Should I Buy Long-Term Care Insurance?

One of the most frequent questions I get from clients is whether to buy long-term care insurance. With the average cost of a private room in care facilities topping $94,000 a year, according to a 2013 study by insurer John Hancock, it’s a reasonable concern. Many of us will need some form of long-term care (LTC), so the question of whether to buy insurance to help with the associated costs is a real one. I think the decision is a very close call. At …

A Different Type of Long-Term Care, Resort-Style

I used to cringe when the staff at Pop Pop’s nursing home called him “Sweetie.” Bernie would have been fine. Mr. Covitch would have been better. Sweetie, to me, wasn’t a name you’d call a man who identified as a military officer, a business owner and a father of three. It was just too cute and too casual. So when I recently visited a long-term care resort in Thailand, I initially was struck by how the owner insisted on calling residents guests. Well, “care …

Improving Quality Measurement and e-Health in Medicaid Home- and Community-Based Services: The TEFT Demonstration

Many Americans with personal care needs receive services in their own homes to help them with daily tasks such as bathing, dressing and meal preparation. But the quality of care provided in private homes often is not measured. The medical community is beginning to adopt electronic health records: health information in a digital format that can be shared with providers. Unfortunately, these records may not be helpful to consumers, especially those with long-term care needs, in managing their own care. …

What’s Different About Family Caregiving Today?

This is a pivotal time. Converging sociodemographic trends and more complex care needs are contributing to historically unprecedented challenges in family care of older people in the U.S. For most of human history, requiring help in old age was uncommon. As Atul Gawande writes in Being Mortal, “The natural course was to die before old age.” Only 41 percent of people born in 1900 survived to age 65. In sharp contrast, an estimated 84 percent of people born in 2010 …

Paying for Home- and Community-Based Services: Lessons From Oregon

Many older adults need services to stay in their homes or in community-based settings. Getting help with shopping, meal preparation, transportation, medication management, bathing, dressing or mobility can extend community living. But Medicare and private health insurance do not pay for these types of services, and Medicaid (which does) is limited to people with low incomes and almost no savings. As a result, most people pay for these services out of their own pockets. The Symposium Even people who can …

Older Adults and People With Disabilities Want Choice and Control

We all like to have choices. Being able to decide where we live and work, what we eat and how we spend our leisure time all enhance life satisfaction. Having a disability doesn’t diminish the desire for choice. But unfortunately, people with disabilities often lose control over how services are provided when they depend on Medicaid for home- and community-based services (HCBS), such as meal preparation or help with bathing and dressing. It doesn’t have to be this way. Participant-directed …