Long Term Care

Do Americans Understand Long Term Care?

October 31st, 2016
 Do Americans Understand Long Term Care?

BY: Lee-Lee Prina – Health Affairs Blog

Results from a new national telephone survey found that “Americans continue to misperceive [the] cost and risk of needing long-term care,” said the SCAN Foundation, funder of the survey, in a July 9 e-alert.

The Associated Press (AP)-NORC Center for Public Affairs Research conducted “Long-Term Care in America: Americans’ Outlook and Planning for Future Care,” the third in a series of annual surveys. The results, released in July 2015, are based on interviews with 1,735 adults, age forty and older, in all fifty states and Washington, D.C., during spring 2015.

The survey looks at older Americans’ understanding of long-term care, what they know or do not know about the cost and likelihood of needing long-term care services, and “their attitudes and behaviors” about planning ahead for possible care needs, according to a press release.

Experts estimate that 70 percent of Americans who get to age sixty-five will need some type of long-term care, “and our findings show that many Americans are unprepared for this reality,” commented Trevor Tompson, who directs the AP-NORC Center, in the release.

And, as most of us know, the need for long-term care is only going to increase with the large numbers of baby-boomers turning sixty-five every year now. “With this expanding need comes a demand for ways to maintain high-quality services and to make financing such care manageable for families and governments alike,” the national survey report notes.

Only a third of respondents in this survey said that they are “very or extremely confident” in their ability to pay for ongoing living assistance possibly needed in the future, the report notes. (“Ongoing living assistance” is essentially the people-friendly term for long-term care, Gretchen Alkema of the SCAN Foundation explained to me. It is defined in the survey instrument, she said.)

It is no wonder that respondents are concerned. The report cites a statistic from Genworth Financial that the median cost of nursing home care is now $91,250 per year.

And some 20 percent of respondents did not know if private health insurance covers ongoing nursing home care. (Most such plans do not.) Twenty-seven percent of respondents did not know if Medicare covers ongoing nursing home care. (Medicare, the report reminds us, only pays for intermittent stays in a nursing home.) That second response is troubling, but it is actually not surprising to me, an aging boomer myself.

The report states that the “likelihood of planning for ongoing living assistance increases with a number of factors.” These include being older, having a higher income, having more education, and being in better health.

The broader national survey included an oversample of Californians age forty and older. Survey results from the California respondents are in a separate issue brief titled “Long-Term Care in California: Policy Attitudes and Perceptions,” also funded by the SCAN Foundation, which is located in Long Beach, California.

The survey of Californians included questions about California’s In-Home Supportive Services (IHSS) Program. Most Californians surveyed were not aware of this state government-funded program “that pays for ongoing living assistance for Medi-Cal [California Medicaid] eligible adults,” the brief says. Through IHSS, adults age sixty-five and older and people with disabilities can stay in their homes to receive care there instead of moving to a nursing home or other care facility. The brief also explains how IHSS allows participants to choose their own care provider, who can even be a family member or friend.

As of now, IHSS providers “are not required to have any formal training on providing ongoing living assistance.” After hearing a description of the program, 65 percent of Californians surveyed somewhat or strongly favored a requirement for formal training.

The survey of Californians also found that only 27 percent are confident that they have the finances to pay for long-term care, and that percentage, the brief says, “is significantly lower” than the proportion (33 percent) for people elsewhere in the United States.