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 http://www.longtermcarepoll.org/Pages/Polls/long-term-care-in-america-expectations-and-preferences-for-care-and-caregiving.aspx..

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Candidates Mum on Social Security

Published in Pawtucket Times on February 8, 2016

Just a week before the New Hampshire primary, scheduled for Tuesday, February 9, AARP releases a new survey, of likely primary voters, that finds Social Security is “one issue that transcends the partisan divide and unites people of all ages.” Both surveyed Democrats and Republicans alike agreed that all presidential candidates should give details as to how they will strengthen or expand Social Security.

In recent presidential debates, moderators focus on the economy, abortion, gun control, immigration and defense, hardly touching on aging issues. The January 29 AARP survey found that voters want more specifics about Social Security. More than nine in 10 New Hampshire primary voters across party lines and age groups say it is important for presidential candidates to lay out their specific plans to make Social Security financially sound for future generations.

Presidential Candidates Dodging Social Security Issue

“New Hampshire primary voters are sending a clear message to the presidential candidates that having a plan to keep Social Security strong is a test of leadership,” said AARP New Hampshire State Director Todd Fahey. “Yet, some presidential candidates are dodging the issue. Our survey confirms New Hampshire primary voters agree if a candidate thinks they’re ready to be president, they should at least be able to tell voters where they stand on Social Security’s future.”

According to AARP, the recent survey of 1,004 likely New Hampshire primary voters, was conducted by telephone from January 12 through January 16, 2016. By design, half of the respondents consist of likely Democratic primary voters (501) and half consist of likely Republican primary voters (503).

The AARP survey is part of nonprofit’s 2016 presidential election issue campaign, “Take A Stand.” In November, the nonprofit launched its its 2016 election accountability campaign initiative which demands on behalf of America’s voters that presidential candidates detail their specific positions on making Social Security financially sound.
The survey findings indicate that nine in 10 New Hampshire primary voters (93 percent Democrat and 92 percent Republican) across party lines and age groups say its important for presidential candidates to lay out a detailed plan to make Social Security financially sound for future generations. Regardless of age, nearly half or more of likely primary voters in each party think this is “very important.”

Also, more than three in four New Hampshire primary voters, across party lines and across age groups, agree that having a plan for Social Security is a basic threshold for presidential leadership. This includes 89 percent of likely Democratic primary voters and 80 percent of likely Republican primary voters.

Moreover, nearly nine in ten or more voters across both parties and age groups believe it is important that the next president and congress take action to make Social Security financially sound. This includes 96 percent of Democratic primary voters as well as 92 percent of Republican primary voters.

“If our leaders don’t act, future generations could see their Social Security benefits cut by 25 percent. That’s a $4,000 to $10,000 per year benefit cut! This survey confirms how critical it is for the next president to have a plan to update Social Security and a commitment to act on that plan,” said Fahey.

On the question of which presidential candidate they expect to vote for on February 9, the AARP survey found that among likely Republican primary voters, Donald Trump is the leading choice for president (preferred by 32 percent) with Marco Rubio preferred by 14 percent and John Kasich preferred by 13 percent However, more than one in four (26 percent) are less certain who will get their vote.

Among likely Democratic primary voters, Bernie Sanders is the leading choice for president (preferred by 59 percent), with Hillary Clinton coming in second (preferred by 33 percent. But one in five (21 percent are less certain who will get their vote.

“AARP said early on in the election cycle that Social Security is too critical a matter – and one affecting far too many people – to allow it to be skimmed over, breezed by, or paid only lip service,” said AARP Rhode Island State Director Kathleen Connell. “The presidential candidates need to take a stand on how they would update Social Security to keep it financially strong and adequate for future generations,” she says.

“Unfortunately, Social Security does not seem to be top-of-mind for candidates nor a discussion that finds its way into the debates,” says Connell, observing that some candidates, including some frontrunners, remain silent on the Social Security issue.
(You can get the very latest news and read what candidates with plans did say at http://www.2016takeastand.org.)

Connell says, “The challenge itself – keeping Social Security strong for the future – gets talked about a lot. You can be sure that when a candidate or elected federal official visits a senior center there will be a pledge (one I happen to believe has been sincere in Rhode Island) to protect Social Security.”

“You don’t hear so much about how. The devil is in the details. And, as the saying goes, ‘It’s complicated,’” adds Connell.

Older Voters Have Political Clout

From inside the Beltway, Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, considers voters age 50 and over are one of the most important voting blocs in the nation. “It is a numerous group and these people vote in higher percentages than those who are younger. They often are decisive in elections and candidates have to take their views seriously,” says West.

Connell agrees about the clout of older voters. “The average age for a Rhode Island voter in the 2012 presidential election was 48.6, and that was up from 48.5 in 2010. We know that older Rhode Islanders vote in high percentages and we know that the 50+ population is grown as people live longer. But I have to say that when it comes to Social Security, voters 50 and older are united on the issue; they expect some form of accountability from the candidates on how they would lead on this issue, she says.

Anyone who thinks they’re ready to be President of the United States should be able to tell voters how they’ll keep Social Security strong,” adds Connell. “If our leaders don’t act, future retirees could lose up to $10,000 a year. Every year our leaders wait and do nothing, finding a solution grows more difficult,” she says.

Aging issues impact everyone, says Connell. “When I am asked about ‘aging issues it seems to me to indicate how people often default to a narrow view of ageing. Access to and the cost of healthcare is an issue for all ages. Taxation is an issue for all ages. Affordable housing is an issue for all ages. Protecting pensions is an issue for all ages, even for voters working in their 30s or 40s – as is the issue of Social Security. Our aging population presents a challenge to all Americans and I think you will see 50+ voters becoming increasingly liked-minded making more and more of an effort to be heard.”