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Are We Underestimating How Much Help Aging Parents Need At Home?

Senior woman with caregiver at homeLots of people think of the possibility that their aging parents might need a little help. The parents may be struggling, but don’t want anyone coming into their home. They say “I’m fine” when their children suggest a helper. So, they all wait.

No one calculates the actual cost of help until a crisis hits. Like a fall or broken hip. After the hospital and then the rehab facility, it’s back home. Then the adult children are shocked to discover that Medicare does not cover a home care worker to be there to help mom with her bath and meal preparation. Medicare does not cover anything else that is categorized as help with “activities of daily living”. The concern is whether the adult children are going to have to pay for that help out of their own pockets. Many aging parents do not have the income to cover this help.

We just got a reality check in a report from the Congressional Budget Office about how many hours of daily assistance an aging person is likely to need. The report tells us about our aging parents who have trouble functioning independently in their activities of daily living (ADLs), which include bathing, dressing, eating, toileting, walking, and transferring from bed to chair.

People with functional limitations who receive assistance from others primarily rely on informal care to obtain the assistance they need. Generally, this means family caregivers. The number of hours of paid care is highest for people with three or more activities of daily living and who are 85 or older. Many are widowed and thus without a spouse to care for them. People age 85 or older with that degree of impairment typically receive about 11 hours of assistance per day, mostly informal. And for those whose aging parents 85 and up who have limitations with three or more ADLs and who also have cognitive limitations (this includes dementia) receive an average of more than 14 hours a day of informal and paid care.

The cost of an unlicensed home care worker who provides basic care is paid out of pocket for those who are not eligible for public benefits. According to a 2012 MetLife study of the costs of long term care, including home care workers, the average national cost is $20 per hour. If you pay a worker to come to your 85 year old parents’ home to care for them with three functional limitations and dementia, the cost will be an average of $102,200 per year for daily, 14 hours a day help. Since most elders cannot afford this, the writing is on the wall. Family members provide much of the needed help themselves. Will this be you?

Long term care insurance is the only private benefit that covers home help with activities of daily living, the kind of help most elders need. But most people in the U.S. don’t have it. The Congressional Budget Office report cites statistics from America’s Health Insurance Plans, Who Buys Long-Term Care Insurance in 2010-2011 that among the adult U.S. population only about 3 percent had LTC insurance in 2011 .

It is prudent to consider the long term picture even if your aging parents are just fine at the present.  Most of us are going to need some help at some time in the future if we live to be that old.  Aging parents need to see their financial planners to be sure their assets are available to cover these potential costs.  And if they do not have that kind of assets, be prepared for the alternatives.  It may be up to you to pay or provide care on your own.

Excerpted from an article written by Carolyn Rosenblatt, RN and Attorney, published in AgingParents.com (http://www.agingparents.com), July 08, 2013 http://ow.ly/wiIoM

 

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