Start Planning for Long Term Care

Who needs long term care?

Anyone at any age may need long term care

Long term care is not just for someone with a chronic illness or disability. A young person who leads an active life may sustain a serious injury that results in a temporary or permanent disability. Others may develop a chronic health condition that limits daily activity. This could happen at any age.

The likelihood of needing long term care increases as we get older. In fact, 70 percent of those who are older than 65 will need long term care at some point in their lives, and 60 percent of all long term care is provided to those who are 65 and older.

According to an HMSA Foundation study, Hawaii residents live longer compared to those in other states across the nation. We live longer than those in other places throughout the world. Women generally live about five years longer than men in Hawaii. But living longer means we may eventually need some type of long-term care. Women generally need long-term care longer than men, primarily because they live longer than men.


What is long term care?

Long term care includes services and supports to meet health or personal care needs over an extended period of time. This includes medical and non-medical care. Planning for long term care contributes to a better quality of life. It focuses on making sure those with an illness or disability can enjoy the best quality of life.

Long term care services include medical and non-medical care for people with a chronic illness or disability. Long term care helps meet health or personal needs. Most long term care services assist people with Activities of Daily Living, such as dressing, bathing, and using the bathroom. Long term care can be provided at home, in the community, or in a facility.

For Medicaid eligibility and payment, long term services are those provided to an individual who requires a level of care equivalent to that received in a nursing facility.

There is a difference between health care and long term care. Health care provides medical treatment for health conditions or illness. This is usually for a short period of time. Long term care provides help with daily activities over a longer period of time.


Can I prevent the need for long term care?

The best way to prevent or delay the need for long term care is to lead a healthy lifestyle now, know your family’s medical history, and reduce or manage the risk factors.

Your community may offer various health, prevention and wellness programs. To learn about these programs to promote a healthy lifestyle, contact your local Aging and Disability Resource Center at 643-ADRC(2772) or


How much long term care will I need?

Everyone’s long term care needs are different, and change over time. For some, assistance may be informal through the help of family members and friends. Others may need a higher level of care. Although long term care can be at home or in a facility, the majority of individuals prefer to age in place, in the comfort of their home.

On average, a person who is 65 today will need some type of long term care for three years, and some may require long term care for longer than five years.

How much care you will need depends on your personal and family’s health history, as well as a number of risk factors. Risk factors are conditions that increase your chance of developing a chronic disease. Your health risks increase when there is a combination of factors such as:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Overweight/obesity
  • Physical inactivity
  • Poor diet
  • Tobacco use
  • A combination of these factors


How can I start the conversation with my family members?

As you prepare your long term care plan, you’ll want to include your immediate family and relatives in the conversation since they are often identified as the long-term caregivers. An open conversation allows you to share your needs and expectations with family members. This allows long term care plans to accommodate you as the recipient, and future caregivers.

Talking about long term care can be difficult, especially if there are cultural taboos that prohibit us from mentioning any reference to long term care. Some may believe even talking about it is bad luck.

Important conversations are often the most difficult ones. Our comfort and quality of life, and the ability to exercise our independence and choices are important to all of us. Long term care starts with a conversation.

It doesn’t matter how old you are or what stage of life you are right now, talking about our future dreams and aspirations is a positive way to start the conversation. According to a Genworth study conducted in March 2015, 57% of consumers have not talked to anyone about the potential need for long-term care.

Here are some tips to having a constructive conversation about long term care, whether you will be receiving care or serving as a caregiver:

Talk story. Here in the islands, we enjoy talking story, sharing about our experiences and the experiences of others. We may all know someone who is receiving care or is a family caregiver. Talking about what’s good or bad about their situation can be a useful launching point.

You can also use a news article or other information about the costs of long term care and the value of planning. These can also prompt spontaneous conversations that reveal our family member’s preferences about long term care.

Be receptive, reflective and interested. When starting the conversation, reflect and show that you are truly interested. Begin with reminiscing about the past, share childhood memories, the old times, and find out what’s most important to each other. As you learn more about your family members, you’ll be able to better understand each other’s preferences for care or caregiving in the future.

Show you care. Be helpful. Older adults generally do not want to be a burden on others, and family members generally want to do their part to honor an elder’s plans. This helps to frame the conversation in a positive light, and may make everyone more receptive to being more candid for a more productive conversation.

Ask for advice. Some may be reluctant to share about their own plans when it comes to long term care, but may be willing to offer their advice. Listen carefully. You may learn some things you never knew about a family member that can be useful to help be prepared for long term care planning.

This is a great way to get the discussion rolling. Tell them that you’re starting a retirement account or preparing a will and ask for advice. Then ask how they planned ahead and if they feel fully prepared. The goal is to have long term care planning as a norm, just like setting up a college fund or discussing retirement.

Write your thoughts. If broaching the subject is difficult, consider writing down your thoughts and concerns. A letter or e-mail outlining your concerns you would like to cover may be helpful. This can be especially helpful if you have limited time. You can pave the way and get them to start thinking about it before you get together.


Nursing Home Care?

Groceries. Mortgage. Car Payments...and now budgeting for long term care. It’s not easy, but I know that I have to make long term care a priority.