Elder Planning Counselor Designation Program Desk Reference Module 2 – Social & Psychological Issues Contents at a Glance CHAPTER 1 – Long Term Care Issues .................................................. 13 1 - 1 KEY OBJECTIVE OF THIS CHAPTER ............................................ 13 1-1.1 How Will This Objective Be Achieved? ............................................. 13 1 - 2 INTRODUCTION ............................................................................... 14 1 - 3 ISSUES AND PROBLEMS ............................................................... 14 1-3.1 The "Silver Tsunami" ......................................................................... 14 1-3.2 Changing Family Structures .............................................................. 15 1-3.3 Institutional Care ............................................................................... 15 1-3.4 The Role Of Government .................................................................. 16 1 - 4 LONG TERM CARE DEFINED ......................................................... 16 1-4.1 Long Term Care - By The Numbers .................................................. 17 1-4.2 The Impact Of Family History ............................................................ 19 1 - 5 THE CONTINUING CARE CONTINUUM ......................................... 19 1-5.1 Problems With the Continuing Care Continuum ................................ 20 1-5.2 Costs ................................................................................................. 20 1-5.3 Capacity Issues ................................................................................. 21 1-5.4 Manpower Issues .............................................................................. 22 1 - 6 TYPES OF CARE ............................................................................. 23 1-6.1 Care Level Classifications ................................................................. 23 1-6.2 Trends/Changes In The Type Of Health Care Needed ..................... 24 1-6.3 Long Term Care "Timing" .................................................................. 25 1-6.4 Types Of LTC Services ..................................................................... 25 1-6.5 Service Providers .............................................................................. 27 1-6.6 The Role Of The Case Manager ....................................................... 28 1- 7 ACTIVITIES OF DAILY LIVING ......................................................... 29 1-7.1 Instrumental Activities of Daily Living (IADLs) ................................... 29 1 - 8 TYPES OF LONG TERM CARE....................................................... 31 1-8.1 Home Delivered Care........................................................................ 31 1-8.2 Community Delivered Care ............................................................... 32 1-8.3 Adult Day Care .................................................................................. 33 1-8.4 Chronic Care ..................................................................................... 33 1-8.5 Convalescent Care or Rehabilitative Care ........................................ 33 1-8.6 Hospital Care .................................................................................... 33 1 - 9 LONG TERM CARE CENTRES……………………………………......34 1-9.1 Common Names ............................................................................... 34 1-9.2 Target Audience/Residential Profile .................................................. 34 1-9.3 Services Available ............................................................................. 35 SPI 1 1-9.4 Housing Arrangements ..................................................................... 35 1-9.5 Payment Methods ............................................................................. 36 1-9.6 Subsidization ..................................................................................... 36 1 - 10 THE COST OF LONG TERM CARE .............................................. 37 1-10.1 Costs Over Time ............................................................................... 37 1-10.2 Three Long Term Care Cost Scenarios ............................................ 38 1-10.3 Provincial Variation ........................................................................... 39 1-10.4 A Two Tier System ............................................................................ 41 1 - 11 LTC COSTS - WHOSE PROBLEM IS IT? ..................................... 43 1-11.1 Individual Responsibility .................................................................... 43 1-11.2 Spousal Responsibility ...................................................................... 43 1-11.3 Community Responsibility ................................................................. 43 1-11.4 Unrealistic Promises ......................................................................... 44 1-11.5 Corporate Responsibility ................................................................... 44 1-11.6 Government Responsibility ............................................................... 44 1 - 12 LONG TERM CARE INSURANCE ................................................. 45 1-12.1 Responding to the Need ................................................................... 46 1-12.2 Buying Long Term Care Insurance ................................................... 46 1-12.3 Long Term Care Policy Defined ........................................................ 46 1-12.4 Policy Structures ............................................................................... 47 1-12.5 Definitions and Pricing ...................................................................... 47 1-12.6 Designing a Plan ............................................................................... 48 1-12.7 Two Valuable Features ..................................................................... 48 1-12.8 Long Term Care Definitions .............................................................. 49 1-12.9 Evaluating The Policy ........................................................................ 53 1-12.10 A Long Term Care Checklist ............................................................. 54 1 - 13 LONG TERM CARE - ALTERNATIVE FUNDING ......................... 55 1-13.1 Investing To Fund Long Term Care .................................................. 55 1-13.2 Major Medical Coverage ................................................................... 56 1-13.3 Self-Pay ............................................................................................ 56 1-13.4 Paying Family Members .................................................................... 56 1-13.5 Government Funding ........................................................................ 57 1 - 14 CONCLUSION ................................................................................ 58 1 - 15 REFERENCES ................................................................................ 59 CHAPTER 2 – Housing Options ............................................................. 60 2 - 1 KEY OBJECTIVE OF THIS CHAPTER ............................................ 60 2-1.1 How Will This Objective Be Achieved? ............................................. 60 2 - 2 INTRODUCTION ............................................................................... 61 2-2.1 Aging In Place ................................................................................... 61 2 - 3 ELDER HOUSING OPTIONS ........................................................... 62 2-3.1 Option One: Staying At Home ........................................................... 62 2-3.2 Option Two: Independen and Active Lifestyle Accommodation ........ 63 2-3.3 Option Three: Assisted Living Accommodation ................................. 63 2-3.4 Option Four: Long Term Care ........................................................... 64 SPI 2 2-3.5 Assessing The Need ......................................................................... 64 2-3.6 Segmenting The Market .................................................................... 65 2 - 4 ELDER LIVING ARRANGEMENTS ................................................. 67 2-4.1 Living As A Couple ............................................................................ 67 2-4.2 Women Living Alone ......................................................................... 68 2-4.3 Living In Senior Residences .............................................................. 68 2-4.4 Proportion Of Seniors In Special Care Facilities ............................... 69 2-4.5 Adding Up The Senior Population ..................................................... 69 2-4.6 Living In A Single Detached House ................................................... 70 2-4.7 Home Ownership .............................................................................. 70 2-4.8 Elders Who Rent ............................................................................... 70 2-4.9 Social Housing .................................................................................. 71 2-4.10 Types Of Social Housing ................................................................... 71 2-4.11 Rental Supplements .......................................................................... 72 2 - 5 ELDERS ON THE MOVE ................................................................. 72 2-5.1 Moving - But Staying Close ..............................................................