JustCare

Tag: Nursing homes

  • Older and living alone, the rise of elder orphans

    Older and living alone, the rise of elder orphans

    Elder orphans, older adults living alone, should be among the chief concerns of health policy gurus and, for that matter, presidential candidates. They are single, divorced or widowed, and without children, or with children living far away. These older isolated individuals need both personal resources and community resources in order to age in place.

    According to a new report out of North Shore-Long Island Jewish Health System, there are now more than 9 million elder orphans or individuals at risk to become elder orphans—roughly 22 percent of the older adult population. In 2012, there were 43.1 million adults over age 65, representing about 13 percent of the population, according to the federal Administration for Community Living.

    Elder orphans do not have a health care proxy. They may be physically or cognitively impaired. They have no one to care for them, to act on their behalf, if they are sick or hospitalized, if choices need to be made about their current situation and the future. They often have little income and few assets. That puts them at great risk of not having their health care or life wishes honored. They often live in nursing homes, with no one to visit them or provide companionship.

    If elder orphans cannot make decisions for themselves, the state appoint may conservators or guardians to be responsible for the elder orphans’ finances and persons. The elder orphans become wards of the state and lose all rights to make decisions for themselves.

    The number of elder orphans is likely to grow substantially as the population ages. In 2012, about one in three Americans between the ages of 45 and 63 were childless and living alone, which is 50 percent more than in 1980. We need a strategy for helping them as they age; we need to plan ahead for the next likely larger generation of elder orphans.

    By 2030, some estimate that more than 5 million people—of the estimated 70 people over 65, including 9 million over 85–will need to live in a nursing home or alternative care facility because they will not have anyone to care for them at home. It’s not even clear whether there will be enough nursing home beds for these elder orphans, if they wanted to enter a nursing home. Today, there are 15,700 nursing homes with 1.7 million beds and 1.4 million residents, according to the CDC.

  • Four things to think about before moving into a nursing home

    Four things to think about before moving into a nursing home

    Before moving into a nursing home, it’s important to do your homework and understand your rights and options.

    1. Care: You have the right to receive whatever care you need to reach the highest reasonable level of functioning or so that your condition does not deteriorate.  Medicaid patients have exactly the same rights to these services as everyone else in the nursing home so long as the nursing home accepts Medicaid patients. And all patients and their families have the right to help develop the care plan so that it is tailored to the resident’s needs
    2. Choice: The nursing home must accommodate the resident’s preferences, whether they be to wake up late in the morning, to participate in an activity, to change schedules or to have family visit any time of the day or night.
    3. Costs: Only the resident is required to be financially responsible for his or her care.  The nursing home cannot force a family member to take responsibility.  Medicare should pick up the costs for residents needing daily skilled nursing or therapy care who have been hospitalized for three days in the 30 days prior to admission, so long as the nursing home is Medicare-certified.  If the nursing home says Medicare won’t pay, you still should insist that it submit the bill to Medicare.
    4. Help: Every state has a long-term care ombudsman program to help ensure the nursing home provides you with the benefits and protections to which you are entitled free of charge. There are also websites where you can find nursing home ratings, but read them with caution.
    For more information from the National Senior Citizens Law Center, click here.
  • Individual saving and spending for long-term care services and supports

    Individual saving and spending for long-term care services and supports

    Fact: Americans pay a lot of money out of pocket for long-term care services and supports. Costs comprise 15% of overall spending in 2011. 

    Fact: In 2013, a private room in a nursing home cost about $84,000. The cost of care in an assisted living facility was $42,000. Home health aides, homemakers and companion services generally charge about $20 an hour. Home care costs can easily total $22,000 a year. Adult day care centers cost about $65 a day.

    Fact: Only 35% of Americans say that they have set aside any money to meet long-term care needs.  Many people will rely on family members for their care because nursing home and home care are so expensive. In fact, 87% of long-term caregivers are unpaid family members. 

    Click here to learn about who pays for long-term-care services and how they are delivered from the Robert Wood Johnson Foundation.  Click here for a brief look at long-term care for older adults from the Kaiser Family Foundation.