Who is Providing Long-Term Care?

As you begin to think about long-term care options for yourself or a loved one you may be wondering how others are dealing with the same challenges. A common question is, “Who is providing for the long- term care needs of an aging society?” Put simply, there are three basic safety nets that aging adults are using to meet their long-term care needs: Unpaid Family Caregivers, Formal In-Home Caregivers, and Long-Term Care Facilities.

Unpaid Family Caregivers

What does the family caregiver look like? According to LongTermCare.gov, “About 65.7 million people in the US (1 in 4 adults) were unpaid family caregivers to an adult or child in 2009. About 2/3 are women, and 14% who care for older adults are themselves 65 or more.” The Scan Foundation in a 2013 survey found that, “three-quarters (78%) of people living in the community who need long-term care get support exclusively from informal, or unpaid caregivers. The average age of this informal caregiver is 48 years of age.” The report went on to point out that, “Nationally, 72% of informal caregivers provide care for a relative, with over one-third taking care of a parent.”

The type of care that informal family caregivers are providing centers on what is referred to as “activities of daily living”. These are the every-day tasks that sustain our basic living such as getting out of bed, dressing, showering, toileting, feeding, etc. It is also common to have a spouse or adult child help manage the household needs including giving transportation to errands and appointments, doing the housework and cleaning, grocery shopping and preparing meals, administering medications, managing finances and paying bills, as well as coordinating supplemental services that are needed to fill any gaps. More and more family caregivers are being asked to complete complicated care tasks such as medication management, catheter care, wound dressing, insulin injections, etc. A discharge from the hospital can leave many adult children or spouses overwhelmed by the level of care that they are responsible for without much or any training. Informal caregivers provide an average of 4.6 years of care with 31% providing care for 5 years or more. Professional in-home caregivers can provide these family caregivers an important respite and resource when care becomes too complex and begins to take its toll at home.

Formal In-Home Caregivers

Professional caregivers giving direct care to those needing long-term care services play a crucial role in maintaining quality of life and safety within the home. For those individuals who want to avoid an institutional care setting, a nursing assistant or home health aide can provide the everyday assistance within the home. According to the Scan Foundation, between 70-80% of paid long-term care in the US is provided by direct care workers, which include home health aides, certified nursing assistants, and personal care aides. These professionals are employed with numerous independent providers across the country. Most long-term care services providing care in the home are not covered by Medicare and are an out-of-pocket expense for families. Having Long-Term Care Insurance can be an important way to supplement your resources to cover the costs over time.  

Long-Term Care Facilities

By 2018, home and community-based direct care workers are likely to outnumber facility-based workers by nearly two to one, according to the Paraprofessionals Healthcare Institute. Right now, approximately 46% of direct care workers, nationally, provide care in a long-term care facility. Institutional care settings can be chosen by families for a variety of reasons including the high level and duration of care needs as well as the social engagement aspects. Particularly with demanding chronic diseases such as Alzheimer’s and other dementias, a customized environment that caters to the needs of the aging adult can be a safe option for care. Some LTC facilities are able to take Medicare. If you have long-term care insurance or are deciding on a plan, it is important to know what your policy will cover. Most have a daily limit that in how much they will pay for facility long-term care as well as a limit of the duration of stay. It is common for family caregivers to take on the initial needs at home to reduce the duration that institutional care would be needed.

If you are a potential or current family caregiver looking for the best options for your long-term care needs a great place to start is to consult with a Geriatric Care Manager. These professionals are Registered Nurses or Masters of Social Work who specialize in the care of older adults. They are able to help families navigate the healthcare maze, do a professional assessment, create customized options that meet the needs, goals, and wishes of aging adults and their families, and oversee and manage their care. By leaning on their expertise, families are able save a great deal of time and money while creating positive outcomes and quality life for their loved ones.

In 1989, Sound Options began with the dream of revolutionizing the way we think about long-term care. By combining Geriatric Care Management with In-Home Care we have fine-tuned a service that provides a high level of care and expertise without leaving home. It all begins by providing education to families and demystifying the world of elder care and healthcare so they can make informed decisions they can feel good about.

Start getting the help you need today. Give us a call or check out our service options online.

Published on August 9, 2015.