Do Your Expectations About Long-Term Care Match Reality?

A poll on what Americans anticipate reveals big disconnects

Myths persist about how people will get long-term care and pay for it as they get older, according to a new poll.

Specifically, an annual poll completed this spring by the Associated Press (AP) and the independent NORC research center shows that many of us need help connecting the dots when it comes to long-term care.

One example: 38 percent of poll respondents mistakenly expect to rely “quite a bit” or “completely” on Medicare to pay for long-term supports and services. The reality is that with few exceptions, Medicare does not pay for long-term care. While Medicare is essentially a health insurance program, most long-term care is non-medical, providing help with basic daily activities like walking, dressing and eating, or managing a home by shopping, cooking and cleaning.

More Impact on Family Than Most Realize

The AP-NORC poll included 1,698 people, all of them 40 or older, and was funded by The SCAN Foundation (which is also a funder of Next Avenue).

The results showed a second big disconnect involving family. Just 18 percent of people in the poll expect to rely quite a bit or completely on a family member to provide care at no cost. But 77 percent of respondents want to be cared for in their own home, and only about one-third said they’ve set aside any money to pay for care. Only 20 percent have long-term care insurance to pay for it.

Most people will get their wish and will be cared for at home, according to the U.S. Department of Health and Human Services. And most of them, not just 18 percent, will rely on care from family and friends. About 80 percent of all care at home comes from unpaid caregivers.

That fact pokes a hole in a third belief expressed in the AP-NORC poll: Just 7 percent of respondents expect to rely quite a bit or completely on a family member’s future earnings, savings or investments to pay for their care. But among respondents who have been caregivers for someone else, 40 percent said they’ve had to miss work to do it. And in a 2011 study, MetLife calculated lost income of about $300,000 (wages, retirement account earnings and Social Security benefits) for an average person 50 or older who reduces work hours or leaves the work force early to care for a parent.

Just 18 percent expect to rely on a family member to provide care. But 77 percent want to be cared for at home, and only about a third have set aside any money to pay it.

Will Support Withstand the Cost?

In a story related to the poll, AP reports that 19 states are considering laws that would require companies to give paid leave to family caregivers. Just three states — California, New Jersey and Rhode Island — already have such laws; New York will put one into effect in 2018.

Poll respondents showed strong support for the idea of paid leave and for other ideas to help families meet the costs of long-term care, from tax incentives that would reward personal saving to Social Security credits for caregivers.

It’s easy to say yes to things that don’t have a price tag, however. So one more dot needs to be connected before that show of support can really be meaningful: a public commitment to pay for the help that family caregivers need.

By Denise Logeland
Denise Logeland is a writer and editor in Minneapolis who has covered business, health and health care. She is the author of Next Avenue's ebook, 10 Things Every Family Should Know: Aging With Dignity and Independence.

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