Making Holiday Small Talk About Big LTC Decisions

By Steve Sperka

With the holiday season upon us, it’s likely that many of us will spend an extended amount of time with family. This can sometimes lead to families coming to terms with the uncomfortable reality of a loved one in decline who is not receiving the help they need. Despite these understandings, the topic of long-term care remains stubbornly taboo.

What’s Important About Long-Term Care Discussions?

In 2017, PBS noted that 85% of long-term care decisions were made in the middle of a medical emergency. The Mayo Clinic echoed that finding last year, calling out the growing need for early planning with respect to long-term care.

According to The Conversation Project’s 2018 survey, 92% of Americans want to have a conversation with aging family members about end-of-life planning. However, due to the uncomfortable nature of this topic, only 32% of Americans ever actually have that conversation.

Current health care trends can make the need for conversations around long-term care all the more salient. The pandemic has exposed many cracks in the eldercare system, with projections raising questions about the future of care. The cost of personal protective equipment, current labor shortages within the health care and eldercare industries, and the need to increase wages for care providers will all play a role to make the future of long-term care more costly overall than it is today.

According to AARP, by 2050 there will be fewer than three caregivers for every person in need. This is down from seven caregivers per recipient in 2010. Furthermore, the Centers for Medicare & Medicaid Services predicts that by 2027, home health care spending will have increased 83% over 2018 levels.

The challenges surrounding long-term care are not the only reason for these discussions, however, as new technologies provide options that warrant a conversation. The introduction of specialized artificial intelligence, for example, can allow families to monitor the health of their loved ones in minute detail. Beyond that, the University of Minnesota has recently piloted a caregiving robot meant to supplement the care provided by its human counterparts.

Although these technologies can enhance our ability to address long-term care needs in the future, their effectiveness hinges on discussions of how to use them today.

What Can Financial Advisors Do To Get The Conversation Started?

There’s no universal reason as to why families tend to avoid the topic of long-term care; however, The Conversation Project survey reported that a majority (53%) of people would be relieved to have someone else begin the planning conversation. This implies that the barriers to starting these conversations may not be too difficult to overcome.

Financial advisors have an important opportunity to begin these conversations with their clients. When doing so, here are three key guidelines to keep in mind.

Do your research and explore the options. “Research” in this context essentially means that you understand your client’s and the options available in the market.

There are two questions your clients should answer:

1) If you need extended care someday, where would you want to receive it?

2.) Who would provide that care?

On the second point, whether someone decides they would prefer to age at home with their family or they would rather join some type of care community, it’s critical that you as their financial advisor understand the current cost and availability of care, as well as the applicable technologies for their preferred setting. This will enable you to guide the scope of these conversations for your clients.

Make it clear that long-term care is a family affair. There is a perception that long-term care is synonymous with nursing homes. That misconception can often lead to a squeamishness that prevents families from having these beneficial conversations. The reality is that most caregiving is done at home by family members instead of in an institutional setting by professionals. As of 2020, 19.2% of Americans were caregivers for at least one adult, according to AARP.

For many, the understanding that their care will be provided and paid for by their family is crucial in helping them see the urgency in these discussions.

Emphasize the need for a plan. Although many clients may feel confident that they will never need long-term care, the odds are against that. It’s important that clients understand the risks of not planning outweigh the benefits of having a plan they may never need to use.

Even if their wishes are to age safely at home with their family, establishing a clear understanding of what that process would look like and which family members will be providing care is better than trying to establish those parameters from scratch during an emergency.

Throughout life, it’s inevitable that we’ll encounter conversations that are simply uncomfortable. Whether they’re about the birds and the bees, or the dangers of drugs, discussions about long-term care certainly fall into this category. Yet just like those conversations, having this uncomfortable discussion ultimately makes us stronger and more prepared for what’s ahead.

Steve Sperka is vice president of health insurance products, Thrivent. He may be contacted at steve.sperka@innfeedback.com.