Skip Navigation LinksHome > February 2010 - Volume 4 - Issue 1 > Long‐Term Care Options
HEART Insight:
doi: 10.1097/01.HEARTI.0000368506.55784.15
Features: Heart-To-Heart

Long‐Term Care Options

Meyeroff, Wendy

Free Access
Collapse Box


What You Need To Know — Before You Need To Know It

When it comes to long-term care, there's good news and bad news.

The good and bad news is that people who have serious chronic cardiovascular conditions, such as heart failure and stroke-related brain injury, are surviving and living for years.

Make no mistake: Those extra years of life are precious to a patient and his or her family. Our healthcare system is geared toward acute, not chronic, illness. But millions of Americans need ongoing long-term care (LTC) because they are now surviving into late age despite one or more serious illnesses.

Age is the major cause of cardiovascular disease. Deaths climb from 40 percent between ages 65 and 74 to 60 percent from age 75 on. Chronic heart disease and stroke now add some $448 billion to the nation's overall healthcare expenditures.

Patients with heart failure, for example, or other chronic, debilitating cardiovascular conditions, often need LTC — but there's a “Catch 22.”

“Many will be denied LTC insurance due to pre-existing conditions,” says Doug Pace, director of the Long-Term Care Solution Campaign for the American Association of Homes and Services for the Aging (AAHSA).

Acute conditions, such as stroke, heart attack and unstable angina, may also lead to the need for LTC after initial stabilization. Stroke is the leading cause of paralysis — accounting for 29 percent of all cases — and institutionalization, as up to 20 percent of stroke patients will need LTC within three months.

Most people are not prepared to cope with LTC needs. Many Americans don't even think of buying long-term care policies until their 70s or 80s, when they're already in a high-risk category and the cost is very high.

“That, of course, is the worst time to start planning,” says Chris Orestis, a principal with Life Care Funding Group in Lewiston, ME, a company that finances “life settlements” that can be used to pay for LTC. A life settlement allows you to trade in your life insurance policy for an amount that exceeds the policy's cash value.

“Most Americans don't know how long-term care is financed, and they're unprepared,” says Pace, noting the need for such care is going to grow exponentially as the Baby Boom generation starts celebrating 65th birthdays en masse, beginning in 2011.

“Even when people do think of funding LTC, many are relying on their home's equity. But if you need that money any time soon, you'll be disappointed,” says Orestis. That's putting it mildly: Pacific Investment Management Company (or PIMCO, the financial management arm of Pacific Life Insurance Co.) predicts that $1 trillion in home equity will evaporate before the housing market hits bottom in the U.S.

Economic uncertainty has only exacerbated the confusion and dread that already conspire to stymie the efforts of otherwise organized caregivers and family members to do the research and make the tough decisions. To get yourself in gear, check out the chart on the next page for basic information about LTC options, as well as resources you can consult for referrals and other assistance.

1. Adult Day Care (Social) Adult Day Care (Health)

Table. No caption av...
Image Tools
Table. No caption av...
Image Tools

2. Personal Care, Home Care or Personal Care Attendant (PCA)

3. Home Health Care

4. Assisted Living Facilities (ALF)

5. Adult Family Home (AFH) or Residential Care

6. Skilled Nursing or Nursing Home

7. Hospice

© 2010 American Heart Association, Inc.