Placement of Family Members in Long-Term Care Settings
Grace Messerschmidt
HCA 333
Elaine Testerman 08 JUN 15

Placement of Family Members in Long-Term Care Settings
At some point in our lives, we have to think about placing a family member into a long-term care setting. Many of us not want to place loved ones into these settings, but we know it is best for everyone involved. This paper is going to discuss what long-term care and how many people end up in these facilities. It will examine the costs of long-term installations, what to look at when placing a member, and who is affected by this placement. Lastly, it will consider the impact of not being able to place a loved one in a facility.
Long-term care is when a person requires someone to aid them physically or emotionally over an extended period of time. This help could be walking, dressing, medications, or providing meals (NCPC, 2014). There are approximately 8,357,100 people who receive support from five primary long-term care services. The services are home health agencies, nursing homes, hospices, residential care communities, and adult day service centers. In 2000, there were 13 million people using these services and by 2050 this number will most likely double to 27 million people because there are older people living longer.
Many families try to have their loved ones live at home, but this takes a toll on the family and the ones needing the help. There are informal caregivers and family caregivers, and formal caregivers. Informal and family caregivers are unpaid and are family members, partners, friends, and neighbors. Formal caregivers are volunteers or paid providers connected with a service system. “Over a caregiver’s lifetime, they will lose income and benefits totaling an estimated range of $283,716 for men to $324,044 for women, or an average of $303,880” (Family Caregiver Alliance, 2015).
Long-term care is very expensive, and the costs are continuing to rise. The average yearly cost of a private room in a nursing home is $90,520. Medicare’s purpose is to provide healthcare coverage to the elderly (65 or older), permanently disabled, and those who have a kidney disease. There are four main parts to Medicare and they are Part A, Part B, Part C, and Part D. Part A provides hospital insurance and some sections of long-term care, Part B provides supplementary medical insurance that covers physician care, Part C is the so-called Medicare Advantage plan that deals with managed care organizations, and lastly, Part D which covers medications. Medicare will provide coverage for skilled nursing facilities but are limited to 100 days per benefits period. The patient has to pay a portion of the cost from day 21 to day 100. Medicare does not cover assisted living or adult day care facilities (Pratt, 2010)
Medicaid provides health care for the poor and has no age limit, so it covers people of all ages. It does have some income limitations, and it is funded and operated by the federal government. Medicaid covers more services than Medicare does to its receivers. According to the Kaiser Family Foundation (2008), Medicaid spending for home and community-based care has increased from $22 billion in 2000 to $45 billion in 2006.
Medicaid pays for 40 percent, and Medicare pays for 23 percent of post-acute care. Unfortunately, the rest of the cost comes from out-of-pocket spending (The Heritage Foundation, 2013). In 2012, the total spending (public, out-of-pocket and other private expenditures) for long-term care was an estimated $219.9 billion for all United States personal health care spending. 16.4 billion Medicaid dollars were spent in 2002 for home and community-based services within long-term care (Family Caregiver Alliance, 2015).
Medicaid will cover both medical and non-medical related long-term care, but one must have less than $2,000 in assets and income that is inadequate to pay the cost of care in order to qualify for Medicaid.