Peace of Mind for the Golden Years: Planning Ahead for Long-Term Care

Although life expectancy in the U.S. declined in 2020 and 2021—a drop largely fueled by the COVID-19 pandemic—the Social Security Administration (SSA) still reports that U.S. residents hitting retirement age this year can expect to live another 16.9 to 19.6 years.

Naturally, we don’t like to think about our health and abilities declining, but it’s hard to predict every twist and turn in our golden years. LongTermCare.gov, a website run by the U.S. Administration for Community Living (ACL) says, “One-third of today’s 65-year-olds may never need long-term care support, but 20 percent will need it for longer than 5 years.” Overall, ACL reports that 69% of today’s 65-year-olds will need long-term care in one form or another.

There are several reasons why it’s a good idea to plan ahead for long-term care:

• It comes at a substantial cost. To get an idea of how much different types of care cost, try using the American Association of Retired Persons (AARP) long-term care cost calculator.
• At the time you need long-term care, the state of your health might make it stressful or otherwise difficult to research care and payment options.
• The elderly population is vulnerable to abuse, especially in long-term care facilities like assisted living and nursing homes. Planning ahead gives you time to find reputable, high-quality services and facilities.

Who Needs Long-Term Care Planning?

Planning for long-term care applies to people of all ages. For example, you may want to consider long-term care if:

• You’re planning for your retirement, regardless of your age.
• Your parents are retired and haven’t considered long-term care.
• You’re retired and living independently but don’t have plans in place for long-term care.

The Sandwich Generation: Caught in the Middle

In recent years, more and more people have become part of what’s known as the “sandwich generation.” The sandwich generation isn’t a particular age group; rather, the term describes those who have minor children or are supporting an adult child and also have one or more parents over age 65.

The nonprofit Pew Research Foundation says that this description fits 23% of adults in the U.S. and 54% of those in their forties. If the elders in these scenarios don’t have a plan for long-term care, the burden of their care in their declining years—in terms of time and finances—may fall on their middle-aged children.

Families may find it difficult to discuss long-term care, but having the discussion can help avoid much more discomfort later on.

Understanding Long-Term Care

Long-term care is care that meets the medical, physical, and emotional needs of elders in a variety of contexts. For example:

• Medical care includes skilled nursing services, such as administering medications or changing the dressing on a wound. Medical care can be provided at an elderly person’s home by a traveling nurse or in a nursing home.
• Physical care includes help with daily activities, such as bathing, dressing, preparing food, doing laundry, or cleaning. Physical care may come from a family member, a paid caregiver who visits an elderly person at home, or staff at an assisted living or skilled nursing facility.
• Emotional care refers to caring for the emotional well-being of an elder—through a phone call, visit, or planned activities in a senior community, such as an adult day care facility or an assisted living home.

It’s hard to predict when someone’s need for care will evolve from simple things that family members can do into more complex care that must be provided by trained medical personnel.

Long-Term Care Options for Seniors

Options for long-term care are affected by individual idiosyncrasies and varying states of health. For example, one person may want to live independently for as long as possible; another may start investigating retirement communities from the day they leave their last job. An Alzheimer’s or Parkinson’s diagnosis may prompt a search for facilities certified to provide memory care.

When planning long-term care for the elderly, it’s helpful to be aware of the range of options available.

In-home care helps elders who need assistance with personal hygiene or tasks around the house continue living in their own homes. In-home health care providers also extend an elderly person’s ability to live independently by providing nursing services or physical therapy at home.

Resources for in-home care include family members, volunteer organizations (e.g., meal delivery), and paid caregivers. In-home care options are generally more affordable than residential care options.

Residential care includes assisted living facilities and nursing homes (also known as skilled nursing facilities). In assisted living, elders live in a community of older adults and receive meals and help with daily activities. Assisted living does not include medical care.

Nursing homes provide the same kind of care as assisted living facilities but also include medical care from nurses and doctors on staff. Nursing homes are generally the most expensive type of long-term care.

Adult day care centers provide an intermediate step between at-home care and residential facilities. For example, an elderly person might spend the day in an adult day care center and receive help from a family member at home in the morning and evening.

Continuing care retirement communities (CCRCs) are retirement communities that offer a range of care options. They typically require a significant payment up front as a buy-in. Once an elder is part of the community, they can live independently or transition to assisted living or skilled nursing care as needed.

Be sure to visit any long-term care residential living facility you’re considering. Be aware that elder abuse is a problem in some assisted living facilities and nursing homes, and learn to recognize the signs of elder abuse.

The Money Question: How Will You Pay for Long-Term Care?

Quickly rising costs are one of the main reasons why it’s a good idea to create a long-term care plan.

Long-Term Care Costs in Bakersfield, California

Here are the average costs of some long-term care services in the Bakersfield area, per AARP:

• In-home care, 10 hours per week: $1,241 per month
• Adult day care, 5 days per week: $1,827 per month
• Assisted living: $3,750 per month
• Nursing home: $9,155 to $10,342 per month

For many people, care offered by family members is an integral part of a long-term care plan. However, although care from family members doesn’t involve out-of-pocket costs, it does cost their time and pull them away from other responsibilities and enjoyments.

Long-Term Care Payment Resources

Given these costs, you’ll likely want to consider every available resource to pay for long-term care, including:

• Personal or retirement savings: These can be quickly exhausted if you find yourself in need of assisted living or nursing home care.
• Health insurance:
  • Many seniors rely on Medicare for their health insurance. Medicare does not apply to in-home help with daily tasks, adult day care, or assisted living. Medicare covers nursing home care for up to 100 days, although there is a $200 daily copay after the first 20 days.
  • Medicaid covers some long-term care for those who meet specific income qualifications. In California, Medicaid programs are administered through Medi-Cal.
  • Veterans who use the Veterans Administration (VA) for their health care may qualify for VA assistance with in-home care, assisted living, or nursing home care.
• Long-term care insurance works much like car insurance. You pay monthly premiums for coverage that pays for long-term care when you need it. Carefully review the benefits offered by a long-term insurance plan before buying, and make sure you’re able to afford the premiums.

Contact Kern County Aging and Adult Services for information on government and community resources for the elderly.

How to Plan for Long-Term Care

Here’s a checklist to get you started on crafting an extended care plan for yourself or a loved one:

1. Living arrangements: Do you want to live independently for as long as possible, or is the idea of a retirement community appealing to you? If you plan to receive care from family members, it’s wise to think about the proximity of your residences. You might look into building an accessory dwelling unit (ADU) or adding an in-law suite to your home.
2. Facilities and services: If you need a nursing home, where will you go? Develop a list of two or more well-run facilities before you need them. Do the same for assisted living and in-home services.
3. Financial planning: Does it matter if you exhaust all your financial resources before you die, or is it important to leave something to your children? The answer to this question may inform how you plan to pay for long-term care. It can be helpful to consult a financial planner for expert advice on how to afford long-term care.

Dealing With Abuse in Long-Term Care Facilities

Despite optimal planning, elders too often encounter abuse in long-term care facilities like assisted living and nursing homes. If you or an elderly loved one were abused by a caregiver, the experienced Bakersfield elder abuse attorneys of Chain | Cohn | Clark can help you hold the perpetrator and their employer accountable.

Contact us today for a free evaluation of your case.