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What We All Need To Know About Health And Long-Term Care

As consumers, the first thing we should know and understand about health care and long-term care is that these two complex issues are constantly changing.

The latest update in health care is the landmark passage of the Patient Protection and Affordable Care Act by the United States Congress and signed by President Obama, which brings important and positive change to consumers.

As with all big changes in life, the road to health care reform will be bumpy, but overall will be positive. Big changes are also coming to long-term care; however, the path forward is less clear because of vast canyons between wants and needs; care and capacity; and access and efficacy.

Rightfully so, most people prefer to age in place in our homes. Yet according to research by AARP, while 89 percent of baby boomers polled would like to age in place, less than 18 percent of us have adequate financial resources to meet our long-term care needs. And while most of us want to age in place at home, studies show that 65 percent of people age 65 and over still will need some type of formalized long-term care in their lifetime.

Many consumers falsely assume that Medicare provides for formal and informal extended, custodial long-term care. It does not. Compounding this dilemma is the fact that most people have not saved adequately for their own long-term care.  As a result, many families find themselves paying privately for either community or formal center-based custodial care until their loved one’s savings are depleted and they then become eligible for Medicaid Medical Assistance.

Medicaid Medical Assistance is a partnership between states and the federal government in which state tax dollars matched by federal dollars are used to underwrite the health and long-term care needs of people with low incomes. Medicaid Medical Assistance has become the default payer for center-based, long-term custodial care.  In Maryland:

With most consumers lacking adequate resources to personally pay for long-term care and our baby boomers quickly maturing, combined with our growing reliance on Medicaid to pay for long-term care, our nation faces a long-term care financing crisis.

Each year, more than 30,000 of Maryland’s most vulnerable long-term care residents receive care in one of the state’s nearly 250 nursing and rehabilitative centers.  More than 32,000 Marylanders work in those long-term care facilities – nearly two percent of our state’s total employment – helping generate a direct economic impact of nearly $3.7 billion.

Going forward, action is needed to establish center-based care for long and short stays; to create a public/private partnership to rebuild the aging physical plant of our facilities; and to build a stronger, more integrated continuum of care that includes increased community-based services.

The challenge remains – How will we accomplish these tasks while ensuring that sufficient resources are available for the quality care of people currently residing in facilities, while preparing for the growing number of people who will need care in the future? Working together, we must – not should – meet this challenge.

We also must educate consumers on the important steps they can take now to prepare for their future.   Here are some steps consumers can take:

If statistics hold true, most of us will want to age in place at home.  With this in mind, start looking into the things you can do now to stay at home and remain independent as long as possible:

These are just a few things you can do to help age in place at home.  If these steps seem overwhelming, research and seek the services of a Certified Aging-in-Place Specialist (CAPS).  The designation was developed by the National Association of Home Builders (NAHB) Remodelors™ Council.

Finally, to help you prepare and to thrive as you age in place, familiarize yourself with public/private services and assistance available in your community.  A good place to start to help gather this information is your local office on aging.

As you identify assistance available, be sure to explore respite services for your caregivers.   As we age, many of us will care for spouses and partners or have family members and friends help provide care for us.   Respite for caregivers is critical for the health and well-being of all.

Since statistics show that a majority of us will still need formal long-term care, prepare for that transition by having a plan that will help you continue to thrive in a facility such as an assisted living center, a continuing care retirement community, or a skilled nursing and rehab center.

When shopping for a more formal setting, look for a center:

Thankfully here in Maryland, we have hundreds of formal care setting options with the most well-trained and passionate workforces in the country.  Research those centers now – before you need them. Be confident that the center you chose will allow you not only to survive, but to thrive!

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