The Costs Of Long-Term Care Are High – But Are The Risks Even Greater?


From a financial perspective, most people feel at least somewhat underprepared for retirement. Sure, they might have some savings, but today’s retirees also have more debt than prior generations, are less likely to have pensions, and they face a comparatively higher cost of living. For these Americans, Social Security won’t be enough to keep them afloat, even with healthcare support of Medicare. And if they become seriously ill and require long-term care, the expenses associated with getting that care can be disastrous.

About half of people over age 65 will require long-term care at some point, either in a nursing home or at home, and many people don’t realize that Medicare won’t cover long-term care – and neither will private health insurance. Considered to be a form of custodial care, long-term care can quickly wipe out a family’s savings. What’s worse, though, is that seeking affordable care for a loved one can mean compromising their safety.

The Risk Of Nursing Home Abuse

Depending on an individual’s health needs, many of those who need long-term care will spend at least some of their time in a nursing home, rather than receiving care at home. That’s because, while hiring a home health aide may be more affordable, wages are low, so there’s a shortage of home healthcare workers that’s only projected to get worse. As a result, families are forced to place relatives in more expensive nursing homes where they have less control over the environment and may not be able to visit as often.

While it may not be immediately obvious when visiting the facility, the healthcare worker shortage impacts nursing homes as well – many are understaffed, which is one reason why they can be so dangerous for vulnerable adults. Nursing homes also cut staffing to increase profits, hiring fewer individuals and individuals with less advanced training so that they can pay them less. With too few staff providing proper oversight, research has shown that patients are vulnerable to many forms of nursing home abuse, including neglect, sexual assault, and financial abuse. Families regularly have to hire lawyers specializing in nursing home abuse, increasing their stress at an already difficult time.

Does Money Increase Safety?

If some of the hazards of understaffing can be directly linked to profit motive, can families protect their relatives by spending more on their long-term care? The jury is out. What we do know, though, is that staffing levels and stability of staffing are among of the most important determinants of care quality. When choosing a nursing home, ask about the staffing ratio as well as turnover rates. You’ll also want to inquire about the qualifications of staff. Many nursing homes opt to hire CNAs and others with minimal training in place of fully qualified nurses, or only have a nurse or two on staff on weekdays. Look for a facility where appropriate medical staff is always available when choosing a nursing home.

Location is another key element in the nursing home safety equation. A nursing home with a higher staffing ratio but that’s further away – meaning you wouldn’t be able to visit often – may be more dangerous for your relative than one that’s nearby. Patients who have frequent visitors and family involvement are less likely to be targets of abuse, since perpetrators know they’re more likely to be caught. Be realistic about how far you’ll be able to travel to visit and how often when choosing a location.

Perhaps the primary way in which money helps to prevent elder abuse is that having more money means that an individual is more likely to be able to age in place. Those who can afford to independently hire – and pay more for – home health aides are less likely to be subject to abuse. Actually, home health aides may face more abuse than their charges when working with older adults, which represents a different type of crisis.

Looking To The Future

If our long-term care structures are going to be effective, everyone needs advocates – and that includes both seniors and their care providers – but there also need to be more financial supports. Those who care for our most vulnerable adults should be properly trained and paid at a rate commensurate with their skill and responsibilities. That starts with Medicare, not with private savings – we just can’t solve this problem by funneling more money into our 401(k)s.


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