Retirement and Long-Term Care

October 4th, 2011 by @lamberts

Homecare Advocate Blog Post: Retirement and Long Term CareMost Baby Boomers are expecting a healthy, active retirement according to a new poll conducted by Harvard School of Public Health, NPR, and the Robert Wood Johnson Foundation.  However, are these Golden Years slightly Gilded?  Unlike generations before, these boomers are more aware of the fiscal consequences of long-term care and don’t necessarily feel financially prepared, perhaps from the experience of caring for an aging parent themselves.  In fact, this generation of boomers see things quite differently from those before them, particularly concerning their physical and financial health in the years ahead.

The expectations of “pre-retiree” boomers was compared against the realities of current “retirees” in this study, and it produced some staggering realizations about our new generation of seniors and their outlook on retirement, health, and quality of life.  Over 1200 pre-retirees and retirees were surveyed and asked about key areas of retirement life, including finances, health, institutional care, and more.

The results?  A disconnect between those who anticipate retiring versus those who are retired.  As Jeff Goldsmith, author of The Long Baby Boom: An Optimistic Vision for a Graying Generation, puts it, “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.”  This poll confirms what we saw at the Knoxville Home Remodeling Show a few weekends back (which we blogged about in the last post on psychological barriers to independence at home).  As the Huffington Post columnist Glenn Braunstein, MD quipped, ” Americans are notorious disease-and death-deniers. We cling to the fantasy that death will come quickly and peacefully as we sleep and only when we’re age 100 and have earlier taken a brisk walk, read the Wall Street Journal and had a romp in the hay.  It doesn’t happen that way.”

This poll touched on some of the delicate issues we must each consider as we plan for our future and for aging.  To have the retirement we desire, we must have an honest discussion about what our needs are, what they will be, and what resources will be needed to take care of ourselves. Here are some of the significant findings from the poll:

“Pre-retirees may under estimate the challenges of retirement.”

13% of pre-retirees expect their health to be worse in retirement, but 39% of current retirees say that their health is worse than it was 5 years prior to retiring.

“Finances play a key role in the decision to delay or even avoid retirement among those not yet retired.”

54% of pre-retirees are deliberately postponing their retirement due to their financial situation.  Many suffered in the economic collapse of 2008 and do not feel financially secure enough to retire as early as they may have originally planned to.  Renowned financial planner Dave Ramsey offers a financial investment calculator on his Web site that helps individuals estimate the savings they will need to accrue for comfortable retirement.

“While pre-retirees and retirees agree on many community characteristics that keep retirees healthy, retirees draw attention to drug store access.”

Community pharmacies and home medical companies are a vital but often overlooked component of remaining healthy at home for many older Americans.  77% of retirees cited the importance of access as a critical component of them maintaining a healthy lifestyle and remaining in their homes.  Likewise, a September study of 2000 Americans by Harris Interactive revealed that nearly 4 of 5 Americans think the federal government should strengthen patient access to home medical equipment and services.  If programs like the ill-conceived Competitive Bidding eliminate suppliers, our seniors will feel the void and suffer as result.

Paying for Long Term Health Care

Of particular interest to us at Homecare Advocate was boomers’ impression of long-term care.  Though they better understood the cost of care, they were not well informed on the resources that paid for it.  The study revealed that 32% of pre-retirees and 43% of retirees thought that Medicare would pay for the majority cost of their 3-month nursing home stay if needed and only 10% and 7% thought Medicaid would, respectively.  However, the National Health Policy Forum revealed that in 2009 the $203.2 billion dollars spent on long-term services and supports was largely covered by Medicaid.  Over 10 million Americans currently need long-term care for daily living, and there are strict qualifiers like a very small income and essentially no assets in order for Medicaid to pay.  Medicare, on the other hand, does not pay for long-term care and would only temporarily pay for a nursing home stay in the instances of rehabilitation or skilled nursing care after a qualifying hospital stay of 3 days.  Neither Medicare nor Medicaid will pay for Assisted Living and will not cover personal support services like grooming, bathing, meal preparation and eating, and more.  Both Medicare and Medicaid are undergoing significant budgetary changes at the state and federal level, and boomers and seniors must be prepared for what lies ahead.

The poll also echoed a recent AARP study that revealed that 89% of people want to remain in their current home for the rest of their lives.  In the poll, pre-retirees and retirees alike were “very” or “somewhat” worried about the prospect of being admitted into a nursing home, citing:

  • an institutional environment is not as comfortable as home (82%; 78%)
  • cleanliness of the facility (78%; 74%)
  • having too few nurses for the care needed (77%; 69%)
  • quality of health provided (76%; 69%)
  • limited privacy (74%; 65%)

What about long-term care?

“More than 2/3 said they were very or somewhat likely to have trouble paying for long-term care if they or a spouse needed it.  That’s slightly more than the 3/5 who feared they might have trouble paying overall medical bills” reports NPR.

According to the National Advisory Center for Long Term Care Insurance, those 65 and over have a 70% chance of needing long-term care at some point.   The American Association for Long Term Care Insurance says that long term care is a woman’s issue because of longevity and caregiving.  Since women live longer than men, the women are typically caregivers for their spouse.  However, when widowed, they have no one to care for them and can develop more chronic health problems with their longer life-span.

Dave Ramsey strongly advocates for Long-Term Care Insurance for older Americans aged 60 and older.  “I’m a huge fan of this insurance. If you become ill, it ensures that your spouse will have enough money to eat and your kids won’t be burdened with huge payments. Not having LTC insurance can be a $300,000 to $400,000 mistake.”

Rebalancing Act

As our population ages, a rebalancing act is occurring in several states throughout the country as older adults and people with disabilities seek long-term services and desire to remain at home.  Yesterday groups met on Capitol Hill to discuss long-term care options and to gain a better understanding of how we can efficiently and effectively care for people needing long-term health care services.  The forum, held by the Alliance for Health Reform and the Commonwealth Fund, focused on serving more people through home and community based services than through institutional care.

Homecare is cost-effective, patient preferred, and results in better clinical outcomes than institutional care.  Tennessee is one of the growing number of states that supports home and community based options for seniors through its CHOICES Program. 61% of Americans favor investment in community- or home-based care to improve cost-effective health care.   A homecare-based approach will address the goal of former President John F. Kennedy who eloquently stated, “It’s not good enough for a nation merely to add new years to life–our objective must also be to add new life to those years.”

As a fellow Homecare Advocate, I encourage you to learn more about long-term care and how you can prepare yourself for the future so that you can truly enjoy the golden years.


3 Responses to “Retirement and Long-Term Care”

January 24, 2012 at 9:41 am, Long Term Elder Care said:

There are difficult topics everywhere, such as where and how you need to have a discussion with your family about long term health care. Life seems to be rather tough sometimes.


March 13, 2012 at 10:12 am, Cedric Policastri said:

Really enjoyed this blog.Thanks Again. Much obliged.


April 10, 2012 at 7:36 pm, Inell D. said:

Interesting topic to write about.


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