Will You Need Long Term Care?

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Young woman holds man's hand with a ball in it

The folks who know these things say that many of us will live at least into our 80s.  About a quarter of us will get to 90.  That in itself is a mixed blessing.  Now what happens if we get to 90 and can’t take care of ourselves any more?  Long term care is what.  The average long term care user needs assisted living or skilled nursing care for three years.  Medicare will pay for a lifetime total of 100 days.  We should be figuring out whether we will need long term care.

What does it cost?

Depending on your location, staying in a nursing home could cost you in the $30,000 a year range in Missouri or over $70,000 a year in New York.  It’s expensive.  Staying in your own home and having services there costs at least $10 an hour for aide and homemaker services;  much more for nursing visits.  The people costs are quite high, and if you are in an area where people get paid more, expect to pay more for help.

Most people would rather have services, especially personal ones, at the hands of someone they know and love.  Just know that having them do it means they won’t be able to work at something else too, once your needs get beyond a certain level.  You will at least have to contribute to the household income for your keep.

If your caregivers have medical conditions as well, they must take care of themselves too.  Caregivers often skimp on their own care to take care of a loved one.  Once they get sick, hired help or a stay in a facility becomes the choice.  The savings end.  To avoid this, they may have to hire some help so they can get a break occasionally.  The savings are reduced again.

Will you need long term care?

A lot of things go into the answer to this question.  You can, however, figure the odds, using longevity calculators to see how old you could get.  Try more than one because they all go about it different ways.  The questions they ask will give you something to think about too.  It’s definitely worth playing with.

Don’t forget to look around at your family, past and present.  How long did your grandparents live?  How old are your parents, if they’re still with you, and what kinds of health challenges do they have?  What runs in your family?  If your family on Dad’s side tend to get old and then demented in their 80s, and you favor that side healthwise, be aware this is possible for you and think about how you’ll deal with it.

Things you can do with lifestyle.

If you haven’t yet, find a way of eating that agrees with you and allows you to maintain a healthy weight.  We’ve been finding out over the years that no one diet works for everyone.  But if you start with basic food groups and edit out the stuff that bothers you or is associated with conditions you are managing or avoiding, you can do pretty well.  Working with a dietician is helpful for folks with diabetes and other health challenges.

What lands people in medically-dependent lifestyles?  Head injuries, fractures, strokes, heart trouble, dementias and bad lungs, among others.  So we want to make sure we are strong enough, have good bones, keep our balance, treat our hearts and circulatory systems well, and keep our lungs clear.  We want circulation to our brains to get in the oxygen and energy to make them run right.  We need safe surroundings to be sure accidents don’t lay us up.

Have a look around your house.  Are there places that trip you up, like rug edges or thresholds?  Are your cellar stairs uneven or poorly lit?  Do you have grab bars in the bathroom for getting in and out of the tub or shower?  Once you begin to shuffle a bit walking around, this sort of thing becomes a big deal.  Make sure you can handle the surfaces you walk and stand on, and that you have help if your balance is off or you’re feeling weak at times.


As much as I hate to say it, exercise is very important.  A dedicated couch potato, I resist movement for its own sake and avoid sports.  But when faced with a “move it or lose it” scenario, I move.

Pick the varieties that suit your needs.  If’ you’re wobbly, get checked out for why, and if the doctor OKs it, take a balance class or look up some supported exercises you can to do to improve your balance.  That way, you avoid having falls.

Make sure you get some aerobic exercise as well, walking or swimming or something else that makes you breathe and your heart beat a little harder.  It keeps the calcium in your bones.  It circulates nutrients to the brain.  Nearly anyone will benefit from some of this.  You can get it doing housework or mowing the yard; it doesn’t have to be extra stuff all the time.

Many of us have lost muscles over the years.  If you feel you’re getting a little too weak to securely carry the laundry basket,  do some weight training with hand weights or full water bottles to tone up.  Check out how they do it on YouTube or get someone to show you.  That way you don’t wrench something and get hurt.

Other things to watch.

Take care of your eyes.  The weaker your vision gets, the higher the risk of your becoming dependent.  Have an annual eye checkup and follow up with any treatments you find yourself needing. You’ll continue to enjoy seeing the world around you and you’ll be a lot safer too.

Stay current on your inoculations.  Getting a flu shot beats getting the flu.  The flu can morph into pneumonia and land you in the hospital just with that.  You could also hurt yourself in a weakened condition and break a hip or something.  Why take the chance when there are prevention steps to take?

All the stuff you’ve been told all these years is even more important now.  Be careful of medications and alcohol; they hit older people differently.  Wear your seat belt.  Wash your hands.  You know the drill.

What if I need long term care?

You can spend a lot of money on a long term care insurance policy, but there are other ways.  Some insurance companies offer life insurance with a way to tap into it to pay for long term care.  There are also annuities that will switch to long term care payments when you need it.  If leaving something to the family is essential in your world view, and you have the money, look into these.

Should you be pretty sure you’re headed for Medicaid, keep an ear open for changes to that program.  For instance, you can give your heirs their inheritance early.  However, Medicaid won’t let you qualify till 5 years after the gifts have all been made, at least in the states I know.  Check with yours to be sure of the rules.  And don’t wait if you decide to distribute the goods.  You risk spending them all if a sudden change means you need nursing care, either at home or in a skilled nursing facility.

Do you feel you may need long term care?  If so, what options have you considered?



Young woman's hand holds older man's hand with a ball in itPerson in hospital gown using walkerA walker stands in an institutional room



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