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Sheehy Says Long Term Care Managers Needed

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NEW ORLEANS–America is undergoing a longevity revolution, said baby boomer expert Gail Sheehy in the keynote address at the Intercompany Long Term Care Insurance Conference here, sponsored by the Society of Actuaries, Schaumburg, Ill.

With their parents aging, the next big passage for many boomers is caregiving, said Sheehy, author of the 1976 best seller, “Passages.” Her new book, “Passages in Caregiving,” due out in May, is largely about a developing crisis in providing long term care to those with chronic health conditions.

Sheehy praised a feature of some new LTC policies that provides a care coordinator to help caregivers handle the duties of tending to elderly family members in need of extended assistance.

Sheehy became an extended caregiver when her late husband, Clay Felker, founder of New York Magazine, developed cancer. Starting when she was in her 50s, she played caregiver on and off for 17 years as Felker’s condition passed in and out of remission.

Caregiving “is a job nobody applies for,” Sheehy said. “No pay. No benefits. But someone is going to suffer unless you intercede.”

The couple did not have long term care insurance, “much to our great regret,” she said.

Almost 50 million people in the U.S. are in a caregiver role, she said. Many don’t know how to negotiate Medicare rules or to find the different treatments available for their loved one, or how long their parent would need extended care.

She described caregiving as “a labyrinth, a long path with abrupt twists.” Eventually, the caregiver gets to the point where he or she says, “I can’t do this any more.”

It’s important for the caregiver to have help so he or she can have respite.

“If you know what to expect, it’s easier,” Sheehy said.

It takes a community to help the caregiver and the person receiving care to shape a path through the labyrinth, she said. With Felker unable to find a job, his former colleagues worked to figure out what work he could do while recovering from treatments. Ultimately, he landed a job teaching at the University of California.

Sheehy urged LTC carriers to develop policies that include the assistance of care coordinators for phases of chronic illness between acute care and hospice care.

She also suggested that providing for hospice care for as long as 12 months instead of the usual 6 would increase the number of people going into hospice while decreasing the use of more costly acute care and emergency treatments.

Assistance from trained care managers would make a big difference for patients and caregivers if there was coverage for such assistance, Sheehy said.

Moreover, strengthening support for family caregivers would enable them to keep their jobs rather than quitting, as many do, to care for their aging relatives, she suggested.

Sheehy had hired a caregiving manager to help her in the last 2 years of her husbands’ life. Until then, she said, she had begun “to lose my self” tending to the pressing needs of her husband.

“Caregivers often have to put their life on hold” to keep their loved one cared for, she said.

Currently, caregivers do not have much choice when family members approach end of life. They can sign them into a nursing home or to hospice care for 6 months, she said.

An alternative is palliative care, which enables the patient can get out of the hospital and receive care at home, she said.

“We don’t do aging in this country,” she said. “We do anti-aging. You can make life worth living for people in their 80s and 90s.”


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