How Knowledgeable and Prepared Are Americans for Long-Term Care? An AARP Survey Explains

In the ’80s or even the ’90s, if someone asked a person about long-term care, often they would respond that they don’t need help with lawn care. You read that right: lawn care. This is because the term “long-term care” was not yet in most people’s vocabulary.

Today most people are aware of long-term care, having heard that most people will need it, and they know the impact it can have on families and finances. Older adults face the prospect of needing assistance with activities of daily living (ADLs), which involve help with things such as bathing, dressing, and using the bathroom. However, even today, few have given much thought to how they will continue to live independently or how they will pay for long-term care, according to a recent AARP survey.

AARP Releases the Results of the “Long-Term Care Readiness” Survey

The AARP’s “Long-Term Care Readiness – An AARP Survey of Adults 50+” surveyed 1,011 U.S. adults 50 and older to gauge attitudes and behaviors related to long-term care planning.

AARP’s survey shows that nearly seven in ten adults believe that they will need assistance with their daily activities as they age, yet fewer than three in ten have given any thought to how they will pay for that care when they need assistance.

The findings are as follows:

  • Most Americans believe they will need assistance as they age:
    • Sixty-eight percent of older adults believe they will need assistance with their daily activities at some point.
    • Only 28 percent have given much thought to how they will continue to live independently if they need that assistance.
    • Only 3 percent believed there was no chance they would ever need assistance when they get older.
  • People don’t want to burden loved ones. In fact, one of the top concerns that 62 percent of those surveyed have is not becoming a strain or burden on their families. Other concerns noted were:
    • Not being able to continue living independently (63 percent).
    • Slightly fewer said they are concerned about savings (59 percent), living in assisted living or a nursing home (58 percent), or not being able to remain at home (57 percent).
  • Attitudes on needing assistance varied by age:
    • Seventy-four percent of those 65 and older indicated they likely will need assistance, compared with 64 percent of respondents aged 50 to 64.
    • The 65-and-older group also gave more thought to how they will live independently, with 31 percent indicating they had given it a lot of thought and 48 percent indicating they had given it some thought, compared with 25 percent and 47 percent, respectively, of respondents 50 to 64.
    • Respondents aged 65 and older were more likely than other respondents to be concerned about not being able to live independently as they age and about becoming a burden on family (64 percent) and needing to live in an assisted living community or nursing home (63 percent).
  • Unpaid family caregivers often feel untrained and unprepared for their difficult job:
    • The goal for most people is to live and thrive independently.
    • There are 53 million unpaid family caregivers in the United States.
    • As we age, we experience declining health and mobility problems, making that difficult or impossible. Adult children often feel concerned about the safety and well-being of their aging parents.
    • Home health care is beneficial, and professional caregivers are trained to provide care. However, family caregivers find it hard to keep up.
  • The COVID-19 pandemic seems to have had some effect on thoughts about independent living:
    • Sixty-two percent of those aged 60 and older said they think about how to live independently as they age, about the same as two years ago.
    • Thirty percent indicated that they are thinking about it more often now.
  • Planning for the future also varied among age groups:
    • Adults 65 and older were more likely to have written a will (65 percent), signed a power of attorney for health care and finances (57 percent), planned with their families about how they will be cared for as they age (32 percent), set aside funding to pay for that care (31 percent), and researched community-based services (22 percent).

The Most Alarming Finding

Even though traditional health insurance plans, including Medicare, don’t pay anything toward long-term care services, about half of the adults 50-plus in AARP’s survey mistakenly believed that Medicare covers care in a nursing home or care in their own home from a home health aide.

Here’s what Medicare covers:

  • Medicare pays for health care for people age 65 years and older, people under age 65 with certain disabilities, and people of all ages with end-stage renal disease.
  • Medicare only covers medically necessary health care (not long-term care) that focuses on keeping people healthy or getting them better medically. Medicare Part A covers primarily inpatient hospital stays; Medicare Part B covers doctor visits, and Medicare Part D covers prescription drugs.
  • Medicare Part A also covers short-term rehabilitation, such as physical therapy to help you regain your function, after injuries such as a fall or a stroke.

Medicare does not pay one penny, ever, for long-term care nor does Medicare pay for supervision needed by those suffering from dementia.

What causes many people confusion is that Medicare will help pay for a short-term stay in a skilled nursing facility, for hospice care, or for home health care, but this is only after a hospital stay and only if you meet certain strict conditions as described in this Centers for Medicare and Medicaid Services (CMS) guide.

Planning Ahead Is Vital

In 2022, the average cost of a nursing home in the DC Metro Area is around $12,000–$14,000 a month, and home care can often be just as costly, and sometimes even more expensive depending on how much care is needed in the home. And long-term care costs are rising sharply because of inflation, increasing labor costs, and higher demand for services.

Being proactive when planning for long-term care is incredibly important. You can’t avoid aging, but you can plan for the costs and burdens of aging and the impact long-term care will have on your family and finances.

Planning requires thinking ahead and being realistic about the risks we face in the future. Changes in our health as we get older mean we will likely need help with ADLs. How will you handle the rising cost of long-term care?

Planning in Advance for Long-Term Care

The significant costs of long-term care can devastate retirement plans, savings, and income, and can also impact the level of care one receives. That’s why it’s so important that people speak with an experienced Elder Law attorney, such as myself, about long-term care preferences and put a long-term care plan in place.

Medicaid Planning for Long-Term Care

Medicaid is the only governmental benefit that pays for long-term care for non-veterans. For certain wartime veterans, there is a benefit called Veterans Aid and Attendance that will also help pay for long-term care. Planning can be started while you are still able to make legal and financial decisions or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care. In general, the earlier someone plans for long-term care needs, the better. But it is never too late to begin your planning. To begin long-term care planning (and incapacity and estate planning) right away, please call us now to make an appointment for an initial consultation:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.