What We Want to Believe About Our Needs as We Age Versus The Facts

Seventy percent of people living beyond 65 will need some help for the last eight years of life. Are you prepared if you fall in that category?

Posted 11:26 a.m. Apr 29, 2021 — Updated 11:26 a.m. Apr 29, 2021

Liisa Ogburn

One need not look far to know it is human nature to avoid thinking about hard things until one has to. When it comes to aging, most assume they will be part of the 25% of people over the age of 65 who will not need any help until they pass away.

In my mid-fifties and with the good fortune of good health at the moment, I’d like to believe I fall into that 25%, however, the longer I work with the aging population, the more I come to understand that it is much more likely that I won’t; that I will fall in the 75% of people over 65 who will need ongoing help.

What do I mean by “help?”

Some facts:

For people living beyond the age of 65, 70% need some help for the last 8 years

Now, that could be help with Instrumental Activities of Daily Living (ADLs), such as driving oneself to go shopping or attend appointments or arranging transportation; safely managing medications; paying bills and overseeing financial affairs; or keeping up with household affairs, including cleaning, maintenance, etc. It could also include more significant needs.

In terms of significant help with Activities of Daily Living (ADLs), men need on average significant help with ADLs for the last 2.2 years and women need significant help for the last 3.7 years.

What does significant help mean? It means help with toileting and/or managing incontinence; personal care (hygiene and grooming); dressing; transferring (being able to safely move oneself from bed to wheel chair to toilet); and eating (able to independently feed oneself without help or assistive devices).

Agency home health in the Raleigh-Durham-Chapel Hill area costs $24-$30/hour, depending on care needs (whether companionship or personal care), whether it's for an individual or a couple.

Agencies typically require four hour minimums three times per week. Families can curb costs by hiring privately (and doing the background and reference checks, scheduling and payment themselves).

Assisted Living in this region, depending on the community, whether in a private or shared room or private apartment, the level of care needed, care ratio, amenities and other factors, runs from $4,000/month up to $12,000.

Memory Care runs from $5,500/month up to $12,000/month.

Medicare does not pay for residential Assisted Living or Memory Care, only associated medical costs.

Very few people qualify for Medicaid, called "Special Assistance," for Assisted Living and Memory Care (see my earlier post).

While the facts are hard to hear, the facts can also help one better plan. And sometimes, I've found, knowing the facts can allay the anxiety associated with not knowing them.

Few people want to saddle their children with the burden of responding to their healthcare needs in crisis. Perhaps this provides a realistic grasp of the kinds of help people typically need as they age, for how long and at what cost. And while there is so much we cannot control as we age, it may also provide some motivation to take control of the health behaviors we do have control over (our eating habits, exercise, social connection, substance use, mental health, and spiritual health).

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