Long-term care planning
Summary
Almost two-thirds of individuals in the United States will need some sort of assistance with daily activities as they age, but too many people leave the planning of long-term care until the need is immediate. This article offers recommendations for things to consider and questions to ask in advance when you are planning for a person’s long-term care.
What is long-term care?
Almost two-thirds of individuals in the United States will need some sort of assistance with daily activities as they age, but too many people leave the planning of long-term care until the need is immediate.1 Long-term care refers to a wide range of services and supports to assist people in their daily needs. It does not necessarily refer to medical care, but does include considerations like daily medication maintenance and support. It includes the activities of daily living (ADL), like bathing, dressing, eating and using the toilet. Long-term care also encompasses broader topics like housing, retirement planning, and money management as they change over time.
Planning activities of daily living (ADL)
As a person ages, they may require more assistance with everyday tasks that were once easy to perform. By talking it over ahead of time and having a plan for who helps with these tasks, how often, and also for how they will be compensated, you and the person you’re caring for can rest easier knowing they’ll be taken care of when the time comes. Common ADL include:
- Taking medication
- Buying groceries, cooking, eating, and cleaning
- Bathing, using the toilet, and dressing
- Managing daily spending and bills
Long-term housing planning
Most older adults want to stay in their homes for their entire lives. Planning for this requires care and consideration. Here are some questions to address:
- Is it financially feasible? Can the individual afford the rent, as it is now and in case it rises? If they own their home, are they able to keep up with property taxes, maintenance, and repairs?
- Does the home need renovations to accommodate changing mobility needs? If the home is two stories or more, can a stair lift be installed or can living quarters be arranged downstairs? Is there bathroom access on the first floor? Can countertops, showers, and toilets be renovated to accommodate wheelchair access? Can an entry ramp be added to the outside doors?
- What support services are available in the community? Does the local, state, or federal government provide meal delivery, transportation services, in-home daily assistance, or other services? Are these services available for hire in the area? How reliable are these services?
Long-term medical care planning
For many older adults, medical costs are one of the highest expenses. Living on a fixed income can mean that unexpected medical bills take a large chunk out of a person’s funds. Consider the following questions when planning long-term care:
- Health insurance. How much, and exactly what, is covered by individual health insurance?
- Medicare coverage. What portion of the person’s expected medical expenses does Medicare cover? Things like regular doctor’s visits, prescription coverage, and routine testing can be budgeted for in advance.
- Foreseeable medical procedures or treatments. Are there likely to be any major medical procedures or treatments in the next few years? Planning out in advance for how to pay for these can ease the worry over unexpected bills.
- Unexpected expenses. Can money be set aside each month for unexpected expenses? How will the person pay for emergency medical expenses? A savings account, retirement funds, reverse mortgage or other funds? It’s always a good idea to have a backup plan for emergencies and to know which financial options are the last resort.
Three key questions to consider
There are so many things to think about when planning for long-term care that it can be overwhelming. Breaking down every individual possibility is impossible: life changes fast, and there’s no way to plan for each individual circumstance that pops up. Instead, consider each contingency as it relates to the following three questions:
- What kind of care will the person need? Medical, daily living, cognitive, financial?
- Who will provide the long-term care? A paid professional, yourself, a relative or friend, a combination of these?
- How will the person pay for the long-term care? Government assistance, retirement savings, loans, help from friends and relatives?
By holding these three questions at the top of mind, it’s a little easier to remember the long-term, big picture plan instead of getting bogged down in the details.
Related information
Getting financial assistance
Investigate long-term care options
Overview of financial assistance
Paying for health care
Paying for long-term care
End notes
1 Administration on Aging. Long Term Care Planning.
