I have written about the housing problems faced by seniors in their Golden Years. I’ve only half-jokingly written about the Golden Girl solution, with unrelated women sharing housing. Why do we call them Golden Girls rather than Golden Guys? Mostly because women tend to require long-term care more frequently than men.
About 83% of nursing home residents are age 65 or above. Nearly 39% are 85 or above. It varies with the type of care (nursing home versus assisted living), but for every seven women, there are only three men who require assisted living. That is partly because women are more likely to develop Alzheimer’s disease, because they tend to live longer. Also, wives care for their husbands, who often precede them in death. It is not always that way, however. Sometimes both partners are living, but age at different rates. The Wall Street Journal wrote about one such couple.
Every morning, Fred, 94 years old, wraps a small piece of cake in a napkin, leaves his apartment and walks over to see his wife. Betty, 93, has dementia and lives in an apartment in the same complex, where she receives memory care.
The Schlissels are a similar age but aged at dissimilar rates.
Dr. Louise Aronson, a geriatrician and author, says aging paths often diverge as people grow older, due to biology, behavior and, at times, luck. There are gender-based differences in immune and blood systems, cell structure and brain, as well as different genetic traits and habits. A partner who smoked, loved red meat, didn’t exercise and was a stressed workaholic is likely older biologically than a similarly-aged partner with healthier habits, Aronson says.
It is common for couples to have different health needs later in life. One may need nursing home care, assisted living or memory care, while the other may be able to live independently. Or it could be worse where one needs assisted living, while their spouse needs memory care. Care homes are not cheap. Independent assisted living, which is living mostly independently in an institution that provides assistance in house cleaning, meals or home care, can cost from $5,000 to $10,000 a month depending on the services. Memory care is much higher. Medicare and Medicaid do not cover these types of higher-end services. They are mostly private pay. While WSJ did not reveal the annual cost, the Schlissels likely pay more than $250,000 a year for services.
Most couples cannot afford $250,000 a year, $100,000 a year or even $10,000 a year. Long-term care insurance is also relatively rare. Meanwhile, the market for long-term care insurance is collapsing. Insurance companies cannot collect premiums, invest them and generate returns that grow enough compared to medical inflation that’s driving up the cost of long-term care. In the year 2000 about 585,000 long-term care policies were sold. In 2023 it was around 35,000. That represents a drop of 94%. Furthermore, many people who initially bought long-term care policies are finding their premiums skyrocketing. Indeed, insurers counted on people paying premiums for years and expected 5% to later drop coverage. Most did not and insurers’ costs are rising at unsustainable rates.
Long-term care policies tend to be for a finite duration or at least a fixed amount. The average length of stay in a nursing home is 835 days. However, keep in mind that nursing homes are also used for rehabilitation after surgery. The average length of stay is much shorter for people discharged after rehab, about nine months. That suggests some people stay much longer than 835 days. Rosewood, a company that owns nursing homes, reports women tend to stay 3.7 years, compared to 2.2 years for men. Also, married residents have four-months shorter stays on average compared to unmarried residents. Interestingly, the richest residents have stays averaging six months less than the poorest quartile.
Many couples age at different rates. This often means women are widowed without the ability to live independently. Other times, it means both partners are unable to live independently. That can double the cost of long-term care.
Read more at WSJ: One Couple in Their 90s Confronts a Stark Reality: Aging at Different Speeds