Posts Tagged "dementia"

seniors in a retirement home

Medicaid to Help Fill Gap in Seniors’ Care

Two previous studies on long-term care reported in this blog estimated how many of today’s 65-year-olds today will require care for minimal, moderate, or severe levels of need as they age and how many have the financial resources to cover each level of care that might be required.

In the third and final study in this series, the Center for Retirement Research matched the specific levels of need each retiree is projected to have in the future with their resources to determine how many of them will fall short.

Among all retirees, 22 percent are expected to have minimal needs for care and 9 percent will lack the family and financial resources to cover it – in other words, just under half of the people in this group will fall short. The shortfall among people with moderate needs will be larger: the comparable figures are 38 percent of all retirees will be at this level and 21 percent of retirees will fall short. Finally, 24 percent of retirees are expected to have severe care needs – for at least five years – and 16 percent will fall short.

But there is another critical source of support: Medicaid. The researchers find that the joint federal-state program dramatically reduces the share of retirees with insufficient resources to cover their care.

Not everyone qualifies for Medicaid, however. Older Americans can get the funding if they meet two conditions. First, they must have a serious health issue, such as dementia or a physical or medical condition that limits their activity. Second, the program covers nursing homes only for retirees with little in the way of financial resources, either because they had lower-paying jobs and didn’t save or because they exhausted most of the retirement savings they had scraped together.

Medicaid and LTSS graphWhen Medicaid is added to the picture, the program makes a significant dent. Among the 65-year-olds who will need moderate care, the share of all retirees who lack the resources to cover it drops from 21 percent to 14 percent when Medicaid funding is included. Medicaid also reduces the burden on boomers who will need high levels of care: the share lacking adequate resources drops from 16 percent to 11 percent.

The researchers didn’t include Medicaid in the resources available to the 9 percent of retirees who will need only minimal help with chores like cleaning or grocery shopping. The program typically doesn’t pay for these services, though there has been movement in a handful of states and at the federal level to loosen the restrictions around housekeeping. …Learn More

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How to Pick (or Be) a Retiree’s Financial Ally

If you need help managing your finances in old age, it’s a lot of work to find someone – and not a very pleasant task to think about.

But it’s crucial that retirees plan for this. As to when or whether you might need help, it really depends on your individual circumstance.

Attorney and researcher Naomi Karp cites a variety of studies that provide some clues to the different ways this process can play out. People who develop dementia obviously need what she calls a financial advocate. This might be a trusted friend, family member, lawyer or professional financial adviser.

But roughly a third of aging Americans who are experiencing natural cognitive decline are prone to making poor decisions about their money, she explained during a recent webinar sponsored by the federal Consumer Financial Protection Bureau (CFPB) where she used to work.

Financial acumen actually peaks well before retirement – at 53! – but wisdom makes up for some of that, she said. During one’s 70s and 80s, financial literacy declines, but unfortunately confidence about one’s abilities remains high. “That’s a risky situation,” Karp said.

She and other financial experts have put together an interactive website the Thinking Ahead Roadmapwith six steps to follow to find an advocate. Each step has tips, tools, and information to guide you through the process. An adult child or caregiver could also use this website if they feel the need to assume more responsibility for an elderly parent’s finances. …Learn More

Boomers Will Struggle with Care in Old Age

Granddaughter and grandmotherThe bulk of care for the nation’s elderly is informally provided by spouses, adult children, and other family members. But if family can’t fill the need, will retirees be able to hire an in-home caregiver or pay for a nursing home in the future?

Just one in five 65-year-olds has enough family and financial resources combined to provide the support they would require in the event they develop the most severe care needs as they age, according to new research by the Center for Retirement Research. At the other extreme, more than one in three will have insufficient resources to cover even a minimal amount of care.

The study builds on previous report showing that most retirees will eventually need some care, though only one in four is predicted to have severe needs. And one in five will not need any care. The new study used data from a national survey of older Americans to determine how many total hours of care are required for three different levels of need – minimal, moderate and severe.

For example, 924 hours of family or professional care per year are used by the typical person who gets minimal assistance, such as housekeeping or cooking for a few weeks or months. But people with severe needs receive nearly 2,300 hours of care per year – with half supplied by family members. This would add up to more than 11,000 hours over a five-year period, which is the length of time the researchers used to define severe care needs.

Next, the researchers calculated how many hours of care could be covered informally by family and how many hours of formal care the retirees could purchase with their income and any financial assets. If the total hours of care they can cover with their resources fall short of what is required for a given level of need, then retirees have insufficient resources to meet that need.

Unmarried women are in the toughest position, because they lack not only a spouse to take care of them in old age but also the financial advantages enjoyed by married couples, who tend to be wealthier than single people. Over half of unmarried women will not be able to cover even minimal care needs. In contrast, only a third of couples could not provide for any future care.

There are also big disparities by race: nearly half of older Black Americans and two-thirds of Hispanics do not have the family and financial resources to provide at least minimal care, compared with only a third of whites. …Learn More

Retirees Can’t Afford Hearing, Dental Care

Hearing loss can amplify cognitive decline by isolating retirees and forcing them to divert precious brain power to participate in a conversation. People who lose teeth have trouble eating, sacrificing their health. And poor vision, uncorrected by cataract surgery or the proper magnification in eyeglasses, is dangerous when driving at night.

These problems are facts of aging. But Medicare doesn’t cover their often-expensive solutions such as hearing aids, dental implants, or eyeglasses. A report by the Kaiser Family Foundation identified a gap between need and access is wide.

Among the 16 percent of Americans over 65 who said in a survey that they couldn’t get hearing, dental or vision services, nearly three out of four couldn’t afford them.

Three charts, based on Kaiser’s analysis of the survey data, show the average out-of-pocket spending for hearing and dental care was around $900 for the Medicare beneficiaries who used the services in 2018. The cost of vision care was significantly less, averaging $230.

Retirees usually don’t need all three services in a single year. For example, dental implants cost thousands of dollars, and an individual might get one or two in a lifetime. But when retirees do get the expensive dental care, a new Kaiser report shows the bill can really pack a wallop – and become an obstacle to getting the necessary care. …Learn More

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Retirees’ Need for Caregivers Varies Widely

Nothing causes dread in a retiree quite like the prospect of having to go into a nursing home someday or becoming dependent on someone who comes into the house to help with routine daily needs.

But media reports or studies with alarming predictions of infirmity in old age are not very useful to retirees or their family members. A new study provides a more nuanced picture of the various scenarios that can play out.

home care tableResearchers at the Center for Retirement Research estimated that roughly one in five 65-year-olds will die without using any care, and another one in five will need only minimal care.

But one in four will have such severe needs that they will require high intensity support for three years or more. The largest group of people – 38 percent – will fall somewhere in the middle: they are likely to need a moderate amount of care for one to three years. A strong indicator of how much assistance someone will require is whether they are healthy in their late 60s.

To determine future need, the researchers combined two dimensions of care: intensity and duration. The intensity of care varies widely. Many retirees can remain largely independent if they hire someone for a couple days a month to clean house or manage their finances, while others will need round-the-clock support.

The duration of care also varies. The researchers divided duration into three categories: less than a year, one to three years, and more than three years. Many retirees need assistance for only a few days or weeks after being released from the hospital. But others, including people who develop severe disabling conditions such as dementia, may need years of care.

The researchers used 20 years of biennial surveys of older Americans and data on caregivers to predict the share of 65-year-olds who will have minimal, moderate, or severe lifetime needs.Learn More

Video: Secrets to Protect Your Aging Brain

Just a few weeks after my 64th birthday, I discovered an interesting video. The timing couldn’t have been better.

The topic: maintaining brain health as we age. This video has tips, based on research, for preserving or improving memory and reducing brain inflammation, which is a culprit in cognitive decline.

“Daily lifestyle habits have a much bigger impact on your longevity than your genes,” Dr. Gary Small, former director of UCLA’s Semel Institute for Neuroscience and Human Behavior, explains in the video.

Did you know that Indian people have less dementia, because they eat so much turmeric in their curries? Or that a brisk 20-minute walk every day lowers the risk of Alzheimer’s disease? Most people know that yoga, meditation and tai-chi reduce stress, but did you know that stress is, according to Dr. Small, “the enemy of healthy aging”?

His message is encouraging: there are things you can control to help you live a good life in old age. “It’s easier to protect a healthy brain than to repair the damage,” he said. …Learn More

Films about Dementia Help Us Understand it

“Supernova” does not have a happy ending. But that’s how stories about Alzheimer’s go, and the film, which recently began streaming, is worth watching.

It’s one of those occasional movies that come along and portray the emotional aspects of this disease with nuance. The films, by using big-name stars like Stanley Tucci and Colin Firth in “Supernova,” lift some of the stigma around dementia that can isolate its victims and their caregivers.

Dementiais still very much a taboo topic,” said Bobbi Matchar, who, as director of the Duke Dementia Family Support Program, facilitates group discussions for people with dementia and their families. “Having movies that more accurately portray the face of dementia is really helpful.”

The newest of these films, “The Father,” is in contention for an Oscar on Sunday, as is its star, Anthony Hopkins.

Julianne Moore also won an Oscar for the lead in the 2014 film, “Still Alice” about a spirited college professor coming to terms with a failing memory. The most powerful scenes are her first realizations – forgetting a class lecture or not recognizing the center of campus, where her jog has taken her. Her denial ends when she admits to her husband (played by Alec Baldwin), “I’ve got something wrong with me.”

In “Away from Her,” Julie Christie is an older woman with Alzheimer’s who wanders the woods near her home on Lake Ontario. For her safety, she and her husband (played by Gordon Pinsent) agree she will move into a nursing home. This movie is about the disintegration of a loving marriage when one partner’s memories fade and then go dark, forcing her husband to grieve while she is still alive.

“Supernova” examines the implications of Alzheimer’s for two men who remain partners until the bitter end. On a road trip, they struggle to communicate about what Tusker’s dementia means for each of them.

Tusker (Tucci’s character) is a writer. His partner, Sam (Firth), becomes angry after discovering Tusker is hiding the extent of his dementia – he finds indecipherable scribbles in a notebook – so as not to burden Sam. …Learn More