Some 90 million Americans are living with serious illness and this number is expected to more than double over the next 25 years as baby boomers get older, says the Center to Advance Palliative Care. Many of these boomers have little or no savings and are caretakers themselves.
“When it’s dementia, caregivers themselves often fall ill from giving care so finding and keeping the best long term care insurance policy is important,” said Bill Novelli, co-chair of the board of directors of the Coalition to Transform Advanced Care (C-TAC) and former CEO of AARP. “Boomers must ensure long-term care support even if it means becoming destitute in order to get care through Medicaid.”
Advisors who want to help can do so by encouraging their caregiver clients to work longer before retiring, to save for their own retirement while caring for an ill family member and to refrain from drawing down too early on employer pensions and other benefits.
“CTAC has worked with financial advisor organizations to promote advance directives, since people need more than a financial power of attorney but also need to think about the kind of medical care they’d want if they can’t speak for themselves,” said Marian Grant, C-TAC senior regulatory advisor and practicing palliative care nurse practitioner in Baltimore.
Respecting Choices, an affiliate of C-TAC, helps train lay people and clinicians to have these conversations.
“We also support professional efforts to include cost information when people actually make treatment decisions and not afterwards when the bills arrive and these efforts haven’t been organized,” Grant told Financial Advisor.
Other avenues of assistance advisors can recommend to their caregiver clients include faith-based organizations like the Jewish Community Center, the Catholic Church and the Methodist Church, which are reaching out to the community with options like senior living centers and adult day care. “These are partly paid for by the church and partly with private funding,” said Novelli. “But it's pretty ad hoc.”
Advanced illness care is an issue whose time has come because the population is aging rapidly. By 2040, 82.3 million Americans will be over 65, twice as many as in 2000, according to the U.S. Department of Health and Human Services (HHS).
However, according to C-TAC, there are no institutional policy or national solutions in the pipeline that would transform the advanced illness care problem, which includes a lack of financial support for family caregivers and payment reimbursement by Medicare to palliative social workers and spiritual guides.
“There have been people calling for HHS to legislate community programs that facilitate home-based care and more care in people’s communities and others calling for better coordination between federal agencies like HHS, Medicare with Medicaid at the state level,” said Novelli.