Americans Underestimate Their Likely Need for Long-Term Care

No wonder we're not prepared.

A recently released poll of Americans aged 50 and over conducted by the Institute for Healthcare Policy and Innovation at the University of Michigan finds that fewer than half (43%) anticipate that they will need long-term care and three out of five (62%) think, mistakenly, that Medicare will pay for their care if they need to move to a nursing home.

Surprisingly, those already receiving Medicare coverage were more likely than younger respondents to believe that Medicare would cover their long-term are needs at 66% as compared to 49%. Similarly, younger respondents were more likely than older ones to anticipate needing long-term care at a rate of 44% of those between the ages of 50 and 64 as compared to 38% of those aged 65 and older.

Those respondents who already had a health problem or disability were more likely to anticipate needing long-term care in the future, at a rate 57%. They were also more likely to be worried about such future need, 58% as compared to 41% for those without a current health challenge or disability being concerned.

Lack of Preparation

Not surprisingly given these numbers, very few of the respondents have taken any steps to prepare for their future needs. Just 27% have executed a durable power of attoney, 24% identified people in their lives to serve as caregivers, 18% made necessary home modifications, 11% bought long-term care insurance, and 7% looked into assisted living or nursing home facilities. But two out of three of those aged 65 and above has taken at least one of these steps as compared to just over one in three of those aged 50 to 64.

Desire to Stay Home

In terms of where they might receive care, just two out of five respondents had a positive impression of assisted living facilities and 13% felt positive about nursing homes with 59% having a negative impression. As a result, almost all (88%) would prefer to stay in their homes if they need care. None said they would want to move to a nursing home if they needed care and just 6% each said they would prefer to move in with a family member or friend or move to an assisted living facility.

The respondents also felt more able to pay for care in their homes than in a nursing home, though the majority said they would expect family members to provide such care.

The Reality

These results are in contrast with the reality that two thirds of us will require some long-term care during our lives with half receiving some paid care, though the paid care is usually relatively short. According to a study of the lifetime risk of needing long-term care services, a quarter of adults aged 65 and above will require more than two years of paid care and 15% will spend more than two years in a nursing home. As we have reported, an analysis by the Center for Retirement Research at Boston College finds that only one out of five older adults will receive no long-term care at all during their lives.

Implications

This huge contrast between the reality of long-term care and the rosy picture in the minds of most older adults goes a long way towards explaining why we’re so unprepared for the coming elder care crisis, both individually and as a society. If most people feel they will not need long-term care and that if they do it will be provided by family members or covered by Medicare, then why worry about it? And, of course, the reality is that most care is in fact provided by family members at often great burden to them.

The only good news from these survey results is that those between the ages of 50 and 64 have a somewhat more realistic view of both their likely need for long-term care and the sources of payment then the older cohort of those aged 65 and above.