By Daniel Weintraub
California’s population is aging, but most older adults underestimate how likely they are to need help with daily living as they grow older, and few are prepared to handle the potential cost, which can be huge.
This disconnect has implications not only for individuals, who risk being left penniless and still needing care, but also for the government and for taxpayers, who eventually will have to pay for nursing homes for people whose medical and long-term care bills leave them impoverished.
Californians, meanwhile, are largely unaware of a new federal program designed to help bridge that gap. That initiative could be wiped out in its infancy if Congress repeals the federal health reform law passed last year.
The survey, conducted for the center by Lake Research Partners with a grant from the non-profit SCAN Foundation, found that more than half of those polled could not afford more than three months of in-home care if they had to pay for it themselves, and about a third could not afford even one month of assistance.
The economic slowdown has hurt the ability of middle-income Californians to pay for long-term care insurance or save for their own needs. At the same time, the sluggish economy has led the state to roll back programs that help low-income people live as independently as possible.
The result is a ticking time-bomb for the state: Demographic, economic and government trends are converging to create a generation of Californians ill equipped to pay for the care they will need even as the state is providing less help to those who can’t afford it.
Steve Wallace, a professor in the UCLA School of Public Health, who helped supervise the poll, said 90 percent of those surveyed said they would like to remain at home as they aged.
But while 70 percent of Americans eventually need help to deal with their daily living, two-thirds of Californians underestimate how many people need such assistance.
“Even people who are caregivers don’t think they themselves are going to become old or disabled and need help for years in their old age,” he said. “There’s a lot denial that goes on.”
That denial means that even people who can and do save for their retirement usually do not factor in the cost of home health care or a nursing home. And very few people purchase long-term care insurance.
According to the Health Policy Research Center, the average cost of in-home care is $2000 per month. And a month in a nursing home costs $6,500.
More than half of those surveyed (53 percent) said they could not afford to pay for more than three months of in-home care. And 66 percent could not pay for more than three months in a nursing home.
Current data and demographic projections suggest that 70 percent of seniors will be unable to live in their own homes without some kind of help. Yet only 37 percent of the people in this poll understand how likely they are to need assistance. The mistake was true across racial and ethnic differences, household income levels and geography throughout California.
Dr. Bruce Chernof, president and CEO of the SCAN Foundation, which funded the poll, said he believes the survey’s most important finding was that a majority of Californians, regardless of party affiliation, believe that “doing something about long term care is a really important public policy issue.”
Chernof said he thinks the state should better educate people about the challenges they are likely to face. He also thinks the state should reorganize its own services for the aging to better coordinate them and make them more centered on the needs of the consumer or patient and less wedded to the needs of the agencies that run the programs.
“That would start by asking, what are the person’s needs?” Chernof said. “A key to that is a thoughtful, uniform assessment. And then asking what resources are available to really help that person in the most effective way?”
An example of the widespread ignorance about long-term care that the poll uncovered was an almost total lack of awareness of a new federal program created as part of the health reform bill passed by Congress last year.
Known as the Class Act – for Community Living Assistance Services and Supports – the program is to be open to all and paid for with voluntary deductions from employee’s paychecks. Employers will have the ability to deduct the premiums automatically unless workers opt out.
People who pay into the program for at least five years would then be eligible for a cash benefit they could spend on services of their choice, including in-home care.
Nine out of ten California voters over age 40 are unaware of the program, which is scheduled to roll out next year. But when told of its details, 88 percent said they favored the idea.
Note: HealthyCal.org receives funding from the SCAN Foundation.