Mrs. T's story is not unique. Many elderly patients come into the ER after accidental falls. Mrs. T knows she needs help, but she can't afford home-care services. And like most seniors, she does not want to move into a nursing home. But in our current system, that might be her only option.
The CLASS (Community Living Assistance Services and Support) Act was supposed to help patients like Mrs. T get the care they need at home. It was a voluntary insurance program for coverage of community living services and support: making a house wheelchair-accessible, hiring a home caregiver to assist with basic tasks, and the like.
The problem that led to last week's decision was that the program couldn't be made to pay for itself. But that doesn't mean we don't need such a program.
American seniors currently have few long-term care options. They can pay for home care out of pocket, which tends to burn through a lifetime of savings quickly. They can give up their independence and get institutional (and at times dehumanizing) care at a nursing home. Or they can take the significant risks of going it alone, as Mrs. T did.
Home care not only keeps seniors in their homes; it keeps them out of hospitals and nursing homes. Nursing home residents are much more likely to develop depression, lose the ability to get around without assistance, and acquire persistent infections. This creates a vicious cycle of increasing health-care needs and costs.
