Long-Term Care Needs: Two-Thirds Of Americans Over 40 Are
In Denial
By Lauran Neergared and Jennifer Agiesta - Associated Press | Wed, April 24, 2013
WASHINGTON — We're in denial: Americans underestimate their chances of
needing long-term care as they get older – and are taking few steps to get
ready.
A new poll examined how people 40 and over are preparing for this difficult
and often pricey reality of aging and found two-thirds say they've done little
to no planning.
In fact, 3 in 10 would rather not think about getting older at all. Only a
quarter predict it's very likely that they'll personally need help getting
around or caring for themselves during their senior years, according to the poll
by the AP-NORC Center for Public Affairs Research.
That's a surprise considering the poll found more than half of the 40-plus
crowd already have been caregivers for an impaired relative or friend – seeing
from the other side the kind of assistance they, too, are likely to need later
on.
"I didn't think I was old. I still don't think I'm old," explained retired
schoolteacher Malinda Bowman, 60, of Laura, Ohio.
Bowman has been a caregiver twice, first for her grandmother. Then after her
father died in 2006, Bowman moved in with her mother, caring for her until her
death in January. Yet Bowman has made few plans for herself.
"I guess I was focused on caring for my grandmother and mom and dad, so I
didn't really think about myself," she said. "Everything we had was devoted to
taking care of them."
The poll found most people expect family to step up if they need long-term
care – even though 6 in 10 haven't talked with loved ones about the possibility
and how they'd like it to work.
Bowman said she's healthy now but expects to need help someday from her two
grown sons. Last month, prompted by a brother's fall and blood clot, she began
the conversation by telling her youngest son about her living will and life
insurance policy.
"I need to plan eventually," she acknowledged.
Those family conversations are crucial: Even if they want to help, do your
relatives have the time, money and knowhow? What starts as driving Dad to the
doctor or picking up his groceries gradually can turn into feeding and bathing
him, maybe even doing tasks once left to nurses such as giving injections or
cleaning open wounds. If loved ones can't do all that, can they afford to hire
help? What if you no longer can live alone?
"The expectation that your family is going to be there when you need them
often doesn't mean they understand the full extent of what the job of caregiving
will be," Susan Reinhard, a nurse who directs AARP's Public Policy Institute,
said. "Your survey is pointing out a problem for not just people approaching the
need for long-term care, but for family members who will be expected to take on
the huge responsibility of providing care."
Most people who have been caregivers called the work both worthwhile and
stressful. And on the other end, those who have received care are less apt to
say they can rely on their families in times of need, the poll found.
With a rapidly aging population, more families will be facing those
responsibilities. Government figures show nearly 7 in 10 Americans will need
long-term care at some point after they reach age 65, whether it's from a
relative, a home health aide, assisted living or a nursing home. On average,
they'll need that care for three years.
Despite the "it won't happen to me" reaction, the AP-NORC Center poll found
half of those surveyed think just about everyone will need some assistance at
some point. There are widespread misperceptions about how much care costs and
who will pay for it. Nearly 60 percent of those surveyed underestimated the cost
of a nursing home, which averages more than $6,700 a month.
Medicare doesn't pay for the most common types of long-term care. Yet 37
percent of those surveyed mistakenly think it will pay for a nursing home and
even more expect it to cover a home health aide when that's only approved under
certain conditions.
The harsh reality: Medicaid, the federal-state program for the poor, is the
main payer of long-term care in the U.S., and to qualify seniors must have spent
most of their savings and assets. But fewer than half of those polled think
they'll ever need Medicaid – even though only a third are setting aside money
for later care, and just 27 percent are confident they'll have the financial
resources they'll need.
In Cottage Grove, Ore., Police Chief Mike Grover, 64, says his retirement
plan means he could afford a nursing home. And like 47 percent of those polled,
he's created an advance directive, a legal document outlining what medical care
he'd want if he couldn't communicate.
Otherwise, Grover said he hasn't thought much about his future care needs. He
knows caregiving is difficult, as he and his brother are caring for their
85-year-old mother.
Still, "until I cross that bridge, I don't know what I would do. I hope that
my kids and wife will pick the right thing," he said. "It depends on my physical
condition, because I do not want to be a burden to my children."
The AP-NORC Center poll found widespread support for tax breaks to encourage
saving for long-term care, and about half favor the government establishing a
voluntary long-term care insurance program. An Obama administration attempt to
create such a program ended in 2011 because it was too costly.
The older they get, the more preparations people take. Just 8 percent of 40-
to 54-year-olds have done much planning for long-term care, compared with 30
percent of those 65 or older, the poll found.
Mary Pastrano, 74, of Port Orchard, Wash., has planned extensively for her
future health care. She has lupus, heart problems and other conditions, and now
uses a wheelchair. She also remembers her family's financial struggles after her
own father died when she was a child.
"I don't want people to stand around and wring their hands and wonder, `What
would Mom think was the best?'" said Pastrano, who has discussed her insurance
policies, living will and care preferences with her husband and children.
Still, Pastrano wishes she and her husband had started saving earlier, during
their working years.
"You never know how soon you're going to be down," she said. "That's what
older people have a problem understanding: You can be in your 60s and then next
flat on your back. You think you're invincible, until you can't walk."
The AP-NORC Center for Public Affairs Research survey was conducted Feb. 21
through March 27, with funding from the SCAN Foundation. The SCAN Foundation is
an independent, nonprofit organization that supports research and other
initiatives on aging and health care. The nationally representative poll
involved landline and cellphone interviews with 1,019 Americans age 40 or older.
It has a margin of sampling error of plus or minus 4.1 percentage points.
___
Associated Press writer Stacy A. Anderson and News Survey Specialist Dennis
Junius contributed to this report.
___
Online:
Government long-term care primer: http://longtermcare.gov
AP-NORC Center for Public Affairs Research: http://www.apnorc.org