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Word of the Long-Term Care Crisis is Spreading

February 3, 2012 by Honey Leave a Comment

“The long term care system in Hawaii is broken, “according to the December 13, 2011 Draft Final Report of the Hawaii Long term Care Commission (http://www.publicpolicycenter.hawaii.edu/documents/LTCC_FINALREPORT_draft14dec.pdf. 2424 Maile Way, Saunders 723,Honolulu,HI96822). And as noted in several previous blogs, the crisis will get worse because of the aging of the Baby Boomers. Furthermore, the population from which care givers are drawn is beginning to decline.

Members of this Commission clearly “get it.” They note that 75% of people over 65 will eventually need some form of long-term care (LTC) and that people need to begin planning for this prospect well before they reach their 60s. The report also cites an average cost of $80,000 per year in a nursing home and the lack of public funds to cover these enormous costs.

A recent survey (2011 Long-term Care Consumer Survey and Quiz Results John Hancock Life Insurance Company U.S.A., Boston, MA02117 includes encouraging evidence that public also “gets it.” In a sample of 1,000 Americans aged 21 – 75, 82% agreed that it is irresponsible not to plan for the cost of long-term care. On the negative side, however, only 11% actually own long-term care insurance (LTCi). And while 62% agreed that LTCi was the best way to do such planning, only one-third were inclined to purchase a policy in today’s economy.

So news about the growing need for LTC and the lack of resources to fund care is getting to the public. But Americans are still reluctant to invest their own money to purchase insurance for their own LTC.

The solution to this perplexing & frustrating problem is nicely summed up in the Hawaiian Commission’s first two recommendations:

“Conduct a long-term care education and awareness campaign

Treat the risk of needing long-term care as a normal life risk” (p. 10)

This has been my mission for over 20 years.

Did lack of $$ to pay for care have a role in these murders?

January 31, 2012 by Honey Leave a Comment

A tragic story in the January 16, 2012, issue of USA Today http://www.usatoday.com/news/nation/story/2012-01-15/ohio-woman-dies-murder-suicide/52584916/1) illustrates the extreme level of stress that family members can experience while caring for a loved one at home.

“LOGAN, Ohio (AP) – A terminally ill woman has died days after her husband fatally shot their adult son and her two sisters in front of her at a southeastern Ohio home and then killed himself.

Authorities said the shootings last Monday in ruralLoganapparently stemmed from family tensions over the care of the cancer-stricken woman, 59-year-old Darlene Gilkey. She was not hurt in the shootings and was taken to a medical facility afterward.

Her daughter-in-law, Heather Sowers, said Gilkey died Saturday, hours before the funeral for her 38-year-old son, Leroy Gilkey ofColumbus.”

The stress on unpaid family care givers has been documented in many studies. Stories like this cause me to wonder how much this family’s lack of finances and lack of access to respite care contributed to these murders. Don’t you think that if Ms. Gilkey owned long-term care insurance (LTCi), the care her policy would have paid for might have made a big qualitative difference for this family, and possibly averted this tragedy?

Bargaining with your child for long-term care

January 26, 2012 by Honey Leave a Comment

In a January 15 Sunday Review article in the New York Times, “Bargaining for a Child’s Love,” Hendrik Hartog stated that the image from the early 20^th Century of adult children lovingly taking care of their parents during their decline has been somewhat romanticized. Yes, the custom was for family members to provide long-term care for their parents, but since over half the US population died before age 65, the burden was often relatively brief. But there were also either implicit or explicit bargains discussed – parents would pass on their homes and other assets to their family caregivers after their death. These often informal promises could lead to family strife, however, after the parent’s death. Hartog adds that “…of course what was at stake was never just an economic bargain between rational actors. Older people negotiated with the young to receive love, to be cared for with affection, not just self-interest.”

He goes on, “Dependency and disability still confront us as facts of life. There is little happiness in the inevitable but unpredictable decline that awaits all of us. And many younger people still experience themselves as trapped by a sense of duty to care for older relatives.”

Hartog argues that policy and bureaucratic supports such as social security, Medicare and Medicaid have softened the burden on today’s family members, but in a letter to the Editor on p. A20 in the January 19, 2012 New York Times (Caring for Elderly Parents) http://www.nytimes.com/2012/01/19/opinion/caring-for-elderly-parents.html?ref=todayspaper, Carole Levine cites dramatic statistics that many children provide long-term care for their parents with little or no assistance from government entities. Citing Hartog’s claim “…that today middle-class family members don’t do the work of cleaning bedsheets, helping a parent into a bathtub, changing a diaper,” Levine counters that “in fact, according to the 2009 National Alliance for Caregiving national survey, this is exactly what at least 21 percent of the country’s 48 million caregivers do, as well as managing complex medications, arranging transportation, financial and legal affairs, and countless other tasks.”

Levine correctly notes that “Most insurance, including Medicare, does not pay for this ‘custodial’ care,” and as I have pointed out many times in this blog, Medicaid provides funds only after families have depleted their own financial resources.

Sadly, neither contributor mentioned LTCi as a wise and reasonable option that will provide funds to pay for long-term care and alleviate the family conflict and stress so accurately described.

One More Study Confirms Public Unprepared

October 3, 2011 by Honey Leave a Comment

NPR aired a story this week called “Boomers’ Delusion About Health in Retirement”. It reports on a study they did in conjuction with Robert Wood Johnson Foundation and the Harvard School of Public Health. The article reports that some experts worry that when it comes to their health, boomers are still woefully unprepared — or worse, in denial.

“The mismatch between how people think the next 10 to 15 years is going to go and what current retirees experience is something that’s very consistent,” says Jeff Goldsmith. “There is no question that one distinguishing feature of our generation is this extraordinary, almost genetic optimism. And the poll results look to me like a lot of that optimism was drawn from a deep well of self-delusion.”

Here’s an example of the public’s denial, “only 1 percent of those not yet retired said they expect the amount of exercise they get to decrease in retirement, while 34 percent of retirees said they actually are getting less exercise.”

Here’s another: “only 13 percent of people over age 50 but not yet retired said they expect their health to be worse in retirement than it is currently. Yet 39 percent of retirees said their health is worse than it was in the five years before they retired.”

The report goes on to indicate the public is still unclear about who pays for long-term care. In the poll, a majority of those both retired and not-yet-retired thought Medicare, private savings and private insurance would be the primary payers if they needed nursing home stays longer than 100 days. In fact, the primary payer for nursing home care across the nation is the joint federal-state Medicaid program. Yet that was identified as the most likely payer for their own long-term nursing care by only 7 percent of retirees and 10 percent of not-yet-retired boomers.

There’s already evidence that people are starting into this retirement era with burdens. A third of the generation is obese, and another third is overweight. And even though people talk a good game in terms of exercise, it’s not clear the numbers actually support it.

The only “silver lining” the linked article gives is that when it comes to long-term care, the boomers are considerably more aware of the possibility of the crushing cost than previous generations have been. More than two-thirds recognize the threat of long-term care expenses to their financial futures.

The public is still choosing not to act to ensure their dignity, options and choices by doing responsible long-term care planning. I am very scared for them.

Dear Public,

Take heed. Make it safer for yourself and less stressful for those you love. Be empowered by being responsible. Stop making excuses to avoid planning for the future.

Sincerely,

Honey

Dear Abby Reader Describes Situation Without Long-term Care Insurance

September 16, 2011 by Honey Leave a Comment

Quoted directly from today’s (September 12, 2011) Dear Abby column:

“Dear Abby:

My longtime friend Jim and a stroke several years ago. His wife was struggling to keep him at home while working, taking care of the house, cooking and doing other endless chores. She found it difficult even to get out of the house for a haircut. She confided to me the hurt she felt when friends never followed through on their general offers of assistance.

Our discussion led to the formation of the FOJ (Friends of Jim’s) Club. Everyone in our “elite” group commits to spending two hours a month with Jim. The time slots we fill are recorded in our FOJ calendar. This time provides a needed respite for Jim’s wife and an opportunity to Jim to interact with others and get out of the house. Because the time commitment is for a defined— but not overly long—period of time, people are more willing and able to make a commitment they know they can keep.

Friend of Jim’s in Champaign, IL”

Honey’s comments: LTCQueen readers who do NOT own LTCi (long-term care insurance), please do everything within your power to imagine how different the scenario above would be if Jim had purchased LTCi.

My guess is that although Jim’s wife is getting some respite from friends, it is still not enough respite to spare her the additional mental, physical and financial stress being his full-time caregiver causes.

If Jim owned LTCi, chances are his policy would pay for home health care and he’d be on collecting from it right now. His policy would also be in “waiver of premium” (requiring no premium payments). I have no way of knowing how much home health care his LTCi would pay for, but chances are that whatever additional, paid home health care it paid for would go far to alleviate his wife’s stress and the resentment this reader describes.

LTCi ownership is all about having dignity, options, choices for not only the person needing care, but just as importantly, for the loved ones surrounding them.

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Word of the Long-Term Care Crisis is Spreading

Did lack of $$ to pay for care have a role in these murders?

Bargaining with your child for long-term care

One More Study Confirms Public Unprepared

Dear Abby Reader Describes Situation Without Long-term Care Insurance

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