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caregiving supportThanks to improved public sanitation, medical advances and smart lifestyle choices, people are living longer.  The US Census reports that the fastest growing demographic is people 90 plus.  They used to constitute 2.8% of all older adults (those 65 plus). Now those 90 plus make up 4.7%. “By 2050, this share is likely to reach 10 percent.”

Many older adults are using this time to pursue second careers, practice hands-on grandparenting, adopt new hobbies and enjoy new or long-standing friendships.  But living longer doesn’t allow a complete escape from changes to the mind and body.

As people move into late adulthood, many must manage a number of chronic diseases: arthritis, heart disease, diabetes, COPD, etc.  Also the risk of dementia increases as people age.  The Centers for Disease Control and Prevention estimates that between 25% and 50% of those 85 plus show signs of dementia. Alzheimer’s disease is the most prevalent form.

As people acquire more and more age-related diseases, they require help with a number of day-to-day activities. Many older adults receive help with activities of daily living from family members—spouses and adult children primarily. Family Caregiver Alliance shares these statistics: “43.5 million of adult family caregivers care for someone 50+ years of age and 14.9 million care for someone who has Alzheimer’s disease or other dementia.”

Family caregivers often make great sacrifices to provide care.  They often suffer setbacks financially, emotionally and physically while serving as caregivers.   They are often too overwhelmed to explore support services such as home health care, respite care and caregiver support groups.  Contacting a local Area Agency on Aging is a good place to start seeking support.

Sometimes, however, the caregiving needs become too much for family members—even with support. The older adult then moves into nursing home care.   But how many people end up living in a skilled nursing facility?

I often see people quote this statistic: Only 4.5% of people 65 plus live in skilled nursing facilities.  True.  But this is a snapshot statistic. It’s similar to saying that in the US only 3% of women 15 to 45 are pregnant – at any one moment.  However, roughly 80% of women in the US have a least one child over time.

By looking at older adults over time, people 65 plus have a 40% chance of living in a skilled nursing facility as reported by Medicare.  The rate increases with age. It increases for every chronic disease a person accrues. It’s also higher for women, who tend to outlive their spouses by several years.

Unfortunately, Medicare does not pay for long-term care. Yes, they will pay partially for skilled nursing for a short time (around 3 months). For example, those undergoing rehabilitation following knee replacement or hip replacement can receive help from Medicare for part of the cost of recuperating in a skilled nursing facility.  With supplemental insurance, the costs for such care are quite manageable. (See your local State Health Insurance Assistance Program (SHIP) for free Medicare counseling.)

The average cost of a year in a skilled nursing facility is about $80,000 a year with the average stay at approximately 2.5 years. This bears repeating: Medicare will not pay for your parent or spouse to live permanently in a skilled nursing facility.  Until I started volunteering as a Medicare counselor a few years ago, I was quite naïve about the costs of Medicare care and long-term care for older adults.  I also assumed that Medicare would pay for more or pay a larger percentage than it does.

The cost of long-term care are paid for by private pay, long-term care insurance, or by Medicaid. The last requires a person to demonstrate low income and low assets prior to receiving benefits.  People must all-but impoverish themselves to qualify for Medicaid.

Yes, there is much to celebrate as we age.  I am enjoying a second career and good physical health.  I can analyze and synthesize material with greater richness than I did as a twentysomething.  My age allows me to take the long view on day-to-day challenges.  I see many others in midlife growing, achieving and developing in amazing ways. Hopefully, we can also apply the strengths of midlife to meet the age-related challenges that our parents and we ourselves will face in the coming decades.

Read more from Karen Austin at The Generation Above Me. Follow her @TheGenAboveMe

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Who’s Paying When You Can’t Live Home Anymore? was last modified: by

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