Historically, the family tribe was everything. Family was your support network when times got bad – when food got scarce, when brigands were attacking your village, when there were children in need of adopting, when work needed many hands, when children needed caring for, when you were sick, and when you were old enough you couldn’t hunt or gather enough to put your equal percentage of food on the table.

As the human population grew, people were more likely to be away from their families and therefore from their support networks. Even a generation ago, parents of large families in the United States could reasonably expect that as they aged, their children and grandchildren would care for them.

However, with family sizes shrinking, women having been more likely to enter the workforce instead of remaining at home, and many careers becoming so specialized that they can only be pursued elsewhere in the country, that core dependency on the family is now a void that needs to be filled. Add to that that medical advances have extended life without doing nearly as much to extend health, and there’s a huge need for long term care.

With November being National Long Term Care Awareness month, some of my continuing education seminars recently have been on long term care. Factoids that were presented that are quite scary include:

• Being a long term care giver can take 10 years off your life.
• Caregivers face twice the rates of chronic and severe conditions as non-caregivers.
• Many women will face the last period of their life without a spouse. At age 85, 60% of men are married, vs only 17% of women are married.

Another perspective is to think about the Lake Wobegon effect. When surveyed, those rose colored glasses show people dramatically underestimate their own future need for long term care insurance, compared to the people they love.

• 33% believe they will need long term care themselves
• 40% believe their spouse will need long term care
• 50% believe their parents will need long term care

But obviously the self and spouse numbers should on average be the same if both halves of the same couples were surveyed, and someday we will be the parents. So don’t be tricked by those rose-colored glasses.

What about the cost of insuring against, or paying for, long term care?

• Women are costing ~40% more for long term care compared to men of the same age and health (likely because they have less caregiver options at home), which is being passed along to women in the form of higher premiums.
• An average year of long term care costs over $102k.

It’s true that the costs of long term care insurance have been going up, options for coverage have been going down, and many policies won’t cover inflation (which if you buy the policy at 60, and you need care from ages 60-95, is pretty serious erosion of buying power). In fact, there may not even be enough care options for everyone who needs it (until we start paying and treating caregivers better, which will of course cost more).

Obviously, long term care insurance isn’t a panacea. However, it’s the best bet we have available to us at this time. This is not a scenario where we should cut off our nose to spite our face.

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Addendum:

There might be a recent slight back-tracking on the trends of disconnected families. As grandparents are living healthily and two-parent working families are unable to afford the rising cost of quality daycare for their children (or maybe like in Olmsted County and the surrounding area, maybe there aren’t even openings in ANY daycare let alone a quality one, as my own family experienced in 2015), grandparents are beginning to re-establish their place in multi-generational relationships (if not households) in the US. Stack that with women leaving the workforce at a much higher rate than men during COVID19 (whether the original trigger was a higher likelihood of being in an affected industry, trying to keep loved ones out of the death traps that some have become with COVID19 running rampant in our communities, or trying to keep children going in their schooling), and there’s now more inter-generational connection. It remains to be seen if that’s a short term blip, or a meaningful long term trend. It’s not something I personally would want to be depending on right now, and one should remember the physical, emotional, and financial costs of long term care giving on your family members (likely daughters or granddaughters) that you’re consigning them to without any options in sight if you forgo deliberate long term care planning.