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Long Term Care Options


According to the U.S. Department of Health and Services, at least 70% of people over the age of 65 will need long term care at some point.  Long-term care (LTC) is a variety of services which help meet both the medical and non-medical need of people with a chronic illness or disability who cannot care for themselves for long periods of time.  Most of us rarely think about long term care when we are young.  We are way too busy with our lives to contemplate it when we are healthy. Now that I’m getting older, my parents are also approaching that critical 65 year mark. We’ll need to have a talk and make a plan in case they need any long term care in the future.

Long term care is a little different than regular health care. People with a chronic illness such as Alzheimer’s and Parkinson’s disease will need assistance with normal everyday tasks that we often take for granted. Basic tasks like getting dressed, bathing, using the bathroom and even eating can be very difficult and the patients will need assistance as the condition worsens. Even with no illness, people need help as they age.

While we don’t have a history of Alzheimer’s or Parkinson’s disease in our family, my maternal grandmother had some other problems. She was diagnosed with stomach cancer and a brain tumor when she was 82. She passed away after about a year, but meanwhile she needed a lot of help with normal day to day living. My mom was retired by then and she was able to provide some of the help grandma needed. It was very stressful for her and things got more and more difficult as the condition worsened. This was not a chronic condition like Alzheimer’s, but Grandma needed a lot of assitance to stay in her home in the last year of her life.

What are the options for long term care?

Pay for it out of pocket

Long term care can be very expensive depending on what you need. I’m not sure how much an onsite health service assistant costs currently, but I’m sure not many middle class families can afford this option. (In 2007, the average hourly rate was around $40 in Oregon.)The other option is a long term care facility, which can be expensive and difficult to find the right fit. Most of us prefer to stay in our own homes and this change can be difficult for older folks.

Younger generation = Care providers

Long term care is one reason why multi generational households are on the rise in the United States. Many families cannot afford home care or a spot in a long term care facility and their only option is to quit work to become the main care provider. NPR did a great story on this topic a while back and I think everyone should listen to the Family Matters series. It can be difficult to put your life on hold while you care for your elders, but we all have that obligation to help as much as we can.


If you qualify for Medicaid, they may help with the cost of long term care. For example, here inOregon, you can qualify by these three areas.

  • Income (300% of SSI for an individual – $2022.00 per month)
  • Resources ( $2,000 in assets)
  • Limitations in Activities of Daily Living

As you can see, most middle class families won’t qualify for Medicaid. I assume most families have more than $2,000 in assets. Medicaid is targeted to low income and limited assets individual who needs help. It’s also important to note that Medicare does not cover long term care.

Local community programs

There are many local community programs that can help people stay in their home. Senior centers, hot meal programs, and transportation services can help older people stay independent in their home. It’s worth the time to check with your local Department of Human services if you just need a little help.


Veterans Administration provides long term care services to someU.S.military veterans. If you are a veteran, this might be a good option.

Long term care insurance

This is a private insurance purchased before you need help. The monthly premiums will get more expensive as you get older, but stop if you are receiving long term care. The insurance will help pay for services and can reduce your out of pocket cost significantly.

As you can see, none of these options are very attractive. However, the reality is that as we get older, we need to have a plan. Now that I am a stay at home dad, I will be able to provide care for my parents if they need it in the future. I’ll also check long term care insurance and see how much a policy cost if I ever go back to work full time.

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{ 4 comments… add one }
  • Andy Hough July 27, 2012, 10:34 am

    Thinking about long term care is depressing. I’ve heard that you should wait until 60 to buy long term care insurance. If you buy it before then and can’t keep paying the premiums all your money is gone.

    • retirebyforty July 27, 2012, 11:17 pm

      I guess it depends on your family medical history. Fortunately we don’t have any history of Alzheimer’s or other problems like that. I think my chance is pretty good that I’ll go quickly… Yeah, it’s a bit depressing.

  • krantcents July 27, 2012, 1:41 pm

    I bought Long Term care insurance 3-4 years ago. I saw firsthand how your savings can be drained when my mother spent years in a long term care facility.

    • retirebyforty July 27, 2012, 11:20 pm

      I think that’s a good decision if you have a family history. Hopefully you’ll be healthy since you exercise and live a healthy lifestyle.

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