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Navigating the Overwhelming Options of Long-Term Care

We are an aging nation. Since 2011, baby boomers have been turning 65 at an average rate of 10,000 per day, a trend that will continue until 2030. And we are living longer. Fortunately, we are also healthier and more active than past generations.

However, according to the Administration on Aging, 70 percent of people turning age 65 can expect to use some form of long-term care during their lives. Thirty-five percent will spend some time in a long-term care facility, such as a nursing home or assisted living community.

What is Long-Term Care?
Long-term care encompasses a wide range of supportive services used by people who need help to function in their daily lives. Long-term care and services are those that help with the Activities of Daily Living (ADLs): managing finances, handling transportation, shopping, doing laundry, preparing meals, household and basic home maintenance, using the telephone and other communication devices, and self-care activities such as getting dressed, toileting, bathing, showering, personal hygiene, grooming, eating, and functional mobility.

The duration and level of care each person requires is as individual as the person needing the support. On average, a person will need three years of long-term care. Women may need services longer than men because they typically live longer. And 20 percent of older adults requiring long-term care services will need care for longer than five years.

Home and Community-Based Services
Most long-term care is not medical care. It includes home and community-based services and supports that provide assistance with daily activities that help older adults and people with disabilities to remain in their home. Home can be their own house, condo, or apartment, assisted living, congregate care, or supportive living. Services such as chore assistance, transportation, meals, adult day services, and personal care are all considered home- and community-based services.

Adult day programs are often a great choice for families who care for loved ones at home, offering enrichment, social engagement, and an opportunity for caregiver respite—an often-overlooked essential for caregiver health.

While a majority of people would prefer to age in place in their own house or apartments, this isn’t always feasible from a safety and/or financial perspective. Caring for someone in their own home can be the most expensive option, especially if 24/7 care is required. Care at home works best if someone needs limited support. But as needs increase, so does cost.

Housing Options
Independent retirement housing, assisted living, skilled nursing, and continuing care retirement communities are all housing options. Assisted living and skilled nursing sometimes include memory care (care for people living with memory loss). Some states, such as Washington state, offer adult family homes as a long-term care housing alternative.

Each housing option has pros and cons. The best fit for a person needing support is determined by a number of factors, including the level of care required, financial situation, personality, preferences, values, the quality of service available, and location (often proximity to family and additional supports).

Genworth Financial offers an annual Cost of Care Survey. In our experience, the survey presents an average of monthly and annual costs for different housing types in metro areas. Costs reflected in the survey are generally lower than what we encounter when assisting our clients in finding the right housing option.

How to Navigate Options
Long-term care options can be overwhelming. Fortunately, there are a number of different resources to help you navigate and make sense of the myriad of choices:

  • Community Living Connections (Seattle & King County) can connect you with the right kind of help, when and where you need it. Adults of any age, adults with disabilities, caregivers, family members, and professionals can call (toll-free) 1-844-348-5464 to get objective, confidential information about community resources and service options. Many services are free of charge. This is a public service funded and coordinated by Aging and Disability Services—the Area Agency on Aging for Seattle & King County. For similar services in other parts of Washington state, click here.
  • Eldercare Locator is a nationwide public service of the U.S. Administration on Aging that offers an efficient way to locate services and resources for older adults anywhere in the country.
  • Aging Life Care Association offers a directory of Aging Life Care professionals (also known as geriatric care managers) who can help streamline your process by assisting in navigating transitions and changes, serving as a local advocate on behalf of an older adult. Care managers can help with care planning and know the local resources best.

Contributor Nicole Amico Kane, MSW, LICSW, CMC, is the care management supervisor at Aging Wisdom, an Aging Life Care practice with offices in Seattle and Bellevue.