Will COVID Change Long-Term Care Planning?

Arguably the biggest story to develop as a result of the Coronavirus is what’s happened in nursing homes. COVID has exposed the vulnerability that seniors face, as well as how nursing homes deal with pandemics and other health crises.

Even before COVID, no one that I ever spoke with looked forward to one day entering a nursing home. When I spoke to clients about it, they insisted they would never, ever go. I still advised them to take measures to protect their estate just in case, and many clients [grudgingly] would set up Medicaid Trusts, take out long-term care insurance or look at other planning options.

For months, the headlines have been grim. Yesterday alone, the Wall Street Journal published an article entitled ‘Coronavirus Deaths in U.S. Nursing, Long-Term Care Facilities Top 50,000.’ That means over 40% of deaths due to Coronavirus were in nursing homes, and as the article states, the true death toll may be higher.

The headlines could not be worse for nursing homes—from families banned from seeing loved ones, to the death count, to understaffed and under-resourced facilities, an already unpopular system is now in crisis with no sign of abating.

What if you, or a loved one needs some sort of assistance in the future? What if doctors and caregivers all say that only a nursing home can provide the level of care you or a loved one needs? Alzheimer’s, frequent falls and old age are most typically the reasons for entering a nursing home.

Many folks have looked to continuing care facilities (CCRCs) that offer independent living and nursing home care when needed. However, CCRCs have not been immune to COVID. Residents are over 65 and may not be in the best health. CCRCs were attractive because of the community and activities offered–that surely came to a screeching halt. Also, CCRCs are expensive.

More and more of us are finding alternatives at home, but that has limitations. Staying in a home with steps or other physical limitations can be problematic. However, as technology has improved, home health care options have expanded. But if you need round-the-clock care at home and the caregiver gets paid $25 per hour, that is $219,000 per year. 

Conversely, a nursing home today costs $100,000 to $125,000 per year. Depending on the specific health condition, you still might be advised that a nursing home is the best option. But I know that many families will object to their loved ones going into a nursing home during the pandemic, unless there is no alternative. 

COVID has forced great change in our society in record time. We have seen the wonders and limits of technology. More people can work from home, more operations are contact-free, and vaccine development is apparently moving forward at record pace. I am sure that we will see long-term care facilities and options change too. New safety measures and protocols will be developed, and residents and their families will demand change from the nursing homes and the government. Consider that just over 100 years ago, nursing homes hardly existed. Instead, we had almshouses, which housed the elderly, mentally ill and orphans. From a quick read of history, these were even more unpopular than nursing homes. We will continue to watch for how the system evolves.