LTC Must Be Placed on Candidates’ Radar Screen

Published in the Woonsocket Call on May 29, 2016

Presidential candidates might just think twice about their political campaign positions on long-term care. With the graying of nation’s voters, Congress will be pushed to put long-term care on its policy agenda. When the dust settles after the Democratic and GOP conventions, the winning candidates must address long-term care issues in their debates before the November election.

In 2013, America’s age 65 or older population made up only 14 percent of the total population, but by 2040, this demographic group will nearly double to comprise about 22 percent. According to the U.S. Department of Health and Human Services the majority of these individuals will require some form of long-term care services (specifically, help with activities of daily living—such as cooking, bathing, or remembering to take medicine—that can be provided in a home or institutional setting.)

Misconceptions About Medicare and Social Security

Survey results in a 17 page report, “Long-Term Care in America: Expectations and Preferences for Care and Caregiving, released by Associated Press (AP)-NORC Center for Public Affairs Research, notes that most older Americans expect Medicare and Social Security to pay for long-term care services while these federal programs generally do not. The survey findings also indicate that respondents, age 40 and over, strongly supported public policies that help a person save for long-term care services and for those that defray the cost of care giving, including state paid family leave programs.

“This survey provides much-needed data on how people perceive the issue of long-term care in the United States,” says Trevor Tompson, director of The AP-NORC Center, in a statement released on May 16, 2016 with the survey findings… “The need for long-term care services and support to assist seniors with activities of daily living is increasing exponentially. Financing high-quality services so that the costs are manageable for families and governments will remain a big challenge for decision-makers,” he added.

“Older Americans of today and tomorrow have a 50 percent chance of living with substantial and often expensive daily needs,” adds Dr. Bruce A. Chernof, President and CEO of The SCAN Foundation. “Medicare and Social Security were not built to cover long-term care, leaving American families unprotected, and as the survey shows, unaware of this fact,” he says.

The AP-NORC survey found that while older Americans’ confidence in being financially prepared to pay for long-term care services remains low overall, there has been a slight increase in public confidence over the past four years, consistent with other measures of consumer confidence post-recession, according to the Consumer Confidence Index. In 2013, 27 percent reported feeling very or extremely confident in their ability to pay for long-term care, increasing to 29 percent in 2014, 32 percent in 2015, and 36 percent in 2016.

The polling finds reveal that a widespread misconception as to what Medicare covers for long-term care services. Older respondents, with an annual household incomes less than $50,000, are more likely to expect to rely on government programs such as Social Security, Medicare, and Medicaid, while those with higher incomes expect to rely more on personal savings to pay for their needed long-term care services. Still, 3 in 10 of these wealthier older Americans report that they will rely on Medicare to support their care as they age. This reflects common misperceptions among older Americans about the long-term care services that Medicare covers, notes the AP-NORC survey.

Thumbs Up to Aging in Place

Seventy seven percent of the survey respondents would prefer to “age in place” and receive care in their own home, w with far fewer preferring to receive care in a senior community (11 percent), a friend or family member’s home (4 percent), or a nursing home (4 percent). Among those respondents who prefer to receive care at home, there are gender differences in preferences for who provides that care: men would prefer to receive care from a spouse (51 percent vs. 33 percent), and women would prefer to receive care from their children (14 percent vs. 35 percent).

There is widespread support for policies to help caregivers face the costs of providing long-term care, with 72 percent supporting state programs to provide paid family leave, 83 percent supporting tax breaks for caregivers, and 73 percent supporting a Social Security earnings credit for caregivers taking time out from the workforce to provide care.

According to the AP-NORC survey, forty-three percent of the survey respondents have either been caregivers in the past or currently providing long-term care to a family member or close friend. Among those with experience as caregivers, 4 in 10 report having to miss work to provide care.

The researchers found that prior experience with long-term care is associated with greater support for several public policies to help people finance long-term care and to help alleviate costs for caregivers. These individuals expressed higher levels of concern about aging and are more likely to anticipate that it is at least somewhat likely that a loved one will need care in the next five years, compared to those without direct care giving experience.

Finally, one-third of the survey respondents reported having done no planning at all for their own long-term care needs. This 2016 finding is similar to the 31 percent who said the same in 2015 and remains lower than the 47 percent and 44 percent who said they had done no planning in 2014 and 2013, respectively.
One Size Does Not Fit All

Meghan Connelly, Chief Program Development at Rhode Island’s Division of Elderly Affairs, provides some thoughts about the findings of the AP-NORC survey. “Long-term care options are not “one-size-fits-all”. In Rhode Island, there are a number of choices one can make, ranging from living independently and receiving care at home to nursing home care. This report highlights that consumers want options when it comes to making these decisions for themselves, or assisting loved ones with long term care choices,” she says…

Connelly adds, the AP-NORC survey “supports the findings of past research: that the overwhelming majority of people want to receive long term care services at home,” noting that in the Ocean State there are many home- and community-based care options. She says that”home care may be available through a physician’s office; at the time of discharge from a hospital or nursing home; or through referrals to state-subsidized programs administered by agencies under the Executive Office of Health and Human Services.”

“The AP-NORC survey also underscores the need to adopt progressive financial policies that support family caregivers who provide the greatest percentage of needed long term care to their elderly or disabled loved ones at home,” warns Connelly.

Greg Crist, Senior Vice President of Public Affairs at the Washington, D.C.-based American Health Care Association (AHCA), notes, “This data generally tracks what our own research has shown: Americans don’t think of this topic every day, and honestly, this is a topic they’d rather avoid. No one likes the thought of aging, and with that aging, the increasing likelihood they will help in their later years. No one welcomes a loss of independence. But here’s the good news – the sector is adapting and innovating.”

Crist asserts nursing homes are meeting the challenge of caring for aging baby boomers. “We’re meeting the growing demands of Boomers, particularly as clinical needs grow, but also in offering amenities such as custom dietary menus, social media communities, and personal rehab care plans that speed recovery times. Whether in Rhode Island or elsewhere, this is an evolving health practice, recognizing that change is needed to meet the new preferences of older Americans,” notes Crist.

Listen to the Older Voters

The AP-NORC survey findings mirror other “long-term care perception” studies released by AHCA and AARP. Democratic presidential candidates Hillary Clinton, Bernie Sanders, and GOP standard bearer Donald Trump must not forget the needs of America’s exponentially growing older population. These older voters do not want to fall through the nation’s public policy safety net when they require the most assistance, paying for costly long-term care services. As the survey report notes, older Americans strongly support Family Leave programs and also call for government administered Long Term Care Insurance programs.

For a copy of the report go to


Survey: Many Put Retirement on Hold

Published in Woonsocket Call on May 15, 2016

The Associated Press (AP)-NORC Center for Public Affairs Research, funded by The Alfred Sloan Foundation, released a study this month that finds that departing the workforce at the traditional retirement age of 65 is no longer a reality for most older Americans. This new study extends the research of an earlier 2013 retirement study to look at efforts made by older workers to improve career skills and their plans to adjust the parameters of work in later stages of their work life. It also takes a look at a variety of implications of the trend of working longer along with the motivations for doing so.

The 10 page report, released on May 10, 2016, finds that there are large numbers of older Americans who are currently, or who expect to be, working longer. However, researchers caution that this does not necessarily mean that older workers are continuing with the same employment circumstances indefinitely. Many are either reducing their hours to part-time status or are planning to switch to a new employer or even a new field. (The AP-NORC study confirms the findings of an AARP retirement study reported in my September 14, column, entitled “Still Getting the Job Done” that noted “new retirement activity.”)

The Graying of America’s Work Force

The AP-NORC survey comes at a time when the size of the nation’s older population is larger than it has ever been and projected to keep growing, say the researchers. Between 2003 and 2013, the number of Americans age 65 and older rose from 35.9 million to 44.7 million. In the next quarter century, this number is expected to rise to 82.3 million. The percentage of the overall population that falls within this group will rise from 14.1 percent in 2013 to 21.7 percent in 2040, notes the study.

“The circumstances and future plans of older Americans must be well understood by decision-makers,” said Trevor Tompson, director of The AP-NORC Center. “Not only are older Americans going to work longer, but 4 in 10 respondents are planning to change career fields in the future. These results point to significant changes in the American workforce with impacts likely felt by workers and employers.”

No Plans for Retirement

Here is a sampling of key findings reported in The AP-NORC’s “Working Longer” study:

According to the survey, a quarter of older workers say they plan to never retire, with this response being more common among lower-income workers than higher-income workers. Specifically, 33 percent of those earning less than $50,000 a year saying they will never retire, compared with 20 percent of those who earn $100,000 or more.

The findings also indicate that more than half of older workers plan to be employed past the traditional retirement age of 65 or already have worked past this age. Additionally, six in 10 older workers age 50 to 64 plan to work past the age of 65. Nearly half of those who are 65 and older say they already work or plan to work during this later stage of life, notes the study.

The study reveals that members of the workforce who are age 65 and older are not limiting themselves to occasional work–this group reports an average of 31 hours per week in the workplace.

Additionally, more than 4 in 10 Americans age 50 and older have spent at least 20 years working for the same employer at some point in their careers. These workers are more excited and less anxious about retirement than those without such long histories with a single employer, says the study..

The findings also show that a majority of the older Americans who are planning to remain in or rejoin the workforce are planning to switch either professional fields or employers in the future. Those who are age 65 and older are especially likely to plan a change. In addition, a sizeable minority of older workers are taking steps to keep their skill sets fresh by pursuing job training or additional education.

Finally, a quarter of adults age 50 and older have looked for a job in the past five years. Many of them are encountering difficulties in the job market, with a third reporting that it has been so difficult that they’ve given up looking at some point during their search.

Fear of Outliving Retirement Savings

“One could say that the [The AP-NORC] survey simply leads us back to the same ‘old’ story,” said AARP Rhode Island State Director Kathleen Connell. “But what is ‘old’ and what are we going to do about it? The survey provides more data to underscore the need for policy changes as well as a refocusing on employment and retirement. In a single generation, the world has changed. On the upside, the numbers reflect people in better health working longer, and many of those folks continue to be fulfilled in their jobs. But we all know that for most people this trend stems from the fear of outliving savings, often compounded by the inability to save substantially for retirement.

“Worries about Social Security are in the mix, also, as people worry that benefits someday may not cover the cost of housing, food and healthcare. The thought of any future reduction in Social Security benefits is daunting. That’s why AARP continues to ask presidential candidates to ‘Take a Stand,” by providing specific plans to address necessary changes in the program. As we have been saying, doing nothing is not an option.

“One of the encouraging trends revealed in the survey is that many workers over 65 say they are certain that they will change jobs or careers before they retire. It says to me that the message is kicking in that reaching what we once accepted as ‘retirement age’ no longer holds people back.”

A total of 1,075 interviews were conducted for this AP-NORC survey with adults age 50 and older representing the 50 states and the District of Columbia. Interviews were conducted in English and Spanish. The combined response rate is 14.2 percent. The overall margin of sampling error is +/- 3.9 percentage points at the 95 percent confidence level, including the design effect. The margin of sampling error may be higher for subgroups.