Few in state prepared for old age

A survey finds little awareness of the cost of long-term care

Islanders who think they can rely on a government program to care for them when they're older may find too late that it's too little.

AARP surveyed 1,456 Americans age 45 and older to see how much they know about costs and funding sources for nursing homes, assisted-living residences and in-home care.

Many knew little about the programs or costs, the organization said in a report released today to educate members, policy makers and the public.

"Americans do not have a clear and adequate grasp of the monumental costs of long-term care," said Bruce Bottorff, AARP Hawaii associate state director for communications.

Tony Krieg, chief executive officer of Hale Makua, which operates nursing facilities and other senior programs on Maui, said the AARP survey "focuses on what some of us in the industry know," but shows "how little people really know about who pays for it (long-term care) and its availability."

About 52 percent think Medicare covers assisted living. Not true.

Nearly six in 10, or 59 percent, think Medicare covers nursing home stays after three months for age-related or other chronic conditions. Not true.

About 60 percent of those surveyed say they are "somewhat familiar" with long-term care services available, but only 8 percent could "reasonably estimate" the cost of nursing home care, the report said.

Bottorff noted that in 2005, with 94 percent occupancy of nursing facilities, Hawaii ranked second in the nation. "We don't have enough beds," he said, adding that the report points to the need for more home and community-based services.

"People want to age in their home as much as possible, but when they can't be adequately cared for in the home, there's not a great deal of choice," he said.

Coral Andrews, vice president, Long Term Care and Home Care and Hospice Divisions of the Healthcare Association of Hawaii, said increased capacity is needed throughout the long-term care system, from institutions to home and community-based settings.

She said the association is "working very hard to address concerns about patients backed up in hospitals," because there is nowhere to place them in the community. "There needs to be attention to the full continuum of services," she said.

Reviewing the AARP data together in a conference call, Krieg and Andrews said it supports studies showing Hawaii has one of the fastest-growing populations of people 65 and older. Interestingly, they noted, Hawaii ranked fifth in the nation, with 53 men per 100 women age 85 and older.

According to the report, isle residents 65 and older were 13.7 percent of the population in 2005, but will be 18.7 percent in 2020 -- a 52 percent increase.

The 65-to-74 age group is projected to increase from 6.1 percent in 2005 to 10.8 percent in 2020 -- a 96 percent jump.

Hawaii's seniors are some of the healthiest in the nation, Krieg said.

Hawaii ranked third nationally in 2005 with 54 percent of nursing home residents with dementia, compared with 45 nationally.

But because people are healthier here, they enter nursing homes at higher ages than on the mainland, "and the percentage of people with dementia goes up dramatically," Krieg said.