Aging-in-Place Wildly Popular, Home Health Aides Less So

The vast majority of Americans would prefer to receive senior care in a home setting, but that doesn’t mean they see professional home health aides as the ideal caregivers.

When asked where they would prefer to receive ongoing care should they need it, 77% of people said their own home, according to survey findings released Friday by The Associated Press and independent research organization NORC at the University of Chicago. A senior community was the runner-up preference, but was chosen by only 11% of respondents. The survey polled nearly 1,700 Americans aged 40 and older, and took place between Feb. 18 and April 9 of this year.

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Source: Long-Term Care in America: Expectations and Preferences for Care and Caregiving

Yet, of the many people who said they would prefer to receive at-home care, only 22% said a professional home health aide would be their first choice for caregiver. Instead, 70% said they would prefer for a family member to provide care. Men are more likely than women to want a spouse to provide care (51% to 33%), and women are more likely to prefer children as caregivers (14% to 25%).

This desire to rely on close family for care may be understandable, but it does not reflect what is currently occurring, given that 46% of those people currently receiving home-based care receive services from an aide. Family members provide care in 52% of these cases.

Furthermore, while it may sound appealing in theory, relying on a spouse for at-home care may not prove satisfactory.

“Those with experience caring for a spouse or partner were the least likely to say it was a positive life experience,” the authors of the 2016 report noted, citing findings from past years. “They were also the most likely to say the experience caused stress in the family, was a burden on personal finances, and weakened their personal relationship with the person for whom they cared.”

Financing Fallacies

U.S. adults still do not have a firm understanding of how long-term care in general and home health care in particular is financed in the United States, the survey findings show.

About one-third of respondents with a household income of $50,000 or more expect that Medicare will be a primary payor for services as they age. This finding reflects “common misperceptions” about financing, the report authors wrote. Among those polled for last year’s report, 36% said that Medicare would pay for ongoing care by a licensed home health aide, which is not true.

In fact, Medicaid is the nation’s largest payor for long-term care, but those funds only are available to those with low incomes or once an individual has significantly spent down his or her assets.

While they may not have a firm grasp on how senior care is paid for, people are increasingly confident that they will be able to finance the care they need. In this year’s survey, 36% of people said they feel confident in their financial preparedness for long-term care, compared with 27% in 2013, the survey’s first year. This may be due to improving economic conditions.

People also widely support government programs that would help address costs of care, with 72% expressing support for state programs that would furnish paid family leave for those taking time off from a job to provide care for an aging loved one. Furthermore, 53% of people said they would support a program similar to Medicare that would be specific for long-term care. However, this issue splits according to political affiliation, with 71% of Democrats, 36% of Republicans, and 44% of independents in favor.

The most widely popular financing proposal is for tax breaks to support the purchase of long-term care insurance.

Other notable findings from the survey include:

– 45% of respondents cited losing memory/mental abilities as a top concern of aging

– 43% cited losing independence and having to rely on others as a top concern

– One-third of respondents said they have no planning for their own long-term care needs

– 64% of those currently receiving long-term care who have two or more doctors say there is an individualized care plan in place

Read the complete report.

Written by Tim Mullaney

Photo Credit: “Home is Where the Heart Is,” by Rosan NepalCC BY-ND 2.0