Rising Need for Long-Term Care Increasing Dependency on Family

One of the largest Long-Term Care Insurance companies released a study showing a growing need for long-term health care, but care is becoming more complex, acute, and not everyone can stay in their home.

Genworth has conducted the study approximately every three years since 2010 as part of its mission to help families prepare for the challenges of aging.

While some observers might think the consequences of COVID-19 would alter some of the findings, the study shows that the factors driving a rising need for long-term health care were essentially the same as in years past - Genworth's Caregiving in COVID-19 Beyond Dollars Study 2021.

"While the experience of caregiving can be rewarding, the physical, financial, emotional, and psychological strain of caring for a loved one is deep and real for caregivers and their family and friends," said Brian Haendiges, President and CEO, Genworth U.S. Life Insurance.

Longevity and Advances in Medical Science Lead to Higher LTC Risk

Increasing longevity still remains the top driver for the need for long-term health care. Medical science allows us to live a longer life; however, longevity increases the need for help with daily activities or supervision due to cognitive decline.

People require long-term health care due to an illness, accident, or the impact of aging. The Genworth study shows the top causes for care. Age-related physical impairments and memory problems are the top reasons people require care.

Demographics shows we live in an aging society. As we get older and medical science continues to improve, the likelihood of health and aging conditions that require a person to need long-term health care―and the length of time that people live with such conditions―increase as well.

With more people needing long-term health care, their families, usually unprepared, go into crisis mode trying to find ways to take of their loved ones, pay for quality care, or provide care themselves. 

Family caregivers are generally untrained and unprepared, and the responsibility of being a caregiver is demanding physically and emotionally. As you would expect, care recipients want to stay in their homes as long as possible, and families attempt to adapt to those needs.

Care is More Complex

Long-term health care is help with activities of daily living or supervision due to cognitive decline - Activities of Daily Living (ADL's) | LTC News. The study's findings show that almost half of the care recipients require help in "all aspects of daily living," and only 8% need "minor assistance," up and down from 39% and 12% respectively in 2018.

Compared to the 2018 study, the most significant jump was in cognitive impairments (32%, up from 26%). More people suffered from age-related physical limitations (47%, up from 44%) and accidents requiring rehabilitation (23%, up from 21%).

Care Needs are More Acute

Care recipients are living longer in a care situation. According to this study, the average duration of a care situation went from 3.5 years in 2018 to 3.5 years in 2021.

Give Me In-Home Care

Not surprisingly, a high majority of individuals want to stay in their homes.

In this study, 79% of care recipients favored home health care services instead of a long-term care facility. The desire for in-home requires money or family or both. Family caregivers were responsible for care services in 42% of situations, 26% used professional care service providers. 

The number of care recipients that moved into their adult children's homes decreased, from 21% in 2018 to 12% in 2021, perhaps due to COVID-19 concerns.

Family members found it easier to find professional caregivers to provide some of the care in 2021 compared to 2018. The growing need for care has blossomed into a growing number of in-home care agencies

Over half (54%) said it was easy to find providers, compared to 36% in 2018. LTC NEWS provides this guide to help families with a loved one who requires long-term health care - Finding Quality In-Home Care | LTC News

All About Family

Family members are finding themselves thrust into the role of caregiver, forcing loved ones to balance their career and family responsibilities with that of a caregiver.

The study showed that family members needed to balance an average of 19 hours a week of caregiving with other responsibilities. Being a caregiver is emotionally draining and physically demanding, and the hardships placed on family members are numerous.

Careers Negatively Affected

The study showed that the role of caregiver adversely affected their job. The impact of the caregiver's job seemed to affect women more than men as 56% of the women, compared to 45% of the men, said that providing care "negatively affected" their ability to satisfy the requirements of employment. 

The impact on their job also negatively affected their income. Still, income loss affected men more than women as 40% of the men and 27% of the women thought they had lost a majority or more of their annual income because of their role as a caregiver.

On the bright side, the employer's flexibility of work location reduced some of the caregiver's strain. Since many employers allowed their employees to 'work at home,' fewer caregivers had to take 'days off' compared to the 2018 research. 

The 2018 study shows that 46% of caregivers said they had to work fewer hours, and 35% cited "repeated absences" because of their caregiving duties. Those figures were lower in 2021, dropping to 38% and 27% respectively in 2021. As more employers return to typical work environments, the total number of work hours missed, and absences, should return to 2018 numbers. 

Caregiving Face Financial Burdens

In addition to lost wages, family caregivers are facing added financial burdens. The study showed higher percentages of caregivers used savings/retirement funds and cut back on luxury expenditures to help pay for care to supplement the care they were providing themselves.  

The caregivers also were more likely to report reducing their contributions to savings/retirement funds, spent money targeted for inheritance, sold personal possessions, cashed out life insurance, and borrowed money from friends and family.

Caregiving Role Adversely Affects Health

It is widely known that stress, anxiety, depression, and other health problems become common for caregivers as they pay more attention to their caregiving role and ignore their own needs. 

Women seem to be more affected than men, with 59% reporting that their caregiving role had negatively affected their own health, compared to 43% of men. 

Stress was reported by 48% of the family caregivers, and 46% said they spent less time on themselves and other people. Being in a negative mood was reported by 42% of family caregivers.

Other health problems included:

• sleep deprivation
• insomnia
• sense of isolation
• guilt
• weight gain

Planning Makes Life Easier 

The first time many people think about long-term care is when a crisis happens. It is hard for some people to realize the consequences of aging - either their own or their parents - or both. Once the need for care is evident, families must start making quick decisions. 

The study showed that 23% used Long-Term Care Insurance to provide some of the funding for the care services. For individuals who utilized Long-Term Care Insurance benefits, 61% reported $500 or less out-of-pocket costs. The study showed they were more likely to use more costly assisted living facilities, perhaps because they delayed using their policy, waiting for the need for care to become greater.

Most Long-Term Care Insurance plans are comprehensive and include coverage for in-home care services, adult day care centers, assisted living facilities, memory care facilities, and traditional nursing homes. 

Long-Term Care Insurance does offer flexibility on how care is delivered. LTC Insurance policyholders were much more likely than non-policyholder (25% to 11%) to receive care in an assisted living facility, where care is delivered in a less institutional environment.

People with little or no assets will generally go from family members providing the care to a nursing home using Medicaid benefits. Medicaid requires an individual to have little or no income and assets to qualify. 

Those who owned LTC Insurance, and their families, experience less stress as well. Long-Term Care Insurance offers greater peace of mind as the entire family knows that the care recipient will enjoy quality care options without draining assets or burdening family members.

COVID-19 Made More People Open to LTC Planning

Genworth's COVID-19 Consumer Sentiment survey showed that people are paying more attention to the future costs and burdens of aging. A majority of people (80%) reported taking some action to be better prepared. 

It was hard to ignore long-term care during the COVID-19 virus crisis as people saw news reports about how both in-home care needs and facility care increased and changed due to the virus. 

Some people were unaware of the number of people who needed long-term health care services in addition to additional people who needed care as a consequence of their COVID-19 infection.

LTC Costs Rising

Being prepared is vital to retirement planning as long-term health care costs continue to rise rapidly due to increasing demand for services and higher labor costs. The costs vary depending on where the care recipient lives and the types of services that are required.

The LTC NEWS Cost of Care Calculator shows the current and future cost of care services by metro in each state and the District of Columbia. 

The national average cost of in-home care services is $4,937 a month (based on a 44-hour week). However, in 25 years, the average home care cost is expected to be $9,967 a month.

Compare the national average to Des Moines, Iowa, where the average cost of in-home care today is $5,486 and in 25 years $11,076 a month - higher than the national average. However, in Jackson, Mississippi, the average cost of in-home health care is $3,730 a month today and $7,530 in 25 years - lower than the national average and in Des Moines. 

The calculator will also show you the cost of nursing homes, assisted living facilities, and adult day care centers. There is also state-specific information about long-term care, solutions, care options, regulations, and more. 

Plan Before Retirement and Avoid Denial

Planning is best when you are younger and healthier as you have more available and affordable options. Long-Term Care Insurance is medically underwritten, so you must enjoy fairly good health to obtain coverage. 

Despite the growing need for long-term health care as we get older due to aging, accidents, or substantial health problems, many people think they 'don't need' Long-Term Care Insurance.

The individual's family and finances will often feel this 'denial' of the realities of aging at some point. Other people think Long-Term Care Insurance is expensive and even have had financial advisors or insurance agents tell them to forget it because of the cost. Yet, Long-Term Care Insurance is affordable and custom-designed. Plus, available tax benefits and partnership plans also add tremendous value.

Most people who purchase Long-Term Care Insurance are in their 50s when their health still allows for multiple policy choices, and premiums are still very affordable. 

Seek help from a qualified Long-Term Care Insurance specialist who works with multiple top companies to help you find the best coverage at the best value. The specialist will match your age, health, family history, and other factors to recommend the appropriate coverage. 

Long-Term Care Insurance premiums vary over 100% between insurance companies, so be sure the specialist reviews all available options - Work With a Specialist | LTC News.

Being prepared for changing health and the consequences of aging will benefit you and your family in many ways. You will have access to your choice of quality care options - including in-home care. You will safeguard income and assets and maintain your lifestyle and legacy. But often, for many people, the primary concern - giving their loved ones the time to be family instead of caregivers. The burdens are great - planning makes it easier for everyone.