Hanging in the Balance: The High Cost of Long-Term Services and Supports

Hanging in the Balance: The High Cost of Long-Term Services and Supports

I recently had the opportunity to participate on a panel sponsored by Genworth that turned out to be a truly candid and oftentimes personal discussion on an emerging crisis. The topic: “Solving America’s Long-Term Care Crisis: What We Can Do Now to Fix the $750 Billion Program.”

In what way was the panel candid and personal? Much of it had to do with cost. Every day across the United States, millions of families sit at kitchen tables grappling with the uncertainty of how they will pay for the long-term care needs of aging parents or loved ones with disabilities. Such care includes help with basic life functions like eating, toileting, bathing, and dressing.

For many of these families, anxiety levels, confusion, and frustration all skyrocket when they learn of a certain reality: neither their health insurance nor Medicare pays for these vitally important supportive services. Ultimately, many people deplete their life savings and turn to Medicaid for assistance as their ability to care for themselves declines.

However, this issue does not only impact individuals with limited to no income. The latest edition of the AARP Scorecard, which examines performance of long-term services and supports (LTSS) by state, found that the cost of LTSS is much higher than what even middle-income families can afford.  In fact, the typical price of a year of nursing home care was twice as much as the typical household income among people age 65 and older in every state. It’s time to face and understand these trends—and tackle them head-on.

Costs Trending Upward

Unfortunately, LTSS cost increases are not slowing down. A just-released Genworth report  finds that the typical annual cost for a private room in a nursing facility will cost you about $100,000 a year, or $8,121 a month. That’s right—nearly $100,000 for one year only.

The numbers don’t get better from there. The base price (national average) for assisted living comes to $3,750 per month or roughly $45,500 a year. However, for any additional care needed, the cost would be much higher.  And while home care is generally less expensive than nursing home care, it can still take a big toll on household finances. For 44 hours a week of support from a home care aide—which does have the added benefit of helping people remain in their homes and communities—the annual cost adds up to $49,192.

When you dig deeper into these national average (as averages can blur the picture), it becomes all the more eye opening. The data underscore that where you live really does matter; that is, there is great variation across the states. In some states, the cost may be up to 20 percent higher than the national average.

Here’s a look at some of the states where the cost for LTSS hits residents the hardest:

Nursing Home Care Private Room (14 states)

State Median Annual Cost
Alaska $292,000
Connecticut $162,060
Hawaii $158,593
Massachusetts $149,650
New York $140,416
Delaware $131,948
North Dakota $130,367
New Jersey $129,575
District of Columbia $126,838
New Hampshire $126,838
West Virginia $122,823
Pennsylvania $120,085
Maryland $118,990
Maine $117,165
United States $97,455


Home Health Aide (8 states)

State  Median Annual Cost
North Dakota $63,972
Alaska $63,492
Minnesota $61,776
Wyoming $61,776
Washington $60,632
New Hampshire $60,357
Hawaii $59,488
Massachusetts $59,488
United States $49,192


Confluence of Factors Forms Crisis

We are facing a growing crisis on multiple fronts. As the population ages, the demand and cost of LTSS will rise rapidly. Consequently, few people can accumulate sufficient savings, even over a lifetime, to cover the cost of LTSS. Moreover, according to the Federal Reserve, nearly half (48%) of all families have no retirement savings. Among people 75 and older who had retirement accounts in 2016, the typical amount was $120,000. A mere year’s worth of nursing home care would consume all of that.

And we’ve not even begun to talk about family caregivers’ costs. They spend nearly $7,000 on average on out of pocket expenses such as personal care services, transportation and home modifications. However, family caregivers who are caring for someone long-distance can incur even higher cost—roughly $12,000 in out of pocket costs.

If these issues go unaddressed, the number of people facing dire financial and long-term care situations will only multiply in the coming years, as costs rise and the population ages. So going forward, we must take a hint from the Genworth panel: We must speak candidly about the challenges because this is personal, and we must move fast. We must pick up the pace in sparking innovative solutions that allows individuals to live independently and to exercise control over their own care arrangements while protecting them and their families from financial catastrophe.

In order to achieve this vision, we will need a multifaceted approach that blends individual and social responsibility as well as greater collaboration between public and private sectors to stimulate a range of affordable, suitable and practical financing options.

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Jeanette Arakawa’s ‘The Little Exile’ tells the story of Japanese American incarceration

Jeanette Arakawa’s ‘The Little Exile’ tells the story of Japanese American incarceration

The historical story of the Japanese American incarceration during World War II is still not well-known in mainstream American culture and literature. When it comes to books, there are only a handful that are based on JAs’ wartime experience. The 1994 novel Snow Falling on Cedars is the most familiar to non-JA audiences (in large part because of the 1999 Oscar-nominated Hollywood film version).

Now, we can add to this short list The Little Exile by Jeanette Arakawa, a first-time author who couches her memoir in a fictionalized novel.

The fiction framing serves the story well, and gives Arakawa the creative freedom of shaping the narrative and dialogue for a sweeping, epic look at her family’s history that starts in pre-war San Francisco and ends as her family returns to the Bay Area after the war, upon leaving the Rohwer concentration camp in Arkansas. Yet, that history is told in exquisite vignettes, as if she’s savoring one memory at a time, turning them over like a Rubik’s Cube in her mind and then lining up the colors before moving on to the next memory.

That may be because Arakawa, who was a child when she and her family were incarcerated, didn’t start out planning to write a book about her experience.

She had been writing, but not fiction. “I was pretty good with grammar and I could write essays. I never wrote for pleasure, so to speak.”

Her introduction to writing about being Japanese American came for a contest. “(The) Hokubei Mainichi (newspaper) had a essay contest. I saw a car that had no license plate but said ‘Pearl Harbor survivor,’ and I had a reaction and ducked under the dashboard.” So she explored her feelings about Dec. 7, 1941.

“I wrote this thing and called it ‘Pearl Harbor Survivor’ and in the process of writing it I added the background of the camp experience. That was like the first time something I wrote was published. I think I won second place or something.”

After her husband retired, the couple began traveling. “I started writing stories about our trips. I would pass them out to my friends. So I thought I would polish up my writing skills.”

She lives near Stanford so she signed up for a continuing ed program for writing skills. “The instructor wanted us to write something about an unusual life experience. I wrote something about camps.”

“The instructor asked, ‘did this really happen?’”

The writing teacher’s parents were professors, and he had gone to school in Little Rock, Arkansas, the state where Arakawa’s family was imprisoned during WWII. But this was the first time he had heard about camps. “He got so upset and said ‘you have to write this in a book,’” he counseled. “That was like 15 years ago.”

“I never faced discrimination in the neighborhood of recent immigrants where I was born. Further, by birthright, I have always thought of myself an American, just like most of my friends who were also born of immigrant parents. (This was demonstrated when I tried to correct my taunters in my new neighborhood. (Page 40 in the book.) I didn’t feel I wasn’t American, I felt that others didn’t regard me as such.

“That started with our move out of our immigrant neighborhood and reinforced by the treatment we received during the war. I believe my work with textbooks was fueled by my strong sense of identity, although severely challenged by internment, to ultimately prevail as an adult.”

Arakawa recounts the years in concentration camps, but unlike other books about the JA experience, she continues the story into the year she spent in Denver, before her family decided to return to the West Coast.

“We stopped in St. Louis on the way to Denver,” Arakawa says. “It was a shock to no longer see nothing but Asian faces. It was like we had come to a foreign country or something.”

As an adult, she became part of the Bay Area’s JA community, and was asked to speak to schools about her experiences.

In the late ’60s and ’70s she was elected to the position of Palo Alto PTA Council Human Relations Chair, and organized a task force for evaluating textbooks for a diverse perspective. She co-authored a handbook on evaluating books for multicultural content.

“One of reasons we aren’t seen as Americans is because we don’t appear in textbooks,” she says. “Our committee went to Sacramento and we had this clause added to the education code that all books be evaluated for multicultural perspective.”

That perspective — being open to all people — drives the narrative of Little Exile.

And, makes it a terrific addition to the JA library.

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Congratulations to AARP’s 2017 AAPI Heroes!

Congratulations to AARP’s 2017 AAPI Heroes!

AARP is proud to announce the winners of its 2nd Asian American and Pacific Islander Community Hero Awards that were created to acknowledge the hard-working staff and volunteers of non-profit organizations serving AAPIs age 50-plus.

We received 61 nominations from around the country including Arizona, California, Colorado, Florida, Georgia, Hawaii, Illinois, New Jersey, New York, Pennsylvania, Texas, Washington, and Washington, DC.

The stellar submissions included executive directors, staff, and volunteers who work in healthcare, housing, social services, education, and media. Ten finalists were selected by AARP; the winners were chosen by AARP AAPI Facebook visitors.

These three AARP Asian American and Pacific Islander Community Hero Award winners and their organizations will each receive a $1,000 cash prize:

Dilafroz Nargis Ahmed
Desi Senior Center Director
India Home
Glen Oaks, N.Y.

Dilafroz Nargis Ahmed has helped new immigrants in the Bangladeshi community in Queens, New York for three decades. At Desi senior center India Home, Ahmed works to improve the quality of life of vulnerable South Asian seniors in a culturally appropriate environment. Since 2014, Ahmed has strived to make India Home a comfortable place for immigrant seniors to come together, adjust to living in a new country, and build community. Ahmed also helps Bangladeshi older adults access services and find jobs.

(Photo by Jacques-Jean Tiziou/www.jjtiziou.net)

Shongchai Hang
Outreach Worker
South East Asian Mutual Assistance Associations Coalition

Shongchai Hang has been dedicated to serving Southeast Asian refugee and immigrant elders for more than 30 years. For the past 11 years, Hang has worked as SEAMAAC’s Lao Outreach Worker to help diverse low-income communities in Philadelphia. At weekly Elders Gatherings, he plays an integral role in building bridges between elders from diverse communities. He helps community members to see their own leadership potential, by recruiting and supporting Lao elders to serve on SEAMAAC’s Elders Council. Hang also helps seniors apply for social services and navigate the health care system. Hang’s ability to speak Lao, Hmong, Thai, and English allows him to serve a diverse groups of seniors.

Linda Mayo
Founder and President Emeritus
Pan-American Concerned Citizens Action League (PACCAL)
Jersey City, N.J.

Linda Mayo has served the local Filipino & Asian American community for more than 30 years. In 1992, Mayo found PACCAL, the first organization in Jersey City to address the health and human service needs of Filipinos and other Asians with a focus on senior citizen and veterans programs. It holds the distinction of being the only Asian Provider Agency recognized by the Hudson County Dept. of Health and Human Services (DHHS), Office on Aging. PACCAL is a multi-service organization that organizes social and recreational activities for seniors, assists seniors and veterans apply successfully for affordable housing, coordinates citizenship and voter registrations, helps victims of domestic violence, and holds education, art and cultural workshops.

“Congratulations to Dilafroz, Shongchai, Sharon, and Linda for their exemplary contributions and dedication to our seniors,” said Daphne Kwok, AARP Vice President of Multicultural Leadership, Asian American and Pacific Islander Audience Strategy. “They are unsung heroes who every day are improving the lives of seniors and their families. They devote their time, talents, and passion to making a difference not only to the elders and their families but to the greater community. AARP commends all of our 2017 Heroes and all of those who were nominated for inspiring each and every one of us.”

Congratulations once again to our 2017 AAPI Heroes, and to their organizations!

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Re-Think How You Search and Hire for a Job

Re-Think How You Search and Hire for a Job

Are you ready for a new job? Want to start a second career?  Or, perhaps get a part-time gig?  AARP’s Job Board may be the solution to that question. Earlier this year, AARP launched a tool that allows 50+ jobseekers to identify opportunities that fit their unique skills and experiences.   The Job Board leverages AARP’s Employer Pledge Program, which includes 380+ companies, and gives job seekers direct access to their career sites. Membership in this program is an outward expression of the employers’ commitment to hiring across the age spectrum and leveraging the value experienced workers bring to the workplace.

So, perhaps you are asking how this Job Board is different from the others. First, AARP knows the 50+ community. We understand the challenges experienced workers have finding employment that aligns with their years of knowledge and capabilities.  Plus, AARP knows there is a need to connect with employers that acknowledge the complexities of being a caregiver, raising children, and the need to stay relevant in the workplace – all critical and necessary to sustaining quality and valuable personnel.  As a result, AARP created a job tool that speaks to the wants of both the job seeker and the job recruiter.

For job seekers, the AARP Job Board is designed to help experienced workers re-think how they search for jobs.  It allows you to search with easy-to-use filters, narrows your search, and matches to employers looking for your experience. This enables you to search by what you desire-whether it’s where you work or how you’d desire to work – full-time or part-time.

For talent managers, the AARP Job Board helps employers re-think their hiring strategy.  They’ll find applicants with the competencies, experience, commitment and motivation needed to propel innovation in the workplace.  Research has shown that hiring workers 50+ brings value to their company.  For example, 50+ workers bring knowledge and wisdom, are highly engaged, have workplace longevity and they bring a degree of reliability and dependability to the workplace.

The AARP Job Board is a great answer for the 50+ job seeker. It offers just what the experienced worker has been seeking – access to employers looking for candidates just like you to fill jobs. To help you prepare, AARP has a host of innovative tools and resources at www.aarp.org/work that range from tips on writing your resume to how to search for a job online. And at  www.aarp.org/Academy there are featured videos on various aspects of your job search, from preparing for your next interview to creating your LinkedIn profile.

To learn more about the Employer Pledge Program or the Employer Resource Center, visit www.aarp.org/employers to access resources. To begin your job search now, visit www.aarp.org/jobs. And, if you want to directly connect with more than two dozen hiring employers, sign up for AARP’s upcoming Online Career Fair, scheduled for September 14, 2017, at www.aarp.org/OnlineCareerFair.

AARP helps people turn their goals and dreams into real possibilities, strengthens communities and fights for and equips Americans 50 and older to live their best lives. Discover all the ways AARP can help you, your family and your community at AARP.

Photo: AARP

Also of Interest

19 Ways to Prep for the Interview
5 Answers to Tough Job Interview Questions
7 Ways to Help Your Résumé Stand Out






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