Long Term Care Support Group

Today I talked with the Duke Fuqua School of Business Caregiver Support Group–about 12 persons who are currently caring for a loved one, most typically a spouse. All of the stories are different of course, but there is a thread that runs through them. Medicare pays for lots of physician and hospital care, without regard for whether it is needed or works. But, it pays for very little in the way of Long Term Care–help and support to enable someone to deal with disability. The folks in this room were ready to have a discussion about trading off some types of curative/high costs disease modifying care for low tech custodial Long Term Care. I have a paper coming out later this Summer that sheds more light on such conversations and trade offs…..more on that later.

Another theme running through many people’s story was that changes in setting often reduced hospital and other formal spending paid for by Medicare. However, the impact on the societal cost of care was ambiguous–it was often simple shifted to families.

Increasingly, I think one motivation for seeking cost savings in Medicare should be to reallocate some of the money spent on medical care to Long Term Care.

About Don Taylor
Professor of Public Policy (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute), and Chair of the Academic Council at Duke University https://academiccouncil.duke.edu/ . I am one of the founding faculty of the Margolis Center for Health Policy. My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

2 Responses to Long Term Care Support Group

  1. Bob Hertz says:

    I was involved in a support group myself when my father was in a nursing home.
    I came away from that experience with a great puzzlement about the economist’s notion that extra years of life somehow add to our national wealth. (David Cutler and others use this formula a lot.)
    All that I saw with the evidence of my senses was that families were being impoverished by long life spans!
    In my darker moments, I thought that the doctors and hospitals that preserve lives should be taxed for what they do, and not subsidized. A senior has severe heart or kidney disease, and preventing their death will bring riches to drug companies and a few surgeons and hospital administrators. Meanwhile the family of the patient gets poorer, either from unpaid medical bills or future LTC costs, or both.
    I came away thinking that if doctors and hospitals want to care for the elderly on a charitable basis, that is fine. But then the LTC costs should be charged to them also.
    I know that all the above is crude economics, but spend enough in a support group and the thoughts do cross your mind!

  2. I agree. Medicare should reallocate some of the money spent on medical care to Long Term Care. Families, specially those who personally take care of their love ones, because they could not afford a facility, are the ones who are usually in need of additional support. One survey says, that about a third of family caregivers spend more than 30 hours a week on care giving, and they are also dealing with daily care expenses therefore these caregivers may not have additional income. Extension of support from the government will somehow alleviate their financial burden.

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