The future of long term care

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Special to the Recorder

I read articles quite frequently these days describing the increasing longevity trends in this country and in others. One recent article stated that average life spans are increasing by one year every five years; so in 20 years, the average lifespan increases by four years. That trend is significant in so many ways and will impact our society far more than we realize today.

One impact that is already apparent is the increased use of long-term care services. These include care in the home, adult day care, assisted living care and skilled nursing home care. Not long ago, the rule of thumb was that those over age 60 had a 50/50 chance of using some form of care before they died. Given increasing longevity, that chance has increased to 60/40 and is headed for a 70/30 probability of using care.

This shift is troubling from two perspectives. First, can our country grow its senior care service sector (qualified personnel, home care companies, long term care facilities, etc.) sufficiently to meet the increasing demand? And second, will those needing care have the financial resources to pay for the care or, if not, will government-funded care be available?

As to the first question, the key ingredient is money. If wages and benefits are high enough, people will be attracted to careers focused on senior care services, although that is not the case at the moment. (Nursing home wage rates are among the lowest of all healthcare positions.) Likewise, if demand is strong and service providers can earn a profit serving the senior population, then more facilities and home-based providers will develop.

However, on the issue of government-sponsored services, the trend is going the other way. The jointly (federal and state) operated and funded Medicaid program is in such serious financial distress throughout the country that the federal government is considering converting it to a block grant program and letting the states decide how best to use the funds.

This will undoubtedly result in states providing long-term care services to fewer people, opting to pay for healthcare for younger recipients over paying for years of custodial care for older adults.

On the facilities side, the news is equally as troubling with more government-operated facilities closing each year. Communities struggle with keeping facilities funded by local governments open; this situation is playing out in communities across our country these days.

What is the lesson here? First, stay as healthy as you can because living longer is a lot more fun if you are healthy enough to enjoy those extra years. Second, prepare for the future in case you need help. There are a variety of ways to pay for long-term care services: explore the options and choose a path that is best for you. For many years, people did not want to invest in long-term care because they feared if they never used it that it would be money wasted. There are options today that if you never have to actually use the long term care policy, it will pay out in the form of life insurance to your loved ones at your death.

The key is to know your options and what fits your needs best. Whatever you do, don’t expect the government to come to your rescue. If the government can’t deliver the mail efficiently or keep our roads and bridges safe, I certainly don’t want to place my future health and care in their hands. Be the master of your future by planning for it.

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