Ten of the Most Common Myths About Long-term Care

Mark and his wife, Josephine, were discussing his mother, Alice, at dinner one night. Alice is in the early stages of dementia, but as her memory gets worse and she needs more assistance, the doctor said she will likely need long-term care services. Mark and Josephine don’t know much about long-term care and are under the impression that Medicare will pay for it and that long-term care and nursing home care are one and the same. When it comes to these myths and others, Mark and Josephine are not alone. Many Americans believe certain things about long-term care that just aren’t true, and should be clarified.

In a recent article in The Washington Post, writer Howard Gleckman discusses the coronavirus pandemic and efforts to reform the US long-term-care system. He discusses five myths about long-term care that are often believed to be true. We will expose the truth about these and five other popular myths:

1. MYTH: I won’t need long-term care: While this may be true for some, according to Longtermcare.gov, if you were to turn 65 today, you would have almost a 70% chance of needing some form of long-term care service during your remaining years. The generation currently facing the greatest growing need for long-term care services are the Baby Boomers. Born between 1946 and 1964, the Baby Boomer generation accounts for roughly 78 million Americans, and according to Medicare.gov, it is estimated that 12 million of them will require long-term care services this year.

 

2. MYTH: My health insurance will cover long-term care expenses: Health insurance doesn’t generally cover long-term care to any meaningful degree. Some plans provide minimal home care and skilled nursing benefits, but these are short-term in nature and designed around your recovery and rehabilitation. But, most long-term care received is custodial in nature, for the safety, maintenance and well-being of those with chronic conditions. If you’ll look close enough at your plan, you’ll likely find language that plainly states: “This plan does not cover long-term care.”

 

3. MYTH: Medicare will pay for long-term care: According to Howard Gleckman, “half of the approximately 800 baby boomers who responded to a 2019 Insured Retirement Institute survey said they expected to rely on Medicare to pay for their long-term care needs. A 2016 AP-NORC poll found that, among respondents age 40 and older, the largest share, 38%, expected Medicare to foot the bill. “

Medicare will not pay for your long-term care needs. While Medicare is designed to help those over the age of 65 keep on top of their healthcare needs, long-term care is not one of them according to the federal government. And while Medicare Supplemental plans are often touted to cover things that Medicare leaves behind, long-term care is still not one of them.

 

4. MYTH: I’m too young to need long-term care: Even if you’re under age 65, you may require long-term in-home or residential care services. On average, around 8% of people between ages 40 and 50 have a disability that could require long-term care services, according to the HHS. While the majority of people who require long term care are older, younger people can require it anytime due to severe unexpected illnesses, diseases, injuries, or accidents. Because the need for long term care can arise at any time in a person’s life, it is wise to plan in advance.

 

5. MYTH: My spouse or kids will take care of me: According to the National Academy of Social Insurance, it is estimated that 25% to 30% of the baby boomer generation “will become divorced or widowed by the time they reach ages 55 to 64,” increasing the likelihood of needing to depend on one’s children to provide care. However, studies have shown that rates of childlessness continue to rise. According to the Center for Disease Control, new data has shown that the birthrate has hit an all-time low. This statistic may not have as large of an impact on older generations who have more children than it will eventually for younger generations that do not.

 

6. MYTH: I can save enough on my own: Personally paying for long-term care expenses is one option. However, you should consider the type of long-term care services you would like and the cost of that care before relying on this method. In 2020, the average cost of a nursing home in the DC Metro Area is around $12,000 – $14,000 a month, and home care can sometimes be just as expensive.
The duration and level of long-term care will vary from person to person and often change over time. Here are some statistics (all are “on average”) you should consider: Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining years. Women need care longer (3.7 years) than men (2.2 years). One-third of today’s 65 year-olds may never need long-term care support, but 20% will need it for longer than 5 years. Imagine paying for 2 years, 3 years, or even 5 or more years of nursing home care at $12,000 – $14,000 a month! Paying for long-term care out of pocket may be an option if you can afford it, but most of us cannot.

 

7. MYTH: Most seniors receive long-term care in nursing homes: According to AARP,approximately 14 million adults in the US currently need long-term supports and services. Approximately 700,000 of these are long-stay residents of nursing homes. Roughly 600,000 are getting short-term post-acute care / rehabilitation in skilled-nursing facilities, and about 500,000 are in assisted living or other long-term-care facilities. The bulk of these 14 million people — approximately 85% or 12 millionlive in their own homes or with relatives and receive in-home care.

 

8. MYTH: Long-term care insurance covers all your needs: Sometimes it does, but it’s more realistic to expect that a long-term care insurance policy will cover about 60% to 70% of your expenses. Also, traditional long-term care insurance can be quite costly and the amount you have contributed may not justify the benefits you’ll receive.

Please keep in mind that sales of traditional LTCI policies have been declining, but consumers are becoming much more interested in hybrid policies that add long-term care benefits to annuities or life insurance. Issuers sold more than 250,000 such hybrid policies in 2018, according to the data firm LIMRA. Read my recent article, “Are Changes on the Horizon for Long-Term Care Insurance” for more details.

9. MYTH: It’s always better to age in place: A 2018 AARP survey found that 75% of Americans ages 50 and older want to stay in their own homes as they age. But aging at home is not always the best option. It requires a strong support network, including active and informed family caregivers or a highly engaged community. Living alone at home can also be isolating, which is itself a serious health risk. Some older adults now living in facilities could have theoretically remained at home. But for others, safe and fully supportive aging in place is unrealistic.

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10. MYTH: You’ll need to parent your parents as they age: Older adults may need support from their children, but they don’t want to be controlled by them. Seniors don’t want to lose their autonomy, and many of them resist allowing their children to take over their lives. This is why adult children should think of themselves as care partners, not caregivers. A 2018 study by Northwestern University geriatrics professor Lee Lindquist found that older people were more likely to accept support if they felt that, contrary to being parented, “by accepting help, they were in turn helping the person providing the help.”

 

Planning in Advance for Long-Term Care

The significant costs of long-term care can impact retirement plans, savings, and assets, and the level of care one receives. That’s why it’s so important that people speak with an experienced elder law attorney about long-term care preferences and to put a plan in place.

Medicaid Planning for Long-Term Care

Medicaid 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 a no-cost 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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