What You Should Know About The Government’s New Nursing Home Rules

For the first time in 25 years the federal government has completed a comprehensive revision of the way it regulates nursing homes, where 1 million older adults and younger people with disabilities reside.

The new regulations—all 700 pages worth—govern everything from staffing and dispute resolution to enhancing the role of residents and families in designing care. They’ll take effect in stages over the next three years. And not surprisingly, both consumer groups and industry officials have already begun raising objections to some of the new rules.

How Can You Help Older Adults Age At Home? Ask What They Need, Then Help Them

Here’s an idea: If you want to know how to help frail older adults age at home, start by asking them what’s important. Then, provide the assistance they need to help them reach their goals. Their challenges, and the solutions to them, are usually pretty straightforward—a grab bar in the shower to prevent falls, good nutrition and medication management, or a bit of physical or occupational therapy to relearn how to safely perform daily tasks. Now, a new study shows that such a program can dramatically improve people’s ability to function at home at a relatively low cost.

Donald Trump’s Plan to Support Family Caregivers

Early in the presidential campaign, Hillary Clinton proposed a package of ideas aimed at helping adult children who care for aging parents and other relatives. Yesterday, Donald Trump embraced  a similar idea. Family caregiving, it seems, is going mainstream.

It is striking that both Clinton and Trump are talking about an issue that until now has flown far below the political radar.  Best I can tell, this is the first time any major party candidate for president, let alone both, has proposed ways to help caregivers.

Getting Real About An Alzheimer’s Cure

For decades, people have been hoping for the magic bullet that will prevent, cure, or even slow the progression of Alzheimer’s Disease or other dementias. Yet, despite small hints of progress– and billions of dollars in research–there is no drug, and no app or game, that can successfully treat these diseases.

This year, results of these efforts have been decidedly mixed. In the past month, the clinical trial of one highly-touted anti-Alzheimer’s drug failed, the Food & Drug Administration put research on two others on a fast-track review process, and the Federal Trade Commission prepared to send out company-funded rebates to customers who had been duped by a popular brain-training product aimed in part at slowing cognitive decline.

The Staggering Cost of Long-Term Care and Medical Care in Old Age

A typical 65-year-old couple will need to save nearly $400,000 to pay for out-of-pocket medical care and long-term care in old age, according to new estimates by the Fidelity Benefits Consulting. That is $60,000 more than a typical couple’s entire savings at retirement, including equity in their home.

Fidelity estimated an older couple will need to put away an average of $260,000 (in today’s dollars) for their out-of-pocket medical costs, even if they have Medicare. And they’d need to save an additional $130,000 to insure themselves against the need for long-term supports and services, in nursing homes or at home. It is important to think about the two costs together since we often think about only one or the other.

A Judge Orders Medicare To Clarify When It Will Pay For Rehab and Skilled Nursing

Imagine your mom has a stroke. Once she is stabilized, she is sent to a skilled nursing facility for rehab. Then she goes home and gets some home health care and additional physical therapy. Medicare may pay, but for how long?

For many years, that was decided by the “improvement standard.” In other words, as long as this care helped mom become more mobile or improve her speech, Medicare would pay at least some of the cost (up to a maximum of 100 days per spell of illness).  But once she stopped getting better, Medicare would stop paying.

Who Owns Long-Term Care Insurance?

About 7.2 million Americans currently own traditional long-term care insurance policies, a number that’s held steady for the last seven years. But who are they? And what does it say about the future of long-term care insurance?

Overall, the share of older adults who own long-term care insurance (LTCi) has barely changed since 2002, according to new research by my Urban Institute colleague Rich Johnson. In 2002, about 10 percent of those 65 and older had coverage. By 2008 that share had ticked up to 12 percent, but in 2014, it dropped back to 11 percent. Among those aged 55-60, the share of policyholders slipped from 7 percent in 2002 and 2008 to just 5 percent in 2014.

Another Big Long-Term Care Insurance Premium Hike

Last week, the federal government announced that premiums for nearly all of its existing long-term care insurance policies will increase—by an average of 83 percent. In other words, they will almost double for federal employees and retirees.

What does such a price hike on current policies mean for consumers, and for the future of long-term care insurance?

First, a bit of background. The federal program, which insures about 274,000 current and retired workers, is operated under contract with a private insurer, John Hancock Life and Health Insurance Co. With the current seven-year agreement about to expire, the government put it out for bid. However, only Hancock wanted the job–which requires it to sell new policies and pay claims on existing policies, including those sold before it first got the contract in 2009.

Democratic and Republican Platforms Back Home-Based Care For Older Adults

For the first time, both major political parties have explicitly recognized in their platforms the need for community-based long-term care. While the Democratic and Republican platforms included few specific recommendations, the fact that they acknowledged the importance of personal assistance and social supports for older adults (and in the Democrats’ case, for younger people with disabilities) is a significant step towards future policy change.

The Democratic platform is far more expansive, addressing the importance of strong home-based services and supports for both paid aides and family caregivers. It also calls for expanded family leave, which could help some working people caring for parents or spouses. Here are the two key sections from the Democratic platform.

Doctors Die Like The Rest of Us

In recent years, it has become conventional wisdom that physicians avoid the end-of-life mistakes that many of the rest of us make.  The story: They die at home rather than in hospital intensive care units. And they rely on comfort care such as hospice or palliative care rather than often-futile high tech medicine.

That conventional wisdom, it turns out, is a myth—at least according to a new study by Daniel Matlock and colleagues published in the Journal of the American Geriatrics Society.  Docs, despite their better understanding of the nature of terminal illness, their knowledge of the limitations of medical treatment at the end of life, and even their ability to talk as peers to their own physicians, die pretty much like the rest of us.