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When Carol Frazier experienced the financial and emotional challenges of becoming her aged father’s caregiver nine years ago, it affected her so deeply she changed careers to try to help others learn about long-term care planning.

“We’re all living a lot longer, and we’ve got to understand the consequences this will have on our family and our finances,” says Frazier, who lectures nationally on long-term care planning. “There are consequences to living a long life.”

After struggling with some of those consequences firsthand with her 90-year-old father, she realized how little she understood about long-term care, so she researched the subject and decided to become a certified long-term care specialist. She counsels people with the goal of protecting a client’s family and finances from the high cost of long-term care.

Despite what she and others consider to be a growing and pressing need for planning care, Frazier says many people put it off because of “ignorance, apathy and denial.”

People are “not knowledgeable about long-term care, where it is provided and how much it costs,” she says. “There are those who worry about it tomorrow. And then there’s denial—that it’ll never happen to me.”

Some 77 million baby boomers are discovering denial isn’t an option for them anymore as they contend with the often stressful and costly process of becoming care providers for their parents, as well as lining up their own care.

One in five Americans will be 65 or older by 2020, says Dr. Lilly Allen, an associate professor at LSU’s School of Social Work who specializes in long-term care. The fastest-growing segment of the aging population is 85 years and older.

While Louisiana’s 12% senior population (65 or older) is close to the national average, this group has a higher disability rate that requires more nursing home care, Allen says. Louisianans experience higher rates of heart disease and cancer, which have contributed to more disability and chronic health conditions in the older population. Additionally, Louisiana lags behind other states in funding home-based services, so elders may be more likely to access nursing home care.

The numbers point to an increasing likelihood that more people, whether care providers or the cared for, will deal with long-term care in the near future.

“It can be a financially and emotionally devastating experience,” Frazier says of dealing with long-term care without planning.

When she counsels clients, she advocates buying long-term care insurance, which she also sells, as a cost-effective option to countering the potentially catastrophic costs of care. Frazier says the plans are flexible in choices, adaptable to needs and can keep pace with inflation by adding inflation protection.

Many people don’t plan for long-term care or consider coverage because they mistakenly believe Medicare will cover it, she says. It’s a misconception that sidetracks people from early planning, leaving them with few choices when they do need care.

After Pete Losavio contended with similar frustrating issues in caring for his mother with Alzheimer’s disease for five years, he became a certified elder attorney.

“It’s an area that will continue to grow because the population will need more assistance in providing for themselves as they become older,” he says. “Most people think when they’re going to the nursing home that it’s covered by Medicare and it isn’t. That’s the crisis point or tipping point.”

Medicare was designed to provide quality medical care, but it was designed for acute care—not long-term care, he says.

Also, the federal government tightening Medicaid rules with the Deficit Reduction Act in 2005—complicating already complex rules in areas like gift giving and scrutinizing assets—has further turned elder law into a fast-growing field. Losavio says it now makes up the majority of his business, and it’s still growing.

“We’re staying alive longer, but the people need help in custodial and unskilled care to ensure quality in those years,” he says. “After you’ve accumulated that wealth, you have to protect it so it takes care of you the rest of your life. It’s all a function of money. People need to be aware of the danger.”

Losavio maintains the system is designed to make a person destitute and give them poor quality care, but the greatest danger may be many people’s refusal to cope with old age.

“Most of us don’t think we’re going to die,” he says. “I’ve had people come to my office and say, ‘If I’m going to die…’ I deal with this every day, but there’s a 50-50 chance if you’re in your 60s that you’ll need long-term care.”

Losavio says he’s dealt with a surprising number of people who don’t have a will, which would ensure the “life estate” goes to the surviving spouse. He also warns the state Department of Health and Hospitals considers this estate a resource, which means the estate would have to be spent down for a spouse to qualify for Medicaid. This also means the surviving spouse and children’s inheritance is at risk if a surviving spouse needs long-term care, which is why he recommends forming a trust.

An elder lawyer can help protect a client by assessing assets and estate documents such as the will, trust or financial power of attorney, and recommending ways to provide for long-term care without losing assets, he says.

When planning, a person should anticipate long-term care involving three sources of money: long-term care insurance, private funds and government funds, he says. Losavio, like Frazier, also strongly advocates long-term care insurance as affordable and flexible option to ease care costs.

“It’s wealth protection, which is really what long-term care insurance is,” Frazier says of the plans, which are age-rated so the younger the policyholder the smaller the premium. “It ensures your retirement can be spent on what it was intended, not on someone to care for you.”

Early planning is particularly important for services is especially important for long-term care because it’s a complicated process, says Allen, who also studies healthy aging across the lifespan at the LSU Life Course and Aging Center. The center is dedicated to helping people with independence and choice so they can “best age in place.”

In addition to the importance of care quality, choice in activities, proximity to loved ones and food quality options may be the most important factors as a starting and enduring point in selecting a facility, Allen says. Selection also means identifying available services, caregivers, accommodations and amenities to try to match them to what is desired or needed in care. “People, above all, wish to be as independent as possible, and the best facilities maximize this essential right,” she says.

Jan Latimer, coordinator for the Capital Area Aging and Disability Information Service with the Capital Area Agency on Aging, says many people start their search for services with her office, which is the closest thing available to a one-stop shop in long-term care planning.

“It’s complex and takes a lot of time because it is something most people don’t want to do,” Latimer says. “The emotional aspects of it make it even more difficult to deal with. They’re frustrated in many cases, dealing with a parent who is their mother and father, and their lives are changing. They’re going to require care, and it’s hard for everybody.”

Growing demand for this assistance spurred creation of this service last year, which was initiated on the federal level to serve in a long-term care consultant capacity. The agency’s counselors help identify needs, who pays for services, especially clearing up the critical misconception that Medicare pays for a nursing home other than for a client to re-cooperate, rehabilitate or recover after a hospital stay, and attempts to match those needs with what’s available in state, federal and private options.

Callers are typically bogged down with their own responsibilities and trying to find care for a parent from another parish or state, Latimer says. Agency counselors are knowledgeable in the field, which is a critical advantage in matching needs with what’s available so callers can make informed choices.

“People who are arranging care have a lot of choices to make,” she says, “and need a lot of information to make those choices well.”