As promised, the Long Term Care Commission has finally made its recommendations. As the members of the baby boomer generation approach retirement age and the number of informal caregivers decreases, this bipartisan commission was charged with coming up with a plan to ensure the availability of long term services and support for people with disabilities and for seniors needing care. According to the commission’s statistics, 70% of seniors over the age of 65 will need some long term care. That’s pretty much most of us.
Although the commission did come up with a list of recommendations, it failed to agree on how to pay for long term care. Among the recommendations was the elimination of the required three day hospital stay that is now needed to make patients eligible for 100 days of skilled nursing care paid for by Medicare. Other recommendations focused on increasing community based care and home care. This included increasing the pay and improving working conditions for paid caregivers who will be in much greater demand as the ranks of informal caregivers decrease. It was also recommended that direct care workers need to have criminal background checks — something that a reputable home care agency does as a part of good business practices anyway.
Despite its recommendations, there was a split along party lines as to how family members would pay for the care. Generally, the Democrats would like to see an expansion of Medicare. With the looming increase in the number of baby boomers, that’s an unsustainable option. In addition, the Republicans tend to see this option as an increase in entitlements. Their solution is the idea of financing long term care through private options such as long term care insurance. This would also include tax advantages for those who purchase long term care insurance policies. That would require an expansion of the long term insurance market which over the last decade has seen a major drop in the number of policy providers.
The bottom line is that for the foreseeable future, nothing much will change. If you are an informal (ie. unpaid) caregiver, don’t hold your breath waiting for relief. The family is and will remain the first line of care as family members struggle with the expenses of caring for their loved ones. The next affordable option for care is the use of a home care agency, followed by assisted living residences and then the most costly, a nursing home. How are you dealing with the financial crisis of providing long term care for a loved one?
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