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44 Navy | Fall/Winter 2017 A dvances in science, better nutrition, and improvements in health care have allowed people to live to unprecedented ages. But this longevity has brought with it challenges for professional and family caregivers. Many Americans are providing care and support to someone with a physical, emotional or cognitive limitation. e proportion of the US population 65 years or older is expected to double by 2050, to more than 87 million. Older adults' needs for assistance in activi- ties of daily living will increase. Sadly, few Americans consider their need for Long- term Services and Supports (LTSS) when planning their financial future and discover later that the cost of long- term care can quickly exceed their retirement savings. Also, few American households have invested in long-term care and long-term care (LTC) insurance premiums have increased by 54 percent between 1995 and 2015. With the average annual cost of a private room in a nursing home now more than $100,000, long-term care for America's growing elderly population is a critically important issue for Congress to address in current health reform proposals. Many Americans don't realize that Medicare coverage of long-term care is extremely limited. Medicare only covers a short duration of medi- cally necessary home or nursing facility care following an episode of acute illness and it won't pay for ongoing nursing home care or home health aide services. Medicaid does pay for long-term care services in both the home and institutional settings for the low-in- come elderly and disabled. For Americans without long-term care plans and whose income exceeds Medicaid qualification, they may "spend down" into poverty and enter the Medicaid program. For many people, the alternative to "spending down" into poverty is to increase their reliance on family caregivers. Negative Impacts on Family Caregivers Over 17 million Americans currently provide long- term care assistance to an elderly or disabled family member. e cost of family care giving can be felt in areas, such as a reduction or loss of work productivity or increased risk of illness and injury. Research has shown that family care giving exacts a heavy emotional, physical and financial toll. Additionally, many care- givers are providing complex health care services with little or no formal training. ey oen learn by trial and error under stressful circumstances such as caring for a family member with a serious health condition. Also, almost half of all family caregivers are over age 50, making them more vulnerable to a decline in their own health, and one-third describe their own health as fair to poor. For these reasons, supporting family caregivers should be a priority for future healthcare reform. If you are currently a care- giver for someone, remember your health and well-being is vital to continuing to provide that care. e round-the-clock demands can negatively impact your health. You may find you don't have the time or energy to take care of your own health needs and this puts you at increased risk for chronic conditions. Caregivers experi- encing extreme stress may even age prematurely. New Responsibilities and Unfamiliar Tasks Some new responsibilities may include making deci- sions that have to do with end-of-life choices. It is important to discuss potential life-prolonging treat- ments. Advance directives are tools that enable people HEALTH TALK Long-term Care and Family Caregivers Over 17 million Americans currently provide long-term care assistance to an elderly or disabled family member. COURTESY OF KATHRYN SERBIN; ISTOCKPHOTO

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