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Long Term Care, Family Caregiving and the Law of Succession Part One

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Long Term Care, Family Caregiving and the Law of Succession Part One Josephine Gittler The Aging Population, Alzheimer s and Other Dementias: Law and Public Policy – PowerPoint PPT presentation

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Title: Long Term Care, Family Caregiving and the Law of Succession Part One


1
Long Term Care, Family Caregiving and the Law of
Succession Part One
  • Josephine Gittler

The Aging Population, Alzheimers and Other
Dementias Law and Public Policy University of
Iowa College of Law March 29, 2012
2
The Aging Population and Long Term Care
3
Needs of Aging Population
  • Chronic Diseases Disabilities
  • Functional Limitations
  • Long Term Care
  • Services Supports

4
The Aging Population Chronic Diseases
Disabilities
  • Most older people have at lest one chronic
    disease, e.g. heart disease, cancer, or diabetes.
  • Physical disabilities increase with age, e.g.
    vision, hearing, and mobility impairments.
  • Older persons, particularly the oldest old are
    at risk for Alzheimers Disease and other
    dementias.

5
The Aging Population Functional and Cognitive
Limitations
  • As a result of chronic diseases and disabilities,
    a substantial proportion of the aging population,
    especially the oldest old have functional and
    cognitive limitations.
  • Functional and cognitive limitations may result
    in an inability to perform or difficulty in
    performing activities of daily living (ADLs) and
    instrumental activities of daily living (IADLs).

6
The Aging Population Long Term Care
  • Older persons with functional and cognitive
    limitations frequently need long term care (LTC).
  • Estimated 70 of persons 65 will need LTC at
    some time, for average of three years.
  • Persons 85 are 4 times as likely to need LTC.

7
The Aging Population Long Term Care
  • Home-based
  • Personal care
  • Home health care
  • Friendly visitor from senior services
  • Emergency response services
  • Community-based
  • Adult day care
  • Senior centers
  • Meals programs
  • Transportation service
  • Facility-based (institutional)
  • Nursing homes
  • Assisted-living facilities

8
Family Caregiving
9
Extent of Informal Family Caregiving
  • Informal family caregivers are the most important
    source of unpaid LTC.
  • An estimated 1 in 6 adults provide unpaid LTC to
    older adult relatives (or friends).
  • It is estimated there were 54.6 to 68.6 million
    caregivers providing care to predominantly older
    adult family members in 2009.

10
Nature of Family Caregiving
  • Family caregivers predominantly provide
    assistance with ADLs and IADLs.

11
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12
Characteristics of Family Caregivers
  • The typical caregiver is
  • a woman
  • age 49
  • employed outside
  • the home
  • providing care to
  • widowed mother

13
From 2012 Alzheimers Disease Facts and Figures
14
Burden of Family Caregiving
  • According to a 2009 national survey
  • over 50 of caregivers reported a medium to
    high level of burden

15
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16
Family Caregiving Health Psychosocial
Consequences
  • Caregiving more likely to have poor physical and
    mental health than non-caregivers.
  • Caregiving may adversely affect family
    relationship and lead to social isolation.

17
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18
Family Caregiving Economic Consequences
  • Caregiving often has negative impact on
    employment status of caregiver, leading to lost
    earnings and diminished social security and
    pension benefits and retirement savings.
  • Caregivers often incur out of pocket expenses in
    connection with caregiving.

19
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20
Family Caregiving Economic Value
  • Estimates of economic value of unpaid family
    caregiving in 2009 range from 199 billion to
    450 billion.

21
Formal Paid Caregiving
22
Cost of LTC Provision By Paid Formal Caregivers
  • In 2011, the Medicare annual rate was
  • 77,745 for private nursing home room
  • 70,445 for semi-private nursing home room
  • 39, 135 for assisted-living facility
  • 43,472 for home health aide services
  • 41,184 for homemaker services

23
Sources of LTC Financing
  • Federal/State Medicaid program
  • Federal Medicare program
  • Out of pocket expenditures by care recipient
  • LTC insurance

24
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25
Medicaid LTC Expenditures
  • Federal/State Medicaid is single largest source
    of funding for formal paid LTC, accounting for
    40 of all LTC expenditures.
  • LTC is a major component of overall Medicaid
    spending
  • Medicaid spending is growing at annual rates
    exceeding state revenues and national economic
    growth.

26
Rationale for Proposal
Public policy and law should recognize and
support contribution that families make to
meeting growing need for LTC. Without unpaid
family caregiving, already strained state and
federal budgets would have to increase enormously
to cover costs of LTC.
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