Even families that have planned for the needs of an older relative and set aside some money may be surprised to learn just how little their savings can actually buy.
The average cost of staying in a private nursing home is $30,000 to $40,000 a year, according to the National Council of Senior Citizens, while caring for someone at home--an Alzheimer's patient, for example--takes about $12,000 a year.
Private insurance policies are not only expensive, but they also vary greatly in the long-term health care coverage they provide.
Government subsidies are available but limited. Medicare covers the costs associated with recovering from short-term illness--but not nursing home care. Medicaid covers nursing home care, but only for people with extremely low incomes.
In some cases, experienced attorneys can save a family time and anguish by helping to negotiate the Medicaid system.
"One missed opportunity, one missed date, can make the difference between survival and impoverishment," said Peggy Denker, director of a.s.a.p., a grass-roots advocacy network run by Families USA, headquartered in Washington. Denker also contributed to the book "Health Care Choices for Today's Consumer."
There is help available, Denker said, if one only looks in the right places. Some organizations maintain libraries of equipment like wheelchairs and walkers. Private foundations sometimes offer grants. Neighbors, church members, hospitals and senior centers may also be aware of other sources of direct assistance.
"It's really very important that people not be too proud to talk about their situation but rather talk to as many people as they can," Denker said, "because you never know where you're going to unearth a vital resource or a good shoulder to cry on."
Health Insurance Counseling and Advocacy Program (HICAP)--A free service of the California Department of Aging. HICAP provides information and assistance to families with Medicare problems and other health insurance concerns. Counselors help applicants evaluate their health care and insurance needs, file for Medicare and other insurance, and plan for retirement and health and long-term care needs. For information, call the Los Angeles Center for Health Care Rights, (213) 383-4519 or (800) 824-0780.
Smart Law--A program of the Los Angeles County Bar Assn., (213) 243-1500
National Senior Citizens Law Center--For information about Medigap insurance and referrals to local legal services available to older people. 1815 H. St. N.W., Washington, D.C. 20006, (202) 887-5280.
National Academy of Elder Law Attorneys--655 N. Alvernon Way, Tucson, Ariz., 85711, (602) 881-4005. Call or write for a listing of attorneys specializing in issues of concern to older people.
National Council of Senior Citizens--1331 F St. N.W., Washington, D.C. 20004, (202) 347-8800. Call or write for general information on Social Security, Medicare, and other long-term care issues.
National Council on the Aging--409 3rd St. N.W., Washington, D.C. 20024, (202) 479-1200. For information on elder services, independent living and long-term care.
California Advocates for Nursing Care Reform--(415) 474-5171.