scholarly journals The Long-Term Care Financing Challenge: What Role for Home Equity?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 691-691
Author(s):  
Jane Tavares ◽  
Marc Cohen ◽  
Lauren Popham
Keyword(s):  
Daily Living ◽  
Home Ownership ◽  
Home Equity ◽  
Term Care ◽  
Public And Private ◽  
Home Value ◽  
Need For Support ◽  
Services And Supports ◽  
The Relationship

Abstract With increasing longevity comes the need for support in activities of daily living. This growing demand for long-term services and supports (LTSS) threatens older adult financial security. About 25 million adults aged 65 and older will have a significant LTSS need that will cost up to $140,000 out-of-pocket plus an estimated $120,000 from public payers like Medicaid; the total public and private costs of care exceeding $250,000. Home equity, the most valuable financial asset owned by Americans, offers one solution to this financing challenge. While seniors boast $7 trillion in collective home equity, opportunities to annuitize this asset vary and the distributions of home ownership and value are highly skewed. Using the 2016 wave of the HRS, this paper explores the relationship between socio-demographic/health characteristics and the annuitized home value. We determine which individuals with LTSS needs might benefit from the annuitization of home equity and to what extent.

scholarly journals Home equity release for long-term care financing: an improved market structure and pricing approach

2014 ◽  
Vol 9 (1) ◽  
pp. 85-107 ◽  
Author(s):  
Doug Andrews ◽  
Jaideep Oberoi
Keyword(s):  
Risk Sharing ◽  
Long Term Care ◽  
House Price ◽  
The Elderly ◽  
Home Equity ◽  
Term Care ◽  
Basis Risk ◽  
Lump Sum ◽  
Home Value

AbstractHome equity release products have been promoted as a potential solution to residential long-term care costs for the elderly. Lower than expected utilisation of home equity release loans has prompted efforts to better model and price the no-negative-equity-guarantee (NNEG) built into the contracts, but loan rates are still widely perceived by homeowners as being unattractive. We propose the introduction of a new adjustable rate loan based on a regional house price index, with the NNEG being borne by a specially created intermediary. The proposed approach allows us to directly address and separately price the basis risk between individual house price returns and index returns. In addition, it offers the opportunity to create securities based on residential real estate that would be attractive to a wider class of investors. The alternative risk-sharing mechanism creates a more transparent and simple pricing structure for the loans. We then use house sales data to demonstrate the approach. We find in our sample that it would be possible to make higher loans than seen in previous literature using standard roll-up contracts. In the most favourable scenario for our simulations, the maximum loan is 89% of the appraised home value if the loan is advanced as a lump sum and 95% if the loan is advanced in instalments.

scholarly journals Socioeconomic Status and Long-Term Care Provision to Parents in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 725-725
Author(s):  
Yoko Ibuka ◽  
Yui Ohtsu
Keyword(s):  
Socioeconomic Status ◽  
Long Term Care ◽  
Living Condition ◽  
Care Provision ◽  
Burden Of Care ◽  
Care Needs ◽  
Term Care ◽  
Japanese Adults ◽  
The Relationship

Abstract Socioeconomic status (SES) is generating considerable interest in terms of health of individuals, but how it is associated with long-term care has not been established yet. We study the relationship between SES and long-term care provision to parents among the Japanese adults using JSTAR. We use the following six measures of SES for the analysis: income, asset, expenditure, living condition, housing condition and education. We find a greater probability of care provision to parents among those in higher SES categories for some SES measures, compared to the lowest category. However, after considering the survival probability of parents, the relationship is reversed and the probability of care provision is found to be greater among lower SES individuals. The association is more pronounced among males. The association is likely to be partly mediated by care needs of parents. These results suggest a higher burden of care disproportionately falls in low SES individuals.

OP48 Nursing Requirements In Long-Term Care: A Health Technology Assessment

2019 ◽  
Vol 35 (S1) ◽  
pp. 11-12
Author(s):  
Paula Corabian ◽  
Charles Yan ◽  
Susan Armijo-Olivo ◽  
Bing Guo
Keyword(s):  
Nursing Care ◽  
Nursing Staff ◽  
Real World ◽  
Research Evidence ◽  
Long Term Care ◽  
Staff Time ◽  
Term Care ◽  
Policy Makers ◽  
The Relationship

IntroductionThe objectives of this study were to systematically review published research on the relationship between nursing staff coverage, care hours, and quality of care (QoC) in long-term care (LTC) facilities; and to conduct a real world evidence (RWE) analysis using Alberta real world data (RWD) to inform policy makers on whether any amendments could be made to current regulations.MethodsA systematic review (SR) of research evidence published between January 2000 and May 2018 on the relationship between nursing staff coverage, care hours, and QoC in LTC facilities was conducted. Panel data regressions using available RWD from Alberta, Canada, were performed to assess associations between nursing care hours and LTC outcomes. Outcomes of interest included quality indicators related to resident outcomes, hospital admissions, emergency room visits and family satisfaction. Nursing care hours considered in SR and RWE analysis included those provided by registered nurses (RNs) and licensed practical nurses (LPNs).ResultsThe SR found inconsistent and poor quality evidence relevant to the questions of interest, indicating a great uncertainty about the association between nursing staff time and type of coverage and QoC. Although some positive indications were suggested, major weaknesses of reviewed studies limited interpretation of SR results. RWE analysis found that impact of care hours on LTC outcomes was heterogeneous, dependent on outcome measurements. There was evidence that total staff, RN, and LPN hours had positive effects on some resident outcomes and magnitude of effect differed for different nursing staff.ConclusionsNo definitive conclusion could be drawn on whether changing nursing staff time or nursing staff coverage models would affect residents’ outcomes based on the research evidence gathered in the SR. RWE analysis helped to fill a gap in the available published literature and allowed policy makers to better understand the impact of revising current regulations based on actual outcomes.

scholarly journals High coverage COVID-19 mRNA vaccination rapidly controls SARS-CoV-2 transmission in long-term care facilities

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Pablo M. De Salazar ◽  
Nicholas B. Link ◽  
Karuna Lamarca ◽  
Mauricio Santillana
Keyword(s):  
Long Term Care ◽  
Mitigation Strategies ◽  
Key Factors ◽  
Modeling Framework ◽  
High Coverage ◽  
Term Care ◽  
Early Effect ◽  
Care Facilities ◽  
The Relationship

Abstract Background Residents of Long-Term Care Facilities (LTCFs) represent a major share of COVID-19 deaths worldwide. Measuring the vaccine effectiveness among the most vulnerable in these settings is essential to monitor and improve mitigation strategies. Methods We evaluate the early effect of the administration of BNT162b2-mRNA vaccine to individuals older than 64 years residing in LTCFs in Catalonia, Spain. We monitor all the SARS-CoV-2 documented infections and deaths among LTCFs residents once more than 70% of them were fully vaccinated (February–March 2021). We develop a modeling framework based on the relationship between community and LTCFs transmission during the pre-vaccination period (July–December 2020). We compute the total reduction in SARS-CoV-2 documented infections and deaths among residents of LTCFs over time, as well as the reduction in the detected transmission for all the LTCFs. We compare the true observations with the counterfactual predictions. Results We estimate that once more than 70% of the LTCFs population are fully vaccinated, 74% (58–81%, 90% CI) of COVID-19 deaths and 75% (36–86%, 90% CI) of all expected documented infections among LTCFs residents are prevented. Further, detectable transmission among LTCFs residents is reduced up to 90% (76–93%, 90% CI) relative to that expected given transmission in the community. Conclusions Our findings provide evidence that high-coverage vaccination is the most effective intervention to prevent SARS-CoV-2 transmission and death among LTCFs residents. Widespread vaccination could be a feasible avenue to control the COVID-19 pandemic conditional on key factors such as vaccine escape, roll out and coverage.

scholarly journals Housing, Affordability, and Community-Based Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 690-691
Author(s):  
Samara Scheckler
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Long Term Care ◽  
Housing Tenure ◽  
Policy Implications ◽  
Housing Cost ◽  
Home Equity ◽  
Community Based ◽  
Term Care

Abstract The house acts as both an environment of care and a vehicle to financially potentiate long-term community-based support. While housing can empower a diverse set of options for a person-centered aging process, inadequate housing can also impede healthy aging in the community. This symposium teases out the nodes where housing acts to benefit or limit safe community-based aging. The first paper in this symposium, Homeownership Among Older Adults, describes typologies of older adult homeownership and sensitively highlights trends, disparities and important considerations of homeownership in later life. The next two papers take these older adults and explores situations where their housing acts as an asset or as a burden. Identifying Cost Burdened Older Adults acknowledges that housing cost burdens look different for older adults than younger cohorts. A more precise definition of older adult housing cost burden is proposed to help researchers and policymakers better synthesize the complex relationships between older adult housing and their long-term care decisions. The Long-Term Care Financing Challenge then explores the role of home equity in expanding the community-based long-term care choice set for older adults. This paper demonstrates benefits (both realized and unrealized) in home equity and suggests policy implications moving forward. Finally, Cardiometabolic Risk Among Older Renters and Homeowners disentangles the relationship between housing and health by demonstrating health disparities that are associated with housing tenure, conditions and affordability. Taken together, this symposium explores the complex and multidirectional relationships between housing, long-term care and older adult health.

Interprovincial Comparisons of Public and Private Sector Long-Term Care Facilities for the Elderly in Canada

1994 ◽  
Vol 20 (3) ◽  
pp. 278 ◽  
Author(s):  
Janet Greb ◽  
Larry W. Chambers ◽  
Amiram Gafni ◽  
Ron Goeree ◽  
Roberta Labelle
Keyword(s):  
Private Sector ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Public And Private ◽  
Care Facilities ◽  
Public And Private Sector

scholarly journals Depression and empathy in health professionals who work in the long-term care institutions for older adults

2021 ◽  
Vol 15 (3) ◽  
pp. 381-386
Author(s):  
Marina Miranda Borges ◽  
Ana Julia de Lima Bomfim ◽  
Marcos Hortes Nisihara Chagas
Keyword(s):  
Older Adults ◽  
Health Professionals ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Reactivity Index ◽  
Cross Sectional ◽  
Term Care ◽  
Patient Health ◽  
The Relationship

ABSTRACT Empathy is an important factor to guarantee the quality of care provided in the long-term care institutions (LTCIs) for older adults, and depression is a factor that affects the health of the professional and, consequently, the care. Thus, it is important that studies are conducted on the relationship of these variables in this context. Objective: The aim of this study is to verify the relationship between empathy and depressive symptoms among health professionals working in the LTCIs. Methods: A cross-sectional study was carried out at LTCIs in the state of São Paulo, Brazil. The final sample was constituted by 101 health professionals (i.e., caregivers and nursing technicians) with direct participation in the care of institutionalized older adults. The instruments were used as follows: the Interpersonal Reactivity Index (IRI) to assess empathy and the Patient Health Questionnaire-9 (PHQ-9) for the diagnosis of depression. For the analyses, the patients were divided into groups with and without depression, according to the score of the PHQ-9. Results: The prevalence of depression among health professionals was 19.8%. Significant statistical differences were found between the groups for the total score of the IRI (p=0.029), for the emotional domain (p=0.023), and for the personal distress (p=0.009). Conclusions: The findings indicate that the presence of depression among health professionals at LTCIs is related to the higher levels of empathy, especially in the emotional domain. Thus, future studies that contribute to understanding how care must be provided with empathy, but without harming the health of the professional, should be carried out.

scholarly journals Review on Pricing Models for Long-term Care Insurance

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Syakir Asrulsani ◽  
Mazlynda Md Yusuf
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Long Term Care ◽  
Financial Burden ◽  
Term Care ◽  
Protection Mechanism ◽  
Long Term Care Insurance ◽  
Risk Protection ◽  
Care Costs

Funding for long-term care costs among elderly people is a critical matter, especially due to high costs and an unexpected length of time. Placement for long-term care that is funded under Jabatan Kebajikan Masyarakat (JKM) is very limited, hence, the next option is through private nursing homes. However, the cost could be up to RM 2,000 a month for each person. Therefore, Long- Term Care Insurance is an alternative to fund for Long-Term Care costs as it is expected to reduce financial burden during old age. It is a risk protection mechanism for an insured that needs health and financial protection when an individual is unable to do activities of daily living (ADL) or supports in instrumental activities of daily living (IADL). This paper reviews three models that have been used in pricing long-term care insurance. All three models use the equivalent principle of premium to price the insurance policy. However, the probability and assumptions used for each model differ, depending on the insured's needs and profile.

Sign in / Sign up

Export Citation Format

Share Document