Are We Ready for Care? Long Term Care?

March 7, 2018

In 2010, 13% of the U.S. population had reached the age of 65. According to 2016 statistics that number has increased to 46 million. Now many of us are over 65 (myself included) and there are times that I resent the implication that I’m part of the growing older population and thus, need help. Although my independence is intact, I worry what the world (my world) will look like when I do need help. There are currently over 6.3 million over the age of 85 with an increase to 7.4 million in the next 7 years.

For those of us in the midst of aging, what can we do to get ready? “ Regardless of race and ethnicity, most elders will require some level of long-term services and supports (LTSS), whether in their own homes and performed by family caregivers or homecare aides, in assisted living communities, or in skilled nursing facilities” (CBO, 2013). More than two-thirds of individuals over 65 will require some form of long term care in their lifetimes. Few people believe this. In fact, only 20% believe they will ever need help as they age.

What do you think of when someone says, “long term care”? A skilled nursing facility (nursing home), an assisted living facility (board & care home), home care services, care management or insurance (long term care insurance)? In fact, it’s all of the above, as well as any help that we receive from others to allow us to remain as independent as possible. Understanding the language and terminology can help us learn how to go about this business of aging.

Advocates and researchers have been alerting the public for some time about the aging of the population and the lack of trained professionals who understand and want to work with older people. “This is particularly true when it comes to long-term settings, such as nursing homes, in which annual turnover rates average above 60 percent annually. “(Generations, Spring 2016). This same article, “America’s Eldercare Workforce: Who Will Be There to Care?” further states that less than 4% of social workers have been trained to work with elders, yet three-quarters of them report that they regularly work with this population. This trend is across all disciplines, including medicine. Physicians specializing as geriatricians are not in abundance, with only 7,356 board-certified geriatricians in 2012. (American Geriatric Society, 2012). Pharmacy schools, schools of nursing and direct care workers are in demand to meet the needs of elders and continues to be a challenge.

For the client/family consumer it can be a confusing challenge to understand what’s out there, who is qualified, how much it costs, whether it’s applicable and how to get started. Knowing ahead to time where to look and who to trust is a crucial piece of long term care services. Since statistics report that over 90% of all elders want to remain in their homes, let’s look at direct care workers—also known as personal care workers, home health aides and in-home providers. These are the individuals that allow individuals to remain in a home-like setting by assisting with everyday tasks that the individuals can no longer accomplish by themselves.

“Of the entire U.S. healthcare workforce, 27 percent are employed as direct care workers “(PHI,2015). “By 2022, this workforce will be approximately 5 million – employing more workers than K-12 teachers, fast-food workers, registered nurses, police, and firefighters.” (Generations, Spring 2016). Where will they come from? Who will train them? Who will pay them? Seventy percent are paid from public funds (federal & state programs) such as Medicaid/Medi-Cal and In-Home Supportive Services (IHSS). The balance is paid by long-term care insurance benefits and you, the consumer.

With the numbers of elders living longer and steadily increasing, finding trained, experienced people can be a challenge in a various fields. That doesn’t mean that you, the consumer, should settle for less. Looking into elder resources, understand what level of care you’re looking for and who you want to provide that care. How important is training, supervision, education and expertise? Making these decisions ahead of time will allow you to develop trust for a new physician, a different nurse, the pharmacy you use, social worker, care manager and others will allow you to enter into your elder years with trusted advisors at your side.

Consider what you want of any or all of your providers:

  1. Understand what it means to the body, soul and mind as I age.
  2. Take time to talk with me to understand why I’ve sought you out.
  3. Be respectful to me. If you don’t have the answer, just say so.
  4. Ask me how you can help and listen to the answers.
  5. Allow me to make my decisions based on my capacity to do so.

Carol S. Heape, MSW, CMC is Founder/CEO of Elder Options. Ms. Heape helped to found the Older Adults Task Force (OATF) in El Dorado County, began the first Alzheimer’s Support Group in the country, served on the El Dorado Community Foundation Board for a number of years, Community Thanksgiving dinner, 4-H/FFA Junior Livestock Auction committee and helped establish the Sierra Renaissance Society, a life-long learning collaboration.

Serving the Sacramento Region with care managed home care since 1988.