Long-term care becoming fact of life for growing number of Americans
By Martha Simmons
Correspondent, The Alabama Baptist
You’ve paid off your mortgage on your comfortable home, are eligible for Medicare and have a liveable, if not generous, retirement income.
You’re pretty much set for your golden years, right?
Wrong.
Odds are, you’re going to spend several years of your life in some sort of long-term care scenario.
According to the U.S. Department of Health and Human Services (HHS):
- 69 percent of us will need some sort of long-term care for an average of three years.
- 65 percent will need care at home for an average of two years. About half that time will be unpaid care.
- 37 percent will spend an average of one year in an assisted living or nursing facility.
Medicare estimates that by 2020 some 12 million people in the United States will need long-term care, a number that’s being driven up by the aging Baby Boomer population. The likelihood of needing long-term care — and for longer periods of time — increases with age, disability and chronic conditions such as diabetes or high blood pressure.
Longer care
Since women usually live longer than men and outlive their mates, they are more likely to live alone and need care for longer: 3.7 years, on average, versus 2.2 years for men.
But don’t think you get off scot-free if you are middle-aged — HHS research says that 8 percent of people between ages 40 and 50 have a disability that could require long-term care services.
Service options
Long-term care services include but are not limited to:
- Medical and non-medical care for people with a chronic illness or disability
- Support with everyday tasks such as housework, taking medication or paying bills
- Assistance with activities of daily living such as eating, dressing, bathing and using the bathroom.
Long-term care can be temporary, as in weeks or months, to rehabilitate after a hospital stay or surgery, recovery from injury or illness, or end-of-life medical services.
But long-term care also can be permanent. Months and years may be required for permanent disabilities, chronic and severe pain, chronic medical conditions or cognitive impairment, bringing a need for constant supervision and assistance with activities of daily living.
Long-term care can be provided at home, in the community or in an assisted living or skilled nursing facility.
In this four-part series The Alabama Baptist will look at some of the options older adults and their families have for long-term care.
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Able family, community support allow many to ‘age in place’
Cyndi Arnold says her mom, Barbara Dean, was like the Energizer bunny — she stayed active and independent as long as she possibly could.
“But in the summer of 2016 it became very evident that she needed some help,” said Arnold, a member of Eastern Hills Baptist Church, Montgomery. “She was on some medication that made her disoriented. She didn’t need to drive anymore and she wasn’t taking good care of herself.”
So Arnold’s family began the difficult conversations of what to do next — what kind of care did she need? What were their options?
In the end they found a way for her to “age in place,” which for Dean meant living in Arnold’s house. That fit well for them and that’s where Dean wanted to be.
Living together
The Arnolds fixed up one of the bedrooms and bathrooms to accommodate her and her needs, and they were able to care for her there more easily.
“She was very happy to have a room in our home,” Arnold said of Dean, who passed away in 2017. “She had pictures and needlepoint from her house that made her feel comfortable there. I think for her living there with us brought a sense of home but also a sense of relief.”
Older adults like Dean who have a willing, able and available family member or friend, may receive long-term care at home, but it’s not always possible — or easy.
The U.S. Department of Health and Human Services reports that about 80 percent of care at home is provided by unpaid caregivers who spend an average 20 hours a week giving care. More than half of these caregivers have intensive responsibilities that include a personal care activity, such as bathing or feeding.
About 43.5 million people in the U.S. have served as an unpaid caregiver during the previous year, according to a 2015 study by the AARP and National Alliance on Caregiving. Two-thirds of these caregivers were women and 14 percent were 65 or older.
With more Baby Boomers remaining childless, unmarried or living far away from family members than previous generations, unpaid home care may not be possible. Paid home care may include a nurse, home health or home-care aide, or a therapist who comes to the home daily or as needed.
“Adult day care services” may be an option for working caregivers or those just needing a break from the 24-hour demands of caregiving. Community-based, structured programs can provide daytime social and support services in a protective setting for functionally or cognitively impaired adults who still live at home.
Social support
Additionally community support services that may help people who are cared for at home include meal delivery programs through local senior centers or faith-based organizations, public transportation and in some communities low-cost housing programs that provide senior services. (TAB)
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What to consider when a loved one wants to live out their days at home
By Grace Thornton
The Alabama Baptist
You or someone you know may have been there, or you may be there right now. An aging parent, grandparent or other relative is losing mobility or the ability to live independently, and they’ve expressed before they don’t want to move into a long-term care facility.
What do you do? Are there ways to respect their wishes but keep them safe and get them the care they need?
The struggle between staying at home and staying safe is a common one for caregivers of aging parents who want to “age in place,” or live as long as they can in the place of their choice, whether that be their own home or the home of a family member.
Making changes
Sometimes the needs are too great for that to be possible. But other times, putting some help in place and making some changes to the home can enable loved ones to live where they want to with the comforts of home for months or years longer.
What are the needs to consider? Let’s walk through a few of those here.
1. Accessibility changes.
Sometimes an injury or a change in stamina and balance can be the factor that pushes your family to have the conversation about where it’s best for loved ones to live.
It’s possible that mobility issues may be solved by getting the right wheelchair or scooter.
Aginginplace.org offers a guide that can help you navigate finding the right wheelchair and helping your loved ones adjust to using it. They also offer a guide to finding portable ramps you can take with you when your loved ones need to get out and about.
And perhaps one of the biggest issues — getting in and out of the house safely — can be tackled with the addition of a wheelchair ramp outside the home.
Don’t know where to start? Contact your local Baptist association and ask if they or a ministry they know of has a carpenters group that could help.
For instance Larry Thompson, associational mission strategist for Washington Baptist Association, said his group, Christians on Missions, has built around 100 ramps for people in the community in the past several years.
Other groups all around the state stand ready to help too.
You also might want to take some time walking around the house to determine if adjustments can be made to make it safer for your loved ones.
Do halls or showers need to be widened for a chair to fit? Do you need a walk-in bathtub, grab bars in the bathroom or higher toilets?
Making some of these changes could help provide your loved ones with a safer way to stay independent in their home or yours.
2. Meal planning.
Something else mobility can affect is buying food and preparing it for themselves. This may be something easy to handle if your loved ones are choosing to “age in place” in your home where you can make sure they have meals each day.
But if they’re staying in their own home an option to consider might be a meal planning service.
If your loved ones are able to get around in the kitchen a good option might be a meal-kit delivery like Diet-to-Go, Silver Cuisine or Hello Fresh, all of which will deliver anywhere in the continental U.S. These boxes with prepared ingredients and recipes are delivered as scheduled. Most meal kit options cover three or four meals a week.
If cooking isn’t an option a meal delivery service might fit your loved ones’ needs better. Local services like Meals on Wheels may provide meals ready to heat or eat. Research to see which one fits your loved ones’ needs and budget.
3. Caregiving needs.
If you’re considering hiring a caregiver for your loved ones there’s a lot to consider. Do you need help a few times a week, overnight or around the clock? Will you hire someone independently or a company that provides medical or nonmedical caregivers? As with most things there are pros and cons to both.
If you hire someone independently you get to be more selective and flexible in who you choose. They can be less expensive too. But your caregiver most likely won’t have backup when he or she is sick or liability insurance if something goes wrong.
Through a company caregivers are easy to hire and they have backup caregivers and insurance, but they can be pricier and may provide a limited range of support services.
Ask around and listen to other people’s experiences. Do your research and decide which one works best for you and your family.
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