Long-Term Care Basics:
As you begin retirement planning, it is important to think about what type of care you might need. Most people over the age of 65 will need long-term care at some point, so it is an important consideration in the retirement planning process. Long-term care comes in a variety of forms and involves legal, family, financial, and social factors.
Long-Term Care is defined as those that need assistance with the basic personal tasks of everyday life, sometimes called Activities of Daily Living (ADLs).
- Using the toilet
- Transferring (to or from bed or chair)
- Caring for incontinence
People of different ages and activity levels and with different health concerns may require care, so the care provided varies from person to person.
Who needs care?
About 10 million people in the U.S. in the 2000s needed long-term care, and 63 percent of these people were over the age of 65. Around 70 percent of people age 65 or older will require some type of care. In most cases, however, the care isn't permanent; many people require care for just a few months while they recover from an operation, an injury, or a health problem.
The likelihood of needing care increases with age and more women need care than men, probably because they live about five years longer than men on average. People who have chronic illnesses or conditions like high blood pressure or diabetes are also more likely to require care. If your parents, grandparents, or other family members have chronic illnesses, you probably have a higher likelihood of developing an illness and needing care.
People who have had accidents resulting in a disability may also need care. About eight percent of people in their 40s have some sort of disability requiring care. More people who live alone need care than people who live with their spouses, partners or other family members.
How long will you require care?
The length of time a person needs care depends on their age and their physical condition. On average, women require care for 3.7 years, while men require care for 2.2 years. Only 20 percent of people around the age of 65 receive care for more than five years.
Where do you go for care?
The majority of people receive care at home, but some people go to community organizations or facilities for care. Some people attend adult day care centers every day or a few days a week.
People who need more specialized care and medical attention may choose to receive nursing home care. Nursing home care includes 24-hour supervision and specialists who can help with most health needs.
You can also receive care at other facilities that are about halfway between at-home care and nursing home care. These include:
- Retirement communities
- Assisted living
- Board and care homes
With providers like these, you will receive a higher level of care than at-home care, but you will have more freedom than in a nursing home. These providers are usually ideal for people who need frequent care and assistance but don't require 24-hour supervision and medical care. Depending on the provider, you may or may not get to choose who your caretaker is.
Who provides care?
Care in nursing homes or other away-from-home facilities is provided by experienced professionals. At-home care can be provided by a variety of people, such as:
- A family member or friend
- A nurse or therapist
- A professional home care aide
Unpaid caretakers, usually family and friends, provide about 80 percent of at-home care. They may help with homemaking, personal care, emotional support, or any other task needed. About 58 percent of caretakers assist with personal care, including bathing and feeding.
Caregivers spend an average of 20 hours a week providing care. More than 60 million people in the United States, or one in four adults, provide unpaid care to a family member or friend, and two-thirds of these caregivers are women. About 14 percent of caretakers are age 65 or older.
How can you pay for care?
Medicare can cover care if you need specialized medical or rehabilitative services. It can cover a nursing home stay of up to 100 days, but the average length of a stay covered by Medicare is 22 days. If you need to hire a skilled home care aide, Medicare will usually cover the cost of the care for a short length of time. It will not cover non-specialized care or assistance with activities of daily living.
If you meet your state's requirements for Medicaid, it can cover a large portion of the costs of care. The coverage amount will vary depending on the type and amount of assistance you need.
You can also receive financial assistance through federal programs like the Older Americans Act and the Department of Veterans Affairs, but most programs only provide coverage in specific circumstances.
Retirement planning is an important step in life as you get older. Many people will require care at least temporarily, and it's important to know who provides care, how you can receive it, and how you can pay for it.