Long-term care threatens to sap seniors' savings

The senior-care coordinator has helped hundreds of Dallas families find long-term care for frail parents. Almost always, they think Medicare will pick up most of the tab, the same as it does for hospital stays and doctor visits."They're shocked when I tell them that Medicare doesn't pay for long nursing home stays," she said. "All of a sudden, they have this look of horror as they realize their parents will have to foot the bill. Those retirement nest eggs go poof."

Over 20 years, Paggi has seen many seniors spend almost their last dollar on personal care at home or an assisted-living community before turning to a nursing home and ultimately relying on Medicaid, the health care program for the poor.

"Our system of paying for long-term care in this country is broken," she said. "Unless you have a big family or thick wallet, you'll run into trouble in old age."

As lawmakers debate how to pay for acute care for 46 million uninsured Americans, advocates for older or disabled adults are urging the Obama administration and Congress to discuss long-term care's financing problems, too.

Possible reforms range from providing more federal money for home care to creating a national insurance pool that would protect people against long-term care expenses.

"It doesn't make sense to figure out how to pay for the hospital care of a heart attack victim but overlook the day-to-day problems of someone living with congestive heart failure," said Howard Gleckman, a senior research associate at the Urban Institute and author of Caring for Our Parents.

Long-term care includes everything from help with bathing, dressing and household tasks to assistance with taking medications. It may be provided by family members or paid caregivers in the home or at a facility like an adult day care center or nursing home.

Ten million Americans require long-term care. But by 2030, 37 million boomers will be living with more than one chronic condition such as arthritis or diabetes, said Larry Minnix, president of the American Association of Homes and Services for the Aging.

Health care and long-term care go hand in hand, experts say.

"If the chronically ill forget to take their medications or they can't get to their doctors' offices, their health will deteriorate, and they'll wind up back in the hospital," said James Swan, professor of applied gerontology at the University of North Texas.

Lawmakers won't wring savings out of the health care system without managing chronic illnesses effectively, and that will mean making long-term care more accessible and affordable, he said. http://www .dallasnews.com/sharedcontent/dws/bus/stories/061709dnbuslongtermcare.3f7878b.html