Dennis Mahar Commentary: Long Term Care Not a Priority for Washingtonians


Our country’s senior population is expected to double in the next 25 years. The so-called “Age Wave,” the boom in the over-65 population, will lead to a dramatic increase in the number of adults needing long term care. Only one-third of seniors have planned for their long term care needs, yet this is a topic that does not rise to the top of the priority list for most of our state’s residents. In a 2014 poll by The Feldman Group, long-term care ranked seventh on the list of priorities for the state Legislature and the governor to address.

This is unacceptable — though sadly, not shocking. In my line of work, I often hear stories of people spending their life savings to take care of their husband or wife’s care. Or adult children taking on the emotionally, physically, and economically draining caregiving duties of their adult parents. These stories are hard to hear but all too common. 

Before this issue becomes a crisis, we must educate our community about the realities of long-term care so they can begin planning as well as let legislators know that coming up with solutions for long term care financing options is a priority.  

All too frequently, families are surprised that there is so little coverage or support when a loved one needs long-term care. They assume Medicare will be there to cover dad’s need for a little help at home — but Medicare won’t provide that coverage. They think Mom can move into a care facility and health insurance will pay the cost, but very few have insurance that pays for this type of care. 

A lifetime of savings goes quickly when paying for long term care. According to a recent survey by Genworth, a month in a nursing home can cost as much as $10,000 in our state. Assisted living private rates averaged $4,625 per month, and home care services rates were comparable. The average Washington citizen requires two years of support services, meaning families can face average costs of between $100,000 and $200,000 or more in long-term care costs for a parent or loved one, regardless of where that care is provided. 

Most families will attempt to provide the care and support themselves, but many family caregivers feel overwhelmed with this undertaking. Almost 60 percent of unpaid caregivers had cut their own discretionary spending to help loved ones cover the costs of long term care. According to the Beyond Dollars 2013 Report, 11 percent actually lose their jobs and another 10 percent report having to change careers — both due to the conflicting responsibilities with care.  And — the number of available caregivers is dwindling. The AARP Public Policy Care Institute projects the ratio of potential caregivers to people aged 80 and older will decline between 2010 and 2030. And while family caregivers try their best, the number of caregivers available in the future simply won’t be enough for the “Age Wave.” 

Long-term care insurance would be a solid option but it is inaccessible to most individuals over 65, and only 7 percent of Washingtonians have purchased the coverage. The high cost is exceptionally expensive, because most people do not think of buying the coverage until fairly late in life. 

So families must turn to Medicaid as a last resort after they try the options above. This federal-state partnership is the single largest payment source for long term care, whether provided in someone’s own home or at a care facility. Unfortunately, many individuals end up spending their life savings in order to qualify.   

Luckily, all is not lost. 

In 2015 our Legislature passed a bill commissioning a study to explore state supported options for long-term services and supports. The bill was endorsed by Washingtonians for a Responsible Future, a coalition of aging and disability advocates, long-term care providers, labor, and consumer rights organizations seeking to protect the financial health and well-being of individuals and families who need long-term care. 

The goal is to identify different options for helping families prepare for the high costs of long term care, whether it’s encouraging people to buy insurance, looking at private-public partnerships and finally, examining a public funding option.  

The study will be complete by December 2016, providing insight and recommendations to the legislature for action.  

I encourage you to let legislators know that long term care financing is a priority now and in to the future. Talk to your loved ones and make planning a goal in the New Year (not a resolution — most people don’t keep resolutions!) It is critical that this issue is addressed now if we are to protect quality of life and care for our families in the future.


Dennis Mahar is the executive director of the Lewis Mason Thurston Area Agency on Aging. He is also a member of Washingtonians for a Responsible Future, a coalition of aging and disability advocates, long term care providers, labor, and consumer rights organizations seeking to protect the financial health of individuals and families needing long term care.