Retirement News : Seniors : Kaskie: Long-term care demands some real choices

Kaskie: Long-term care demands some real choices

Date Added: 21-03-2005

The state faces several challenges as baby boomers grow older, and people over 65 will constitute nearly one out of every four citizens. One challenge is to provide real choices for long-term care services. Some Iowans will want services delivered to their homes, such as meals. Others will need community-based programs; one example is respite care for Alzheimer's patients. Another group will prefer to move into an assisted-living or a nursing facility.

Analyses conducted through the University of Iowa's College of Public Health show a lack of real and affordable long-term care options for older Iowans.

Leaving the long-term care system the way it is may bring a calamity. State officials must present good choices. Fortunately, a consensus has emerged.

In August 2004, representatives from the governor's office, both legislative chambers and political parties, the heads of four state departments, the Iowa Association of Area Agencies on Aging and Iowa AARP resolved that the development of a long-term care assessment and counseling program constitutes the strongest first step that can be taken to improve the state's long-term care system.

Then, in November 2004, at the Department of Elder Affairs' Annual Town Hall Meeting, more than 200 older Iowans and long-term care providers selected the long-term care assessment and counseling program as their No. 1 policy priority.

Finally, in December 2004, the Medical Assistance Crisis Intervention Team, which consisted of leaders from the Iowa Health Care Association, the Iowa Hospital Association, the Iowa Medical Society and the Iowa Association of Community Providers, identified the development of a long-term care assessment and counseling program as a priority.

In keeping with this direction, all older Iowans should be offered a free assessment of their care needs from a qualified, independent clinician. Based on the results, they should be offered a free professional consultation about the types of services that are most readily available locally.

The current lack of balance in long-term care options is most obvious in spending patterns. State Medicaid reimbursements for nursing-facility care surpassed $400 million in fiscal year 2003 while allocations for home- and community-based long-term care were less than $100 million. Older Iowans who needed long-term care but were not enrolled in Medicaid were more likely to pay for nursing-facility care themselves than older adults in other states where Medicare and Medicaid pay for the majority of such care.

There are at least two obstacles that keep older Iowans from using a greater variety of long-term care services.

• First, while most older Iowans prefer to live at home as long as possible, many do not do formal planning to make this happen. They put off the decision and end up purchasing what is marketed to them as the easiest, safest and most readily available options: continuing care, assisted-living and nursing-facility care.

• Second, when the time comes to use long-term care, many Iowans do not receive standard clinical needs assessment or independent, professional counseling that informs them about different services that can meet their needs. All too often, older adults make decisions without reliable information.

The citizens of Iowa, particularly older adults and the baby boomers who follow, demand real options to purchase long-term care in a variety of affordable and convenient locations. Establishing a standard clinical assessment and long-term care service counseling program is taking a strong first step towards meeting this public demand.

For More Information: http://desmoinesregister.com/apps/pbcs.dll/article?AID=/20050318/OPINION01/503180360/1035/OPINION