Aging and care options – what do you need to know?

The State of California requires that all people working as Long Term Care Ombudsmen have 18 Continuing Education Credits (CEU’s) every year.  Because I am an Ombudsman, I recently attended a program done by our County’s non-profit Visiting Nurse Association & Hospice,  Livingston Memorial, on our growing  senior population and the types of care that will be available for us as we age.  The following is a comprehensive review of this very important topic as presented by Livingston Memorial, condensed for this blog.

AGING IN AMERICA – According to Population Reference Bureau’s Key FINDINGS

• – The number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060.
• – By 2030, Americans ages 65 and older requiring nursing home care will rise by 50 percent.
• – Demand for elder care will also be driven by a steep rise in the number of Americans with Alzheimer’s disease, which could more than double by 2050 to 13.8 million from 5.8 million today.
• – It is projected that 70% of seniors will need some type of long-term care services.

WHAT IS LONG-TERM CARE (LTC)?

– The National Institute on Aging describes long term care as: “Long-term care involves a variety of services to meet a person’s health or personal care needs during a shot or long period. ”

WHO NEEDS LONG-TERM CARE?

Department of Health & Human Services and Urban Institute suggests most Americans turning 65 will need long-term care service at some point in their lives.  Below are some key factors:

• Age – The older you are, the more likely you will need long-term care.
• Gender – Women outlive men by about 5 years on average and are more likely to live alone as they age.
• Disability – 69% of people age 90 or more have a disability.
• Health Status – Chronic conditions such as diabetes and high blood pressure will increase likelihood of needing care.
• Living Arrangements – If you live alone, you are more likely to need paid care.

IN-HOME CARE OPTIONS

HOME HEALTH

• – Homebound patients with a skilled medical need – short term, limited time.
• – Includes Skilled Nursing Care, Physical Therapy, Occupational Therapy, Speech Therapy, Medical Social Work, Registered Dietician Services, Home Health Aide Services, 24/7 Nurse On-Call Service
• – Must be under supervision of a physician, require professional services, have reasonable rehabilitation potential, be homebound needing intermittent care.
• – Can be provided at personal residence, Residential Care Facility (RCFE), Assisted Living Facility (ALF), Skilled Nursing Facility (SNF)

PALLIATIVE CARE

• – Holistic care that focuses on reducing symptoms, pain and stress of a serious illness – short term, limited time frame.
• – Includes Skilled Nursing Care, Physical Therapy, Occupational Therapy, Speech Therapy, Medical Social Work, Registered Dietician Services, Home Health Aide Services
• – Must be under supervision of a physician; require professional services; require care for an advancing, serious illness; be homebound.
• – Can be provided at personal residence, or in a number of facilities such as Residential Care Facilities, Skilled Nursing and Assisted Living facilities.

HOSPICE CARE

• –  A team approach of caring for someone when pursuit of a cure is no longer realistic.  Focuses  on comfort and quality of life, through pain and symptom management – limited time frame.  Patient has life expectancy of 6 months or less, although care can be extended if considered necessary.
• – Includes Hospice Physician, Skilled Nursing Care, Medical Social Work, Hospice Aide Services, Chaplain Services, Medications for Symptom Management, Medical Supplies, Durable Medical Equipment, General In Patient (GIP} at local hospital, Bereavement Services for 13 months.
• – Has been deterioration in patient’s condition; patient’s physician has determined patient has 6 months or fewer to live if the disease follows its normal course; the patient has exhausted all aggressive treatment options.
• – Can be provided in personal residence or a facility. Is NOT 24 hour care unless the Hospice is one of the few facilities where that care is provided.

PRIVATE DUTY CAREGIVING

• -Supportive, non-medical home care for those needing personal assistance and household help.
• – Includes bathing, dressing, transfers, mobility assistance, toileting assistance, medication reminders and range of motion exercises
•  Provided by private agencies; references should be checked

WHO PAYS FOR IN-HOME CARE?

• – HOME HEALTH & PALLIATIVE  CARE – Medicare – 100% covered;  Medi-Cal (California’s Medicaid Program) – 100% after share of cost met; Most Private Insurance – depends on coverage
• – HOSPICE – Medicare – 100% covered; Medi-Cal – 100% covered after share of cost met; Most private insurance depending on coverage
• – PRIVATE DUTY CAREGIVING – Medicare does NOT cover this type of care; Medi-Cal – some hours may be covered through In-Home Supportive Services (IHSS) if patient qualifies; possible coverage through long-term care insurance, Veterans Aid and private pay

RESOURCES: FINDING SERVICES

• Your best option for finding services is to contact your local Area Agency on Aging or Senior Center, or ask your physician.
• – Ventura County CA – Ventura County Area Agency on Aging (VCAAA), Health Insurance and Advocacy Program (HICAP), The Aging and Disability Resource Center (ADRC)
• – Nationwide – Eldercare Locator (https://eldercare.acl.gov) is a public service of the US Administration on Aging connecting you to services for older adults and their families on support services, housing, transportation.

 

You may remember that we posted on this topic back in February 2023 – See our post for additional information –  https://agingwomenblog.com/about-hospice-care/