What’s my REAL Risk of Needing Long-term Care?

Q. I just turned 65, but I don’t feel a day over 50! Although I feel much younger than I am, I decided not to fight everything that comes with aging, but to embrace it and plan for it, so I am ready for whatever life has in store for me. I am on Facebook a lot and I often see lots of ads popping up for long-term care. Perhaps I should start planning for it, as I’ve seen the statistic that 70% of people over 65 will need it at some point in their lives. I am curious about something though. Is that statistic really accurate and when they define the long-term care that seniors will need, what does it encompass? Does it include long-term nursing home care, short-term rehabilitation stays at nursing homes, assisted living, and in-home care? Is it a good idea to start planning if I am not even close to needing it (in my opinion). Thanks!

A. Happy birthday! You have an amazing positive attitude, and as I’ve heard many times — you’re as young as you feel!

Many of us have seen the statistic you are referring to that says that 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. Let’s take a look at what long-term care entails, and what exactly is included in the 70%.

What Are Long-Term Care Services?

Long-Term Care Services include medical and non-medical care for people with a chronic illness or disability. Long-term care helps meet health or personal needs, and includes assisting people with Activities of Daily Living, such as dressing, bathing and using the bathroom. Long-term care can be provided at home, in an assisted living community, or in a nursing facility. For purposes of Medicaid eligibility and payment, long-term care services are those provided to an individual who requires a level of care equivalent to that received in a nursing facility.
When it comes to long-term care, examples of home care services include:

• An unpaid caregiver who may be a family member or friend
• A nurse, home health or home care aide, and/or therapist who comes to the home.

Community support services include:

• Adult day care service centers
• Transportation services
• Home care agencies that provide services on a daily basis or as needed.

Often these services supplement the care you receive at home or provide time off for your family caregivers. Outside the home, a variety of facility-based programs offer more options:

• Nursing homes provide the most comprehensive range of services, including nursing care and 24-hour supervision
• Other facility-based choices include assisted living, board and care homes, and continuing care retirement communities. With these providers, the level of choice over who delivers your care varies by the type of facility. You may not get to choose who will deliver services, and you may have limited say in when they arrive.

Distribution and duration of long-term care services

The chart at https://longtermcare.acl.gov/the-basics/how-much-care-will-you-need.html shows you the types of long-term care, the duration, and the percentage of people who receive this care.

So, What’s Your Real Risk of Needing Long-Term Care?

Based on the data in the chart in the link above and findings in studies such as Genworth’s annual long-term care survey, 70% is the most widely-used number for people over 65 needing any sort of long-term care. However, Jesse Slome, Executive Director of the American Association for Long-Term Care Insurance, looks at the answer to the question differently, and his view makes sense, as well.

According to Slome*, the real risk of needing long-term care is either 0% (you’ll never need it) or it’s 100% (you’ll need it). He sees it as a “lottery you don’t want to win … though the odds are significantly greater than winning the lottery!”

Being in the Long-Term Care Insurance business, Slome posed the question about the likelihood of needing long-term care to leading long-term care insurance actuaries (the people who price long-term care insurance). Findings were as follows: when it comes to long-term care insurance utilization, the lifetime chance someone who buys a policy at age 60 will use their policy before they die is 50%. So, in terms of insurance usage, it’s 50%.

As to the statistic that “70% of people over age 65 need some long-term care,” Slome states that this number, based on government studies, may be accurate, but the definition for “long-term care” is really too encompassing, as it includes people who spend just a few days recovering in a skilled nursing facility following a hospital stay, even though stays of shorter then 100 days are technically not long-term care, but are actually considered short-term care.

* Jesse Slome’s research is cited from the American Association for Long-Term Care Insurance at http://www.aaltci.org/long-term-care-insurance/learning-center/probability-long-term-care.php

Planning in Advance for Long-term Care

Once you understand you have a risk, no matter what the risk is, the smartest move you can make is deciding how you will handle it. As you age, you can feel better knowing there are steps you can take to ensure that your wishes, both medical and financial, are carried out the way that you want them. Advance care planning entails discussing your wishes, completing legal documents, and appointing a health care decision maker. Having your decisions squared away and clear, so that there are no misunderstandings or second-guessing, can be the greatest gift you can give to your loved ones, and yourself.

Planning for long-term care will not eliminate your risk of needing it, but it enables you to sort options and make smarter decisions ahead of time. As a result, you’ll have the peace of mind that no matter what happens, you will know what to do as a family. If you or your loved ones have not done Long-Term Care Planning, please call us as soon as possible to make an appointment for a no-cost 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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