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Stay independent with a little help

Created date

April 6th, 2016

Studies show that today’s seniors fear losing their independence and moving into a nursing home more than they fear death. These fears are justified, as 35% of people 65-plus will eventually enter a nursing home, according to the Urban Institute.

Some seniors have numerous complex medical problems and functional disabilities that necessitate the level of care provided at long-term care (LTC) facilities like nursing homes. But some residents of nursing homes or assisted living facilities are there because they lack caregivers or sufficient support to stay at home. According to the Centers for Disease Control and Prevention (CDC), 63% of people over age 65 are in need of some sort of long-term care services. 

Currently, the CDC reports that over eight million people receive LTC services from one of the five main types of providers: home health agencies (4,742,500), nursing homes (1,383,700), hospices (1,244,500), residential care communities (713,000), and adult day care services (273,200). 

Long-term care services

Long-term care is considered the spectrum of services and support you need to take care of personal care needs. Long-term care can include medical care, but most of the support is in the form of assistance with basic activities of daily living (ADLs) such as bathing, eating, dressing, feeding, using the toilet, and moving about your home. Long-term care services also include what are called instrumental ADLs such as preparing meals, housework, laundry, paying bills, pet care, using the telephone (or other communication devices like computers), taking medication, and calling for emergency services.

Even if there are medical services involved, long-term care differs from other types of health care. “The goal of long-term care is not to treat or cure a medical condition, but rather to help people maximize their functioning and be as independent as possible,” says Brian Tremaine, M.D., medical director at Eagle’s Trace, an Erickson Living community in Houston, Tex. 

To avoid entering a nursing home, many seniors need a significant amount of assistance at home. Medicare and most private insurance plans will pay for LTC services only in certain instances. For example, certified home health services will provide a home health aide on a short-term and/or intermittent basis for people with certain medical needs who are also receiving skilled services from a nurse or therapist. Skilled services can include care of an intravenous line, wound care, post-surgical care, diabetes care and teaching, or any other service that is considered medically necessary. Once skilled services are no longer needed or when certain skills can be performed safely by a caregiver, the home health aide is no longer covered. Long-term care insurance, however, covers significantly more.  

Options for at-home assistance

“Long-term supportive care services fill in the gaps that are not covered by Medicare or private insurance,” says Greg Lomax, director of sales development for Erickson Living Health Services. “These services also assist caregivers with patient-care tasks that may be difficult or too time-consuming to perform.”

The Family Caregiver Alliance reports that, on average, caregivers spend 13 days a month  (104 hours) on shopping, food preparation, housekeeping, laundry, transportation, and administering medication. A total of six days a month (48 hours) is spent on feeding, dressing, bathing, grooming, and toileting. 

Private-pay support services are available for individuals who need help that is not covered by Medicare or insurance. The out-of-pocket costs may be worth it, as the costs of nursing homes continue to climb. According to Genworth Financial, nursing home costs have risen by 4.5% to a yearly median of about $84,000. 

Full-time home health aides can be costly, but most people only need intermittent assistance. “Long-term care insurance will cover most of the costs of home support,” Lomax says.

Prolong your independence

“People need to get support services in place before they become too worn out to care for themselves,” Tremaine says. “I have seen patients become visibly unkempt and withdraw from their social activities, but this process can happen so gradually that they are not aware of it.”

Getting assistance early can help prevent such a decline. Companies that provide support services may have different policies and staff availability. “You need to find a company that can provide the services you need when you need them,” Lomax says. “Erickson Living’s support services can provide a home care aide within 24 hours in most instances.” 

You can’t predict the future, so you want to find a home care provider that offers comprehensive services and will be flexible with your preferred schedule. You should be able to choose as much or as little aid as you want.  

“It can be exhausting for people with functional deficits and their caregivers to perform the many tasks necessary to maintain independence,” Tremaine says. “A little support can go a long way to help them stay independent in their homes.”