A University of Alabama Law School Clinical Program funded in part by West Alabama Regional Commission

Who is likely to need long term care?

All of us are likely to need some assistance if we live long enough. Modest needs for assistance may be met through life adjustments, either at home or in assisted living facilities. Most senior care in this country is provided at home, largely by family members, and financed from individual or family resources.

Most older people do not end up in nursing homes for long periods. For seniors who do eventually need nursing home care, the average stay for those under 85 is usually a year or less, and for those of all ages, two to two and a half years. But increased life expectancy does increase the likelihood of living to an age at which disabling illnesses are more frequent. The costs of long term care either at home or in an institution are enormous when they do occur. Only the very affluent have incomes and resources to cover extended care of the kind that most of us would prefer for ourselves or our loved ones

From 65 to 69 the likelihood of spending some time in a nursing home is about 10% (some stays are very short); from 75 to 80, about 20%; after 80 the percentage of those who will spend time in a nursing home is almost 45%, and 25% can probably expect stays of 3 years or more. With annual costs for a semi-private nursing home room in Alabama around $45,000 in 2004 even a two-year stay (plus medical and other expenses) is enough to wipe out many people’s savings, especially if it follows several years of high medical bills.

Costs of around-the-clock home care for a chronically ill person are higher than care in a nursing home, and it is not easy to arrange for good care. It is nearly impossible to maintain a sick person at home unless there is at least one family member willing and able to shoulder most of the load, and it is a heavy load. There are options like day care and respite care to extend the period that a family caregiver can carry the burden, but as an ill person’s needs increase, at present a nursing facility may eventually be the only way to provide the level of care needed.

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