Long-Term Care from A to Z – Part 2
In our prior post we learned that Long-Term Care (LTC) is custodial care that may be needed due to physical issues. Today we will expand the scope a bit, because in addition to physical needs, LTC may also be required due to cognitive impairment, such as Alzheimer’s disease or other forms of dementia. Some studies have shown that nearly 15 percent of people age 71 and older have dementia. Every 68 seconds another American is diagnosed with Alzheimer’s disease.
Although dementia has been the subject of much study, there is no cure at present. Currently, we are seeing the incidence of Alzheimer’s disease double every five years over age 65. The duration of suffering can last from a low of four to eight years following diagnosis, to as long as 20 years or more. Cancer and heart disease kill more people, but Alzheimer’s disease is the most expensive. Because the patient will likely require constant care ranging from simple companionship to active management at home, and once institutionalized, confinement in a locked facility, the cost of care will almost certainly reach astronomical.
Anyone who has cared for an Alzheimer’s patient will tell you: “Until you have lived it, you have no idea how it will change your life and that of your family.” The impact of the disease goes way beyond the patient. It starts at the first circle – typically the spouse, who will try to deal with the gradually declining patient. The stress, sleepless nights and worry will take a serious toll on the health of the caregiver. The emotional drain and physical strain often will cause caregiver’s own personal health care costs to soar.
The next circle is the rest of the family; the children and siblings. They will try to help. But their own families, jobs, and other obligations may create guilt, anxiety, stress and/or resentment.
The outer circle are the other unpaid and paid caregivers; friends, neighbors and agency personnel.
Through it all, the patient is increasingly oblivious to the chaos created in his or her wake.
The burden on unpaid caregivers (primarily family members), although not as easily quantified, was nearly $210 billion in 2011. The major part of the expense is not the cost of drugs or other medical treatments, but rather the care needed just to help Alzheimer’s sufferers get through daily life. The Alzheimer’s Association projects the cost of care (including health care, long-term care and hospice) will reach $1.1 trillion by 2050. This is NOT a subject to be taken lightly, or worse, ignored…until it is simply too late.
LTC scenarios may range from care for a few hours per day (usually at home) to care 24/7 either at home or a nursing home or assisted living facility. Unless a spouse or adult child can be the primary caregiver (typically it’s the oldest daughter) paid caregivers will be needed.
The gradual yet relentless nature of Alzheimer’s disease and other forms of dementia makes it very important to be proactive at the earliest signs of the condition, and develop a plan for care. Get information from the Alzheimer’s Association, have a family meeting and determine who can do what. It’s a family affair (apologies to Sly and the Family Stone). Without thought and serious planning, the family faces the very real likelihood of catastrophic financial and emotional trauma. The patient and the family will need, and deserve, planning.
Next, we will discuss the subject of what it takes to be a caregiver.