THE WOMEN'S ISSUE OF LONG TERM CARE--THE NUMBER ONE WOMEN'S ISSUE !!! 

Part 2: NURSING HOME AND ASSISTED LIVING UTILIZATION IS PREDOMINATELY FEMALE

Not only do the numbers relating to Medicare utilization magnify, due to the extended longevity of women, but also the utilizations of nursing homes, assisted living facilities, and home health and home care (professional and personal), are correspondingly more severe for women.

For instance, The American Health Care Association, whose members are composed of owners and managers of long term care facilities and related providers, has done numerous studies over the years with the results indicating that approximately 75 percent of all nursing home residents are women. 

  One such letter printed in 2001 profiles the typical nursing facility resident as such:

"The typical nursing home resident is a women in her 80's displaying a mild form of memory loss and dementia.  Although physically healthy for  a woman her age, she needs help with approximately 4 of 5 activities of daily living..."

"A typical resident has managed to set aside a total of only $20,000 for her retirement.  With the average annual cost of nursing home care running approximately $41,000, she is unable to afford the care she needs beyond the first six months. The typical resident, however, will spend more than three years in a nursing facility due to her cognitive and physical disabilities.  Her health insurance is limited to Medicare only, with a modest Social Security check for income."

"Financially incapable of meeting the costs of her care, the female resident must rely on Medicaid to pay for her 24-hour care and supervision.  In order to qualify, she must impoverish herself to no more than $2,000 in total assets."

Those are the hard facts as seen by the AHCA, and who would be a better authority than the nation's nursing home providers-professionals in the care business?  Would this be a call for the solution of Long Term Care insurance?  In addition to the "profile" of female nursing home residents, the indication is that the typical female patient will encounter a cost of two to two-and-a-half times what their male counterparts will require during their lifetimes, with again, the numbers being higher because of more utilization brought on by longer lives. 

Another AHCA study done in 1995, says that, "The average American man can expect to spend $56,895 on LTC.  The average woman will spend $124,370."  Remember, those are 1995 figures, therefore, they cannot reflect the 5% average annual increase needed to bring the numbers up to any current cost-of-care amount.    

In a particularly savvy publication, "The State of Older Women in America," the OWL organization (formerly known as the Older Women's League), presents a graph of significant interest showing the disparity between men's and women's occupancy of Nursing homes.  (I have changed the presentation slightly to highlight our discussion, but the statistics remain the same.)

NUMBER OF NURSING HOME RESIDENTS AGE 65 OR OLDER
BY SEX AND AGE GROUP, 1985, AND 1997, IN THOUSANDS

Reference Population: These date refer to the population residing in Nursing Homes.  Persons residing in Personal care or Domiciliary Care Homes are excluded.
Source:  National Nursing Home Survey

Now a very careful look at this table will show some serious recent developments.

1. First, notice the increase in women's occupancy between 1985 and 1997--From 984,000 to 1,093,000--a growth of over 10% in twelve years.

2. In the age bracket 65 to 74, the men's numbers stayed the same while the     women's numbers actually decreased.  My suspicion is that the difference really reflects the growth in Home Care due to the fact that Home Care became another entire growth industry during the decade of the '90's, and younger recipients, both men and women, began to use Home Care as the care delivery system of first choice.

3. We don't see a great deal of change in the age 75 to 84 bracket, except that now we see male utilization growing, with the curve continuing upward for men into the 85 or older bracket.

4. The most significant number is the final one.  Look at the 85 or older occupancy for women and recognize that it confirms what we have discussed thus far.  From 485,000 female occupancies in 1985, to 606,000 occupancies twelve years later.  An astonishing 25% growth rate, which verifies the conclusion of the female demographics and statistics we have been illustrating!

Unfortunately, we have previously concluded (in Article 1) that extended longevity is increasing, and that less-than-perfect health conditions, brought on by older ages, seem to manifest themselves in medical concerns (Medicare utilization data) and Long Term Care needs (Nursing Home utilization data) discussed thus far.  Do the data verify the need for today's woman to be particularly concerned about purchasing Long Term Care Insurance?  I should think so.

ASSISTED LIVING PICKS UP PART OF THE BURDEN

So, are the numbers any different for assisted living needs?  Not really, nor should we expect that they would be.  Again, an AHCA article profiling the typical assisted living resident, points out the demographic similarities.

      "The typical assisted living resident is an 82-year old woman who is mobile,
        but needs assistance with one or two personal activities.  Although most
        elderly assisted living residents are female, due to women's longer life
        expectancies, 29 percent are male.  The average age of elderly residents,
        men and women combined, is 82 years, according to NCAL/AHCA survey
        findings..."

        "Residents of assisted living facilities stay an average of 3.3 years, and leave
        the facility when a higher level of medical care is needed. (NCAL/AHCA, 
        "Survey of Assisted Living Facilities," 1996.)"

The above information would conclude that all needs for care, whether they be Medicare, Nursing Home, or Assisted Living, would also reflect the needs for Home and Home Health Care (which we will discuss next), in about the same proportion.  So, what's the lesson here?  A Medicare Supplement or a Medicare Advantage plan (upon enrolling in Medicare) and a Long Term Care insurance policy purchased as soon as possible, should be regarded as commonplace rather than the exception, particularly for women, in light of the above information.  If the demographic problems facing women were the only ones, the answers would be simpler, but additional issues carve out a need for women to protect themselves as well as they can for the later stages of life.  

We will address those issues in Part 3 of "The Silent Crisis," for they full well illustrate the compounding of problems for women as they approach middle-age and the later stages of their lives. 

The Silent Crisis--The Women's Issue of Long Term Care 

(Editor's note:  This content is adapted from the book, "Guarding Your Gold II," by Ronald J. Iverson, Copyright, 2004.  Even though some of the statistical content is dated--1996 to 2000--the basic premise of the chapter, that of women's issues regarding Long Term Care, remains the same.)