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Survey: Better understanding of long-term care needed

by Carolyn Pennington - November 26, 2007

The results are in from the state’s first long-term care needs assessment in more than 20 years and they reveal that residents have a lack of understanding about long-term care issues.

“People aren’t planning for their future needs,” says Julie Robison, a leader of the Health Center’s research team which conducted the study.

“They aren’t planning because they don’t understand what long-term care is, who needs it, how much it costs, who pays for it, or what choices are available to them.”

The Connecticut Long-Term Care Needs Assessment was authorized by the 2006 General Assembly.

Its purpose is to help the state respond to the looming demand for long-term care services based on demographic trends and in the face of soaring Medicaid expenditures.

Robison and her team presented their findings during a National Association of Social Workers conference Nov. 9 in Cromwell.

Long-term care encompasses the array of services and supports needed for extended periods by people of all ages who need help due to a disability or chronic illness.

Most of the 6,000 plus residents who responded to the statewide survey believe they will need long-term care someday, but few say they can afford it and though their life savings could quickly be drained, few are planning ahead.

“People of all ages have very little, if anything, set aside to pay for long-term care, even though the cost of the average 30-month nursing home care stay – just one part of the equation – is $272,000,” says Robison.

“Part of the problem is that many people erroneously believe long-term care refers exclusively to nursing home care, particularly for older adults.”

The federal Medicare program provides health care coverage for people 65 years of age and older. It does not cover most long-term care services, including nursing home costs.

“The fact is that although almost all of us will require some form of long-term care during our lives, many people believe that they won’t need it, or that Medicare or traditional private health insurance will pay if they do,” says Robison.

“That’s not the case, and as the demand for long-term care increases, the public’s lack of understanding reinforces the imminent need for a major educational program along with systemic changes.”

Medicaid, the jointly funded state-federal program, is the primary payer of long-term care services in the United States.

It covers people who are poor or have disabilities, and those who have “spent down” their assets due to the high costs of long-term care and in doing so have become nearly impoverished.

Nationally, 10 to 15 million Americans currently need long-term care services and support. Government estimates suggest the number could nearly double to 27 million by 2050.

Health Center researchers say the same pattern holds true for Connecticut. More than 188,000 state residents 40 years of age and older currently require long-term care, and the number is expected to jump nearly 30 percent, to 240,238, by 2030.

Robison says Connecticut’s Medicaid program already spends more than $2.2 billion a year on long-term care services.

Sixty-eight percent of the Medicaid budget is spent on institutional care, with the remainder funding home and community-based care. Robison emphasizes, however, that Medicaid “does not support the vast majority of people in their homes.”

That could be a rude awakening for the almost 80 percent of Connecticut residents who responded to the survey and expressed a strong desire to remain in their own homes and communities when they require long-term care, using home health or homemaker services.

“Taken in total, these findings strongly reinforce the fact that we need to rebalance the long-term care system to give older adults and people with disabilities greater independence and choice, while using state and federal funds more efficiently,” says Julia Evans Starr, executive director of the Connecticut Commission on Aging.

“We’re convinced both goals can be achieved by finding ways to provide thousands more people with home and community-based care sooner rather than later.”

“The good news is there’s a growing awareness in Connecticut that the system must be rebalanced,” says Evans Starr.

“The challenge is that there’s a very long way to go and not much time to get there, based on the imminent need driven by the demographics.”

The full Long-Term Care Needs Assessment survey and executive summary may be accessed on the Connecticut Commission on Aging website.

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