Monday, April 21, 2014
Jennifer Agiesta and Lauran Neergaard / The Associated Press
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Andrea Vassel of Mary Washington Healthcare explains the benefits of an advance directive at Mary Washington Hospital in Fredericksburg, Va., as part of National Healthcare Decisions Day on April 16.
AP / Mary Washington Healthcare
Despite the "it won't happen to me" reaction, the AP-NORC Center poll found half of those surveyed think just about everyone will need some assistance at some point. There are widespread misperceptions about how much care costs and who will pay for it. Nearly 60 percent of those surveyed underestimated the cost of a nursing home, which averages more than $6,700 a month.
Medicare doesn't pay for the most common types of long-term care. Yet 37 percent of those surveyed mistakenly think it will pay for a nursing home and even more expect it to cover a home health aide when that's only approved under certain conditions.
The harsh reality: Medicaid, the federal-state program for the poor, is the main payer of long-term care in the U.S., and to qualify seniors must have spent most of their savings and assets. But fewer than half of those polled think they'll ever need Medicaid — even though only a third are setting aside money for later care, and just 27 percent are confident they'll have the financial resources they'll need.
In Cottage Grove, Ore., Police Chief Mike Grover, 64, says his retirement plan means he could afford a nursing home. And like 47 percent of those polled, he's created an advance directive, a legal document outlining what medical care he'd want if he couldn't communicate.
Otherwise, Grover said he hasn't thought much about his future care needs. He knows caregiving is difficult, as he and his brother are caring for their 85-year-old mother.
Still, "until I cross that bridge, I don't know what I would do. I hope that my kids and wife will pick the right thing," he said. "It depends on my physical condition, because I do not want to be a burden to my children."
The AP-NORC Center poll found widespread support for tax breaks to encourage saving for long-term care, and about half favor the government establishing a voluntary long-term care insurance program. An Obama administration attempt to create such a program ended in 2011 because it was too costly.
The older they get, the more preparations people take. Just 8 percent of 40- to 54-year-olds have done much planning for long-term care, compared with 30 percent of those 65 or older, the poll found.
Mary Pastrano, 74, of Port Orchard, Wash., has planned extensively for her future health care. She has lupus, heart problems and other conditions, and now uses a wheelchair. She also remembers her family's financial struggles after her own father died when she was a child.
"I don't want people to stand around and wring their hands and wonder, 'What would Mom think was the best?'" said Pastrano, who has discussed her insurance policies, living will and care preferences with her husband and children.
Still, Pastrano wishes she and her husband had started saving earlier, during their working years.
"You never know how soon you're going to be down," she said. "That's what older people have a problem understanding: You can be in your 60s and then next flat on your back. You think you're invincible, until you can't walk."
The AP-NORC Center for Public Affairs Research survey was conducted Feb. 21 through March 27, with funding from the SCAN Foundation. The SCAN Foundation is an independent, nonprofit organization that supports research and other initiatives on aging and health care. The nationally representative poll involved landline and cellphone interviews with 1,019 Americans age 40 or older. It has a margin of sampling error of plus or minus 4.1 percentage points.Associated Press writer Stacy A. Anderson and News Survey Specialist Dennis Junius contributed to this report.