eight million individuals over the age of 65 reported that they had dementia or difficulty performing the activities of daily living, such as bathing or getting dressed. Nearly three million of those seniors had no assistance at all. Most of them relied on the kindness and caregiving of family members or friends.1
Advances in medical care mean that many elderly adults live longer lives, and the costs of long-term care are expected to grow exponentially. Just how bad is the situation?
The Cost of Long-Term Care in the United States
According to the Congressional Research Service, the costs of long term care already reach half a trillion dollars each year.2 That seems like an astounding number, but when you break down the costs based on care for just one person each year, you start to see why it adds up so quickly.
The Genworth Cost of Care Survey reports on the costs of long-term care in the United States.3 Here are the median monthly costs of certain types of long-term care in 2021:
· Home Health Aide: $5,148
· Homemaker Services: $4,957
· Assisted Living Facility: $4,500
· Semi-Private Room in a Nursing Home: $7,908
· Private Room in a Nursing Home: $9,034
Note that even the cost of a home health aide to provide basic medical care can cost well beyond what most people pay for a monthly mortgage.
These numbers often mean that families must handle caregiving on their own, even when their loved one needs more advanced medical care than what a layperson can reasonably or safely provide. Given that, many families will be forced to hire professional caregivers to help them out. The result can be overextending financially until they are at a point of severe debt.
This can be especially pronounced for those who have dementia. Seniors with dementia can become confused or wander away from home and get lost. Even while at home, they might do things that are dangerous to themselves or others, such as putting dinner on the stove and then forgetting about it, walking away and leaving a potentially deadly situation to unfold.
Many who have severe dementia need round-the-clock care. That can mean that family caregivers must make difficult choices – if you can’t afford home health care or assisted living, but you must stay with your loved one to keep them safe, you might not be able to work or devote time to other life responsibilities. That starts a financial spiral that can quickly deplete even the most robust savings accounts.
Some parts of long-term care at home are affordable. Making some home modifications, especially under the advice of an aging in place specialist, can make a house a safer haven for the elderly. A medical alarm for seniors can help protect them against the consequences of falls and other medical emergencies. Smart tech devices, such as an automatic medication dispenser, can be affordable and reduce the burden on caregivers. These solutions can help keep a senior living at home for longer.
Why is Long-Term Care So Expensive?
Unfortunately, many seniors are blindsided by the high costs they might face with long-term care. The NYT survey found that about half of seniors hadn’t discussed long-term plans with anyone in their families, including who would care for them if the need arose and where the money would come from to pay for professional care if necessary.
And the conversation about long-term care is one that urgently needs to happen, because there is no cohesive system of long term care in the United States.
Many believe long-term care insurance will cover their expenses. Though long-term care insurance has been encouraged for decades, getting that insurance has now become too expensive for many Americans. Rate hikes have gone up substantially as insurers underestimated just how much long-term care was going to cost them.
Additionally, there is a nursing shortage in the United States that has affected all medical facilities, including those that provide home health care, respite care, long-term care services, and more. A lack of home health nurses might mean it’s difficult or impossible to get care, even if you are willing and able to pay a premium price for the services.
Will the Government Help?
Government funding hasn’t kept up with the cost of medical advancement. When Medicaid and Medicare were signed into law in 1965, it was cause for celebration; however, there hasn’t been a significant revamping of funding in the programs in decades. Medical advancements mean that those who would have faced an earlier death from stroke, heart disease, and more are now living much longer.
Though most elderly adults expect Medicaid or Medicare to help with long-term care, they are often surprised to find that in order to get the coverage they need, they must first deplete their life savings to the point of being destitute – and then they might wind up on a waiting list to get into a facility that can provide for their needs. In the meantime, they have little money to sustain themselves and family caregivers take on more of the burden.
Medicare covers home health care only in specific cases, such as a limited amount of time during surgery recovery or rehabilitation.
Medicaid will cover long-term care in a skilled nursing facility but only for those who have exhausted all their income and retirement funds; in fact, most states only allow a person who is in a long-term care facility under Medicaid coverage to receive $50 or less per month in retirement income. According to the Urban Institute, four out of five seniors aged 65 and older will eventually enroll in Medicaid as their funds are depleted and their needs increase.
But then there is the problem of actually finding care. As the elderly population booms, the options for long-term care haven’t kept pace. That means that even when someone does qualify for a room in a facility, they might wind up on a waiting list for years. But in the meantime, their needs will likely only grow.
What are the Options?
Since most people can’t afford long-term care out of pocket for an extended period of time, families often find it necessary to improvise. They might cobble together a system of caregiving that spreads the burden among friends and family members. An emergency alert for elderly adults can help in that situation, to help supplement caregiving. Pendants and wristband systems are available that can summon help 24/7 at the press of a button. Either emergency services, family/friends/neighbors, or both can be alerted in case of emergency, and it is all extremely affordable compared to the cost of formal caregiving.
There are other ways to make the costs more manageable:
· Hire a professional caregiver for only certain hours. Maybe you need someone in the home while you are at work to help ensure medical needs are handled properly; in that case, you could hire a daytime caregiver. Perhaps you can be there with your elderly loved one most of the time, but you find that sleep deprivation is affecting your ability to care for them. Hiring an overnight caregiver can help you stay on track.
· Take advantage of adult day care. If you have adult day care facilities in your area, enrolling your loved one can provide enrichment, a healthy meal, and plenty of socialization. It also gives ample time for caregivers to do other things, such as go to work, run errands, or clean the house.
· Look into long-term care insurance. The ideal is to look at this very early, before you need it, to ensure the best possible rates. There will come a point where advanced age simply prices someone out of any sort of insurance that would cover a long-term care facility.
· Talk to a social worker. A social worker who works for a nursing home or assisted living facility can guide you through the options that are unique to your area and situation. They can provide resources that might be a cheaper option; for instance, depending upon where you live, there might be grants for the elderly that can help pay for certain types of care.
· Look into state waivers. Some states have great plans in place to help care for the elderly population. Grants, waivers, and other assistance might be available to help ease the financial burden. These might apply to long-term care facilities as well as home health care. Contacting your local Area Agency on Aging is a very good place to start.
· Check with an attorney. If you are trying to get Medicaid to cover the cost of long-term care, don’t be surprised if you run into roadblocks. In that case, unraveling the tangled web of requirements can become almost impossible. Consulting an attorney about what to do can help move the process along. The initial consultation is almost always free and can provide valuable advice. Retaining an attorney might actually make the process easier and more affordable.
· Pull in a financial advisor. If you or your loved ones have substantial savings for retirement, talk to a financial expert on how to make that retirement income stretch as far as possible. This might include everything from creative investments and trusts to downsizing your home or even moving to a more affordable area.
· Look into options offered by the workplace. If you are a caregiver for someone who needs your attention more often than you can give it, perhaps your workplace offers ways to make life easier. Remote work, or even hybrid work that allows you to stay home a few days a week, can help ease the financial burden. Some employers offer family leave options that can help you during short-term issues, such as if a loved one is recovering from surgery and needs your attention around the clock for a few weeks.
· Get the attention of your government representatives. The government hasn’t moved the needle much on long-term caregiving, and it doesn’t seem that any sort of solid legislation on the issue will be passed anytime soon. However, as the long-term care issues reach the level of a true financial crisis, the lack of attention to the problem will have to change under the pressure from constituents. Reach out to your local, state, and federal representative with your concerns. It might not effect immediate change, but it helps keep the issue on their radar.
While you work to figure out the intricacies of long-term care, take measures to ensure better safety and security right now. A button alert pendant or wristband for seniors and the elderly from Alert1 can provide day-to-day protection. Trained professionals are at the monitoring center around the clock, ready to respond right away to a press of the button on the medical alert device. Alert1 can bring affordable peace of mind that allows you to truly focus on how to best manage long-term care.
