American Association of Retired Persons. - Planning For Long-Term Care For Dummies

Planning For Long-Term Care For Dummies

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ISBN: 978-1-118-72575-7 (pbk); ISBN 978-1-118-75650-8 (ebk); ISBN 978-1-118-75654-6 (ebk); ISBN 978-1-118-75660-7 (ebk)

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Chapter 1

In This Chapter

Defining long-term care broadly

Seeing the changes and new options

Selecting good advisors

Just by opening this chapter, you have become a member of a select group of people who are taking a big step toward a better future for yourself and your family. Most studies show that only a third of Americans have made even the most basic plans for their future care needs. Perhaps you are already facing this dilemma for an aging or sick parent who lacks a plan for the long term and so you know how important it is to consider the future.

Thinking about the many aspects to consider from finances to health to housing to more is emotionally difficult, but it is also intellectually challenging because the choices available are often not clear-cut. They may involve complex financial calculations as well as personal and family preferences. But ignoring the question only makes the day of reckoning that much more difficult. In this chapter I help you start to think about long-term care in a proactive and positive way.

Long-term care is different for each individual and ideally should be tailored to a person's needs and preferences. I want to reinforce this notion: Long-term care does not start with a place or a payment mechanism or a set of services; it starts with a person.

Many conventional definitions, however, start with a different focus what services are included, who provides them, where they are provided, and, most important, who pays (or won't pay) the bill. These factors are obviously important, but they should not overshadow the person at its center.

In addition to being person-centered, planning should start early at a point when various options for living at home or in a community can be arranged that prolong independence and make it less likely that institutional care will be needed. From that perspective, modifying your home to make it safer and more accessible is part of a long-term care plan. So is considering the possibility of multigenerational living and various forms of group residence in the community. These options are discussed in Part .

The chapters in Part has a chapter on common myths about aging and long-term care and one on using websites with state-by-state information, valuable because so much of long-term care is determined by state, not federal policies. Appendix A is a glossary of terms you may encounter, and Appendix B is a list of resources. Throughout this book I reinforce the idea that a long-term care plan is not just about where you live or what services you get but about how you want to live and how to achieve your goals.

Defining long-term care is, perhaps surprisingly, not straightforward. Many people in the field of aging consider long-term care to be services that are nonmedical, such as personal care (bathing, dressing, feeding) or household tasks (shopping, cooking, transportation). Although these aspects of assistance are essential, in this book I take a broader view to include factors like medical care, housing options, financial considerations, advance care planning, and the community environment. I believe that when considering long-term care, most people should look at the whole spectrum of need rather than only specific segments.

In its 2013 overview of long-term care service providers, the National Center for Health Statistics found that about 58,500 providers served about 8 million people in the United States. These included 4,800 adult day services, 12,200 home health agencies, 3,700 hospices, 15,700 nursing homes, and 22,200 assisted living and other residential care communities. The majority in four of these five sectors were for-profit organizations. Only adult day services were mostly nonprofit. While these numbers may seem large, they do not include the family caregivers who provide unpaid care to the vast majority of older adults who need long-term assistance. The full report is available at http://www.cdc.gov/nchs/data/nsltcp/long_term_care_services_2013.pdf .