Long term care why

It is therefore difficult to track the number of people receiving community care but not living in their own homes or in the homes of family members.

We chose a number halfway between the two at 1. Thus the number of 1. All other numbers and percentages were extrapolated from actual census data and from the numbers already mentioned. Since a large number of care recipients are under the age of 65 we don't come up with as many people receiving long-erm care as indicated in the excerpt from the house committee report above.

The data for the chart below were taken from an AARP research article and represent the year It should be noted that long-term care-recipients below the age of 65 are not typically part of the workforce or ever were. For the most part these are people who were born with developmental disabilities or mental retardation or developed these conditions early in life. They are healthy otherwise and may live a normal life span which could be scores and scores of years.

Most long-term care-recipients over the age of 65 were healthy and functioning prior to developing a need for care. For these people the need for care seldom lasts longer than three to five years after which many will die. Since care-recipients under age 65 may live six to ten times longer than the elderly care-recipients, the younger folks tend to accumulate in numbers and skew the statistics. This often leads to misinterpretation of data describing the age populations receiving care.

If statistics were available comparing the number of people needing long-term care for the first time in any given year, the incidence rate for the elderly population would be significantly higher than that for the younger population. It should also be noted that the younger care-recipients are typically covered by Medicaid and receive payments from SSI. They don't struggle with the same lack of funding issues as the older generation. The reason for a low percentage reporting under age eighteen is because reporting methods for long-term care don't apply to this younger age group.

The chart below reveals significant proportions of the population under age 65 may need physical or emotional help from other people. But, as has already been pointed out above, there are some in the population who have developmental disability or mental retardation and this may explain the high number of disabled under age Of particular interest is the fact that close to half of the population over age 75 is disabled.

Since more and more people are surviving to age 75 and beyond we can only expect an increased demand for long-term care services in coming years. The chart below shows a general classification of the types of disabilities people age 65 and older are dealing with. Note the large number of elderly who are afraid to leave their homes by themselves. About one in five elderly can't leave home alone. The 2 following charts were taken from a presentation for the congressional hearing cited below :.

Sixty percent of this amount was financed through Medicaid and Medicare, one third through out-of-pocket payments, and the remainder by other programs and private insurance. This funding excludes the significant resources devoted to long term care by informal caregivers primarily spouses and children. The CBO estimates that informal care is the largest single component of long term care". If the Federal government were providing this care instead of unpaid caregivers, the combination of funds already expended and the potential costs would be the third largest single budget item exceeded only by Social Security and defense spending.

The chart below was taken from the same presentation from the congressional hearing cited earlier:. The chart below tracks all categories of health care costs for the elderly. There are four categories that pertain to long-term care services. The first of these bars is titled "hospice". This typically covers an hour or less a day for palliative care for a terminal condition.

Additional hospice coverage could be covered out of pocket or by long-term care insurance if a caregiver chose to do this. The second category is called "home healthcare". This is the kind of care covered on a temporary basis and under prescription from a doctor and normally paid by Medicare. The other costs may be covered by the veterans administration, the national institutes of health, the bureau of Indian affairs or private insurance. This care is provided by companies called Home Health Agencies.

These companies provide the skilled and custodial care as part of a plan of care prescribed by the doctor and limited to a certain period of time money is usually provided for a 60 day period. In the last ten years we have seen an astounding growth of companies providing non-medical home care which is not typically covered by government programs but must be paid directly by the family.

Costs are also covered if the recipient has long-term care insurance. Many home health agencies are also offering this care as a separate service.

There is no plan of care unless these services are sub-contacted under a plan of care by a hospice or home health agency which is sometimes the case.

In some states Medicaid will also pay for this kind of care under certain conditions. There is also no limitation on how long Medicaid services can be offered. The data for these services are not represented in the chart below. The third category is entitled "short term institution". This is a misleading title that refers to Medicare nursing home coverage after a three day hospital stay. Note that not all of this care is covered by Medicare. This is because a short term nursing home stay may not have met the three day rule, or did not originate from a hospital or require skilled care, which are all prerequisites for Medicare to pay.

The services may also have been covered by other government agencies such as the VA, the bureau of Indian affairs, private insurance or Medicaid. Note the reversal of who pays the bill. In this case it is shared by the family and Medicaid. The other" category might include payments by the veterans administration and the bureau of Indian affairs or private insurance.

Many of those paying out of pocket are going through a spend-down process to deplete their assets in order to qualify for Medicaid. We recently completed a survey of the cost of all nursing home beds in our state.

We then calculated the average cost and the median cost on a weight adjusted basis of the number of beds in a given cost category. Our average cost was significantly and statistically less than a national sample survey for our state in the same year. Our median cost the halfway point cost of all beds more costly equal to the same number of beds less costly was significantly less than our average cost and the national survey cost. We believe that it is not possible to do a reliable sample phone survey of nursing home costs because all nursing homes in a given state are not the same in structure and operation and marketing philosophy.

Because of a lack of uniformity, all nursing homes in the state will not follow a standard statistical distribution on costs and therefore a random sample survey will not give reliable results. We could probably use up six or seven pages describing in detail the factors that affect private-pay bed rates for nursing homes. Also the application of these factors and different state approaches on regulating nursing homes affect the private-pay bed rates from state to state.

Here are some of the factors:. Sample phone surveys for assisted living costs are acceptable as far as they go, but they probably don't reflect the entire assisted living service market. Surveys are not reliable as a comparison from state to state because of the differences in services offered between states. The term "assisted living" is a marketing tool that refers to a large number of different community living arrangements that also offer care.

There is no uniform regulation of these services from state to state. Some states regulate on the basis of number of residents while other states regulate on the basis of services offered.

Not all states use the term assisted living for these living arrangements. In the states that control services, some of those states allow very little in the type of services offered and residents in those states must go to a nursing home to receive more extended services.

On the other hand, some states allow assisted living to offer nursing home skilled services under certain conditions. Obviously the services offered will affect the cost of care and the cost of an assisted living arrangement. Also in some states assisted living cost includes the cost of long term care services and in other states the cost is charged in addition to room and board. A large number of operations offering community living with care are invisible to the public.

Accessed on January 18, Long-term care. The picture shows the psychologist of the Hellenic Society of Pain Management and Palliative Care — one of our institutional members - talking to a young patient during one of the palliative care team visits. We are a not for profit organization dedicated to the advancement of hospice and palliative care in the world to alleviate serious health related suffering of millions of patients and families around the world.

We have over 30K visitors to our website each month. Long-term care LTC refers to support that is needed by older persons with limited ability to care for themselves due to physical or mental conditions, including chronic diseases and multimorbidity. The needed support, depending on the degree of limitation, can be provided at home, in the community or in institutions and includes for example assistance with daily living activities such as dressing, medication management but also basic health services.

Such services are usually provided by formal or informal workers, paid or unpaid. Formal workers might be skilled health or social workers that are employed, for example in nursing homes.