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POLL: AGING US IN DENIAL ABOUT LONG-TERM CARE NEED
Wednesday, 24 April 2013 08:08 Published in Health & FitnessA new poll examined how people 40 and over are preparing for this difficult and often pricey reality of aging, and found two-thirds say they've done little to no planning.
In fact, 3 in 10 would rather not think about getting older at all. Only a quarter predict it's very likely that they'll need help getting around or caring for themselves during their senior years, according to the poll by the AP-NORC Center for Public Affairs Research.
That's a surprise considering the poll found more than half of the 40-plus crowd already have been caregivers for an impaired relative or friend - seeing from the other side the kind of assistance they, too, may need later on.
"I didn't think I was old. I still don't think I'm old," explained retired schoolteacher Malinda Bowman, 60, of Laura, Ohio.
Bowman has been a caregiver twice, first for her grandmother. Then after her father died in 2006, Bowman moved in with her mother, caring for her until her death in January. Yet Bowman has made few plans for herself.
"I guess I was focused on caring for my grandmother and mom and dad, so I didn't really think about myself," she said. "Everything we had was devoted to taking care of them."
The poll found most people expect family to step up if they need long-term care - even though 6 in 10 haven't talked with loved ones about the possibility and how they'd like it to work.
Bowman said she's healthy now but expects to need help someday from her two grown sons. Last month, prompted by a brother's fall and blood clot, she began the conversation by telling her youngest son about her living will and life insurance policy.
"I need to plan eventually," she acknowledged.
Those family conversations are crucial: Even if they want to help, do your relatives have the time, money and knowhow? What starts as driving Dad to the doctor or picking up his groceries gradually can turn into feeding and bathing him, maybe even doing tasks once left to nurses such as giving injections or cleaning open wounds. If loved ones can't do all that, can they afford to hire help? What if you no longer can live alone?
"The expectation that your family is going to be there when you need them often doesn't mean they understand the full extent of what the job of caregiving will be," Susan Reinhard, a nurse who directs AARP's Public Policy Institute, said. "Your survey is pointing out a problem for not just people approaching the need for long-term care, but for family members who will be expected to take on the huge responsibility of providing care."
Those who have been through the experience of receiving care are less apt to say they can rely on their families in times of need, the poll found.
With a rapidly aging population, more families will be facing those responsibilities. Government figures show nearly 7 in 10 Americans will need long-term care at some point after they reach age 65, whether it's from a relative, a home health aide, assisted living or a nursing home. On average, they'll need that care for three years.
Despite the "it won't happen to me" reaction, the AP-NORC Center poll found half of those surveyed think just about everyone will need some assistance at some point. There are widespread misperceptions about how much care costs and who will pay for it. Nearly 60 percent of those surveyed underestimated the cost of a nursing home, which averages more than $6,700 a month.
Medicare doesn't pay for the most common types of long-term care. Yet 37 percent of those surveyed mistakenly think it will pay for a nursing home and even more expect it to cover a home health aide when that's only approved under certain conditions.
The harsh reality: Medicaid, the federal-state program for the poor, is the main payer of long-term care in the U.S., and to qualify seniors must have spent most of their savings and assets. But fewer than half of those polled think they'll ever need Medicaid - even though only a third are setting aside money for later care, and just 27 percent are confident they'll have the financial resources they'll need.
In Cottage Grove, Ore., Police Chief Mike Grover, 64, says his retirement plan means he could afford a nursing home. And like 47 percent of those polled, he's created an advance directive, a legal document outlining what medical care he'd want if he couldn't communicate.
Otherwise, Grover said he hasn't thought much about his future care needs. He knows caregiving is difficult, as he and his brother are caring for their 85-year-old mother.
Still, "until I cross that bridge, I don't know what I would do. I hope that my kids and wife will pick the right thing," he said. "It depends on my physical condition, because I do not want to be a burden to my children."
The AP-NORC Center poll found widespread support for tax breaks to encourage saving for long-term care, and about half favor the government establishing a voluntary long-term care insurance program. An Obama administration attempt to create such a program ended in 2011 because it was too costly.
The older they get, the more preparations people take. Just 8 percent of 40- to 54-year-olds have done much planning for long-term care, compared with 30 percent of those 65 or older, the poll found.
Mary Pastrano, 74, of Port Orchard, Wash., has planned extensively for her future health care. She has lupus, heart problems and other conditions, and now uses a wheelchair. She also remembers her family's financial struggles after her own father died when she was a child.
"I don't want people to stand around and wring their hands and wonder, `What would Mom think was the best?'" said Pastrano, who has discussed her insurance policies, living will and care preferences with her husband and children.
Still, Pastrano wishes she and her husband had started saving earlier, during their working years.
"You never know how soon you're going to be down," she said. "That's what older people have a problem understanding: You can be in your 60s and then next flat on your back. You think you're invincible, until you can't walk."
The AP-NORC Center for Public Affairs Research survey was conducted Feb. 21 through March 27, with funding from the SCAN Foundation. The SCAN Foundation is an independent, nonprofit organization that supports research and other initiatives on aging and health care. The nationally representative poll involved landline and cellphone interviews with 1,019 Americans age 40 or older. It has a margin of sampling error of plus or minus 4.1 percentage points.
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Associated Press writer Stacy A. Anderson and News Survey Specialist Dennis Junius contributed to this report.
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Online:
Government long-term care primer: HTTP://LONGTERMCARE.GOV
AP-NORC Center for Public Affairs Research: HTTP://WWW.APNORC.ORG
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
Here are 10 things to watch for during the three-day NFL draft beginning Thursday night:
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COMMISSIONER HUGGY BEAR
How many hugs can Roger Goodell endure from all the burly offensive and defensive players expected to be selected in the first round? Last year, he embraced many first-round picks who took the stage and was nearly hugged into submission by the likes of Fletcher Cox, Dontari Poe and Melvin Ingram.
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SHOW ME A QUARTERBACK
Will any quarterbacks be taken in the first round? Possibilities include Geno Smith, Matt Barkley and EJ Manuel, but this is far from the glamour year of 2012, when QBs were huge: Luck, No. 1; Robert Griffin III, No. 2; Ryan Tannehill (No. 8); Brandon Weeden (No. 22). The last time no quarterback was taken in round one was 1996 (Tony Banks was a second-rounder, No. 42, by the Rams); the last time only one was taken was 2001 (Michael Vick, first overall) and the last time two were taken was 2010 (Sam Bradford and Tim Tebow).
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FASHION STATEMENT
Fashionistas surely will be tracking the expensive, colorful designer suits, hairstyles (think dreadlocks) and even socks of the draftees as they take the stage after being selected. (Think Griffin, the Redskins' top pick in 2012, who wore a baby blue jacket, checkered-patterned shirt, purplish tie with horizontal stripes, and burgundy and gold socks with the words "GO CATCH YOUR DREAM."
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TE'O TIME
When that will be exactly is anyone's guess. Some analysts have Notre Dame's All-American linebacker Manti Te'o back to being a first-round cinch, even after a great season was marred by a poor game against Alabama followed by the hoax involving a deceased "girlfriend." He did not perform well at the NFL combine, but did better at pro day in South Bend. ---
BEEFING UP EARLY
Watch for all the beef early in the first round. There's a chance seven of the first 10 picks could be really big fellas. Among them are offensive linemen Luke Joeckel (306 pounds), Eric Fisher (306), Chance Warmack (317), Lane Johnson (303) and Jonathan Cooper (311); and defensive linemen Sharrif Floyd (297) and Ziggy Ansah (271).
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WILL TIDE ROLL AGAIN IN 1ST ROUND?
A year ago, the national champions had four players picked: RB Trent Richardson (No. 3), SS Mark Barron (No. 7), CB Dre Kirkpatrick (No.17) and LB Dont'a Hightower (No. 25). National champs again, there are five that could end up as first-rounders: Warmack, cornerback Dee Milliner, offensive tackle D.J. Fluker, defensive tackle Jesse Williams, and running back Eddie Lacy.
--- FAMILY TIES
Every year, a slew of players with family ties to the NFL are draft eligible. This year is no exception, with a few dozen all-in-the-family connections. Among them are QBs Nate Montana (son of Joe Montana) and Jordan Rodgers (brother of Aaron Rodgers), Jake Ryan (son of Pat Ryan), Duron Carter (son of Cris Carter), Luke Tasker (son of Steve Tasker), Kyle Long (son of Howie Long, brother of Chris Long) and Baker Steinkuhler (son of Dean Steinkuhler).
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HALL OF FAME PICKERS
A total of 32 former NFL players will be announcing second- and third-round picks for teams, including newly elected Hall of Famers Jonathan Ogden (Ravens), Warren Sapp (Buccaneers) and Dave Robinson (Packers). Others making picks for their former teams include Deion Sanders (Falcons) and Larry Little (Dolphins).
--- BEST STORYLINES
Houston cornerback D.J. Hayden and South Carolina running back Marcus Lattimore.
Hayden was moments from death last November after an on-field collision with a teammate tore a blood vessel off the back of his heart. He was taken to a hospital, underwent lifesaving surgery, and now could be a first-round pick. He ran a 4.33 40-yard dash at Houston's pro day in March, and now he'll wait to see if a team believes his talent and speed is worth the risk.
In 2011, Lattimore tore the ACL in his left knee midway through the season. He returned last year, and in October, the star running back suffered a horrific injury to his right knee against Tennessee - it was dislocated and ligaments were damaged as he was tackled. He had surgery a month later, continued rehabbing, and at South Carolina's pro day recently he impressed NFL scouts so much they applauded after his workout. He says he's confident he'll be ready to play when the 2013 season starts.
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MR. IRRELEVANT
As the draft draws to a close Saturday, the fun revs up with the final pick, aka Mr. Irrelevant. As they did last year, the Colts have the honor at pick No. 254. Last year, they went for Northern Illinois quarterback Chandler Harnish (Andrew Luck was the Colts' other QB pick - at No. 1 overall). The last pick will be awarded the Lowsman (opposite of Heisman) Trophy during a weeklong celebration at the Balboa Bay Club in Newport Beach, Calif. In 2012, Harnish's first trip to California included golf at Big Canyon Country Club, a visit to Disneyland and parties galore. The founder of Irrelevant Week is Paul Salata, a former USC and NFL receiver. The first Mr. Irrelevant was WR Kelvin Kirk in 1976.
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
So every now and then, crews will tow the planes around the Texas tarmac a bit to make sure the tires don't rot, then send them back into exile until they can finally get permission to commit the aging aircraft to the boneyard.
It's not an unfamiliar story.
Idle aircraft and pricey ship deployments underscore the contradictions and conflicts as Congress orders the Pentagon to slash $487 billion in spending over the next 10 years and another $41 billion in the next six months. Yet, at the same time, lawmakers are forcing the services to keep ships, aircraft, military bases, retiree benefits and other programs that defense leaders insist they don't want, can't afford or simply won't be able to use. The Associated Press interviewed senior military leaders involved in the ongoing analysis of the budget and its impact on the services and compiled data on the costs and programs from Defense Department documents.
The Pentagon long has battled with Congress over politically sensitive spending cuts. But this year, military officials say Congress' refusal to retire ships and aircraft means the Navy and Air Force are spending roughly $5 billion more than they would if they were allowed to make the cuts. In some cases Congress restored funds to compensate for the changes, but the result overall was lost savings.
In other cases, frustrated military leaders quietly complained that they were being forced to furlough civilians, ground Air Force training flights and delay or cancel ship deployments to the Middle East and South America, while Congress refuses to accept savings in other places that could ease those pains.
Along the eastern seaboard, two Navy cruisers — the USS Anzio in Norfolk, Va., and the USS Vicksburg in Mayport, Fla. — were scheduled for retirement this year but both are now sitting pierside. Navy leaders will soon schedule the ships for significant repairs and begin readying their crews so they can go back into service.
Altogether, Congress is requiring the Navy to keep seven cruisers and two amphibious warships in service, eliminating the $4.3 billion the retirements would have saved over the next two years.
"A lot of it comes down to parochial political interests," said Todd Harrison, senior fellow at the Center for Strategic and Budgetary Assessments. "No member of Congress wants to have a base closed in their district or to have a fighter squadron relocated out of their district."
Members of Congress argue that they believe the Pentagon sometimes makes bad decisions and other times may purposely target programs that have broad support.
"Certainly that has been a pattern, they've cut Guard and Reserves in areas where it's clearly unwise and Congress steps in to put the money in," said Rep. Michael Turner, R-Ohio, chairman of the House Armed Services air and land forces subcommittee.
While the Navy sought to retire the seven ships, the Air Force wanted to save more than $600 million by retiring C-130 and C-5A cargo aircraft, three B-1 bombers and 18 high-altitude Global Hawk surveillance drones.
Congress disagreed, adding various requirements that the Navy and Air Force maintain the ships and aircraft, and in some cases added money to the budget to cover them. Fifteen of the C-5A Galaxy aircraft no longer set to retire are at Lackland, while 11 are at Martinsburg, W.Va., and are flown by the Air National Guard there.
A senior Air Force official said the service determined that it didn't need all of the aging aircraft. And it pushed to cut the Global Hawks because defense officials determined that the U-2 spy plane, first produced more than 50 years ago, was better suited for the high-altitude surveillance job and would cost less money.
The official also noted that while lawmakers rejected plans to retire the Galaxy aircraft, congressional appropriators did not add back money to pay for the fuel or the manpower to fly them. Similarly, the three B-1 bombers will move into backup status and likely will be used infrequently. The official was not authorized to speak publicly about the budget, so requested anonymity.
The decision to block retirement of some C-130s, however, reveals how narrow, yet critical, the political interests can be. Pennsylvania lawmakers declared victory last month when they reversed the decision to retire eight C-130s and shut down the 911th Airlift Wing near Pittsburgh. Local officials and business owners argued that the base, which uses space at Pittsburgh International Airport, provides an economic boost to the entire community.
Sens. Pat Toomey, a Republican, and Bob Casey, a Democrat, lobbied Pentagon leaders and fellow lawmakers to keep the wing. They argued in a letter to then-Defense Secretary Leon Panetta that "the 911th is a very efficient and cost effective installation" and that closing it could be a waste of taxpayer dollars.
Pentagon officials have also been thwarted in their broader efforts to shut down costly and underused military facilities around the country. Congress rejected the department's request last year for two more rounds of base closings, as lawmakers objected not only to the prospect of taking jobs and dollars out of a region's economy, but also questioned whether closing the facilities actually achieves the promised savings.
Pentagon budget chief Robert Hale acknowledged earlier this month that the department spent $35 billion on the base closure round in 2005, and while it saves $4 billion a year, officials won't break even until 2018. The expense is largely because a number of new facilities were built even as some were merged and closed.
"Would a (base closings) round be effective in providing rapid savings? Unfortunately, history has emphatically told us, no," Rep. Rob Wittman, R-Va., said during a recent hearing on the Base Realignment and Closures program. "I believe that aggressively moving forward with the BRAC round could significantly harm our military power and their ability to project power."
Currently, the department saves about $8 billion a year on the four rounds that were carried out before 2005. The Pentagon has proposed another round in 2014 that Hale said would save $1 billion to $2 billion a year. Pentagon leaders insist that the military still has nearly 20 percent too many bases and facilities.
"There is still excess infrastructure," Assistant Army Secretary Katherine Hammack told the House Armed Services Committee last month. "I was just on one (base) that had 800 buildings and we were utilizing 300 of them."
Perhaps the most significant cost savings historically opposed by Congress are Pentagon efforts to scale back military retirement benefits, including proposals to increase premiums or co-pays for retirees.
"I think there's a misunderstanding in Congress about what it is that would change," Harrison said. "They tend to associate changes in retirement benefits with changes to veterans benefits."
But changes to retiree health care would only affect the approximately 17 percent of the service members who stay in the military long enough to qualify for retirement, and those are usually more senior officers who already have a higher income. Veterans' benefits more often help those with lower incomes, and they are included in the Veterans Affairs Department budget, not the Pentagon's.
Turner faulted department leaders for some of the problems with those broader issues.
"I think on policy shifts you need a more holistic approach, and the Pentagon usually doesn't engage Congress in discussions of finding cuts or program changes. They send them up as missiles for Congress to deal with, instead of using a deliberative approach."
Harrison said the Pentagon needs to do a better job explaining and selling its arguments for such politically unpalatable spending cuts.
"If you actually try to do smart targeted reductions, like closing bases, like actually reducing the size of the workforce, targeted cuts have winners and losers," Harrison said. "And Congress has not been willing to make those tough decisions."
As a result, he said, lawmakers resort to broader, across-the-board cuts, such as the furloughs.
"It spreads pain across evenly," he said. "So everyone can wash their hands of it."
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