Is Long Term Care More Important to Women Than Men?

I could hear the panic in Mary’s voice. Her husband Joe’s health had been steadily declining for years and Mary has been his primary caregiver. But last week he fell at home, breaking his hip, and now he’s in a subacute facility. The recovery process hasn’t gone well, in part because of Joe’s age and partly because of the toll that Alzheimer’s has taken on his mind. Mary is now facing the prospect of either long term care at a cost of $11,000 per month or, in an effort to keep the cost down, trying to bring him home and provide much of the care herself, supplementing it with a few hours of home aide assistance. “Joe never wanted to talk about long term care and so we never did plan for this,” she tells me. It’s a classic scenario and one that, so often, is more damaging to the wife than the husband. How so?

Mary’s situation is a typical one. At 72, she’s 6 years younger than Joe. Add the fact that women have a longer life expectancy than men and chances are that the husband will need long term care first. And if the couple haven’t planned for it, they’ll likely spend most of their savings on his care. Mary and Joe have $400,000 of assets plus their house. Without any guidance Mary could be left with as little as $109,000 and the house before the State will help pay for Joe’s care.

What about their income? Mary will lose much of that too, towards Joe’s care. He has Social Security of $1500 and a pension of $2500 while Mary has only Social Security of $500 because she spent many years tending to the needs of her family. She’ll get to keep approximately $1500 of Joe’s income when he qualifies for Medicaid, not enough to meet her expenses. Then, when he dies, she’ll take another hit, because Joe chose the maximum pension for his life. There is no survivor option for Mary. Add to that, the fact that she will only receive one Social Security check (Joe’s because it is the larger of the two) and her income will drop to $1500. It, therefore, is so important for Mary to protect as much of their assets as she can to replace the income she loses.

And when Mary does need care it will likely be more expensive and difficult to administer. Why? Because, she won’t have a healthy spouse living with her to care for her at home. Chances are she’ll need to hire more care and she’ll be more likely to need nursing home care earlier. Her children will need to take on a greater role, to fill the void.

One more thing. Mary’s concern about keeping costs down is causing her to take on more of the caregiver role herself. That can take a physical and emotional toll and may contribute to a more rapid decline in Mary’s health. Had the couple planned for this possibility well in advance, tapping into available sources of payment such as long term care insurance or government benefits Mary would be more inclined to pay for additional help.

When you consider all these factors together, it becomes clear that, for many couples, it is the woman who is at greater risk. Mary now realizes it too. Fortunately, she isn’t too late in reaching out to us. We can still help her protect something. Granted, it would have been better had she called sooner but better late than never.