High cost of health care hurting Nevadans

Friday, March 10, 2000 | 11:10 a.m.

When Thelma Harris was told that her husband had just called a family friend and was making absolutely no sense, she left work and went home immediately.

"He had a bad dream, and he didn't know the dream from reality," Harris said of the incident that happened four years ago. "He was scared to death."

So was she. Her husband's Alzheimer's disease, diagnosed two years before, was progressing.

At that time her husband, Carey, a retired floor coverer, was still functioning independently. Harris called daily from work to check on him. But when a prescribed drug he had been taking was no longer effective, she hired a woman to look after him while she was at work.

At $6 an hour, it cost nearly half of her own hourly pay. Eighteen months later, Harris retired to take care of him.

Within two years he was attending adult day care. When his condition further deteriorated, Harris placed him in a group home. The expense exceeded their resources. She sold everything: their home, two rental houses, land in Pahrump. Her husband died last September.

Harris' experience is common, particularly in the Las Vegas Valley, a growing retirement destination since Del Webb Corp. developed Sun City 11 years ago.

More seniors and their families are encountering financial trouble as spouses and parents confront age-related diseases such as Alzheimer's. The Alzheimer's Association reports there are 40,000 Nevadans in some stage of the disease.

With the average cost of nursing home care being $50,000 a year, many people try to find creative ways to pay for the long-term care. Some adult children use their own retirement savings to pay for parents' care.

"There are some extremely difficult challenges," James O'Reilly, an attorney who specializes in senior law, said. "Many people have to effectively impoverish themselves. The average cost for nursing home care in Nevada is $4,583 a month."

Families of patients who aren't ready to be placed in a nursing home, group home or assisted-living center often take them to adult day care or take advantage of respite care.

Both give temporary assistance to caregivers. At adult day-care centers, patients are dropped off in the morning and picked up again in the evening. They spend the day with other seniors and participating in recreational activities.

For Harris, taking care of her husband was tiring at first. Then it became impossible.

"Sometimes we would sleep an hour. Be up three," Harris said.

She put sensors in front of the bedroom door so that when he awoke and left the room at night, she would hear him.

Eventually, out of necessity, everywhere she went, he came along. Everywhere he went, she followed. And there was his rare violent outburst -- he wouldn't remember it five minutes later.

Harris had convinced herself that she could handle this 24-hour-a-day, seven-day-a-week job.

"Then you get to a point when you find out you can't," she said. "You just get burned out because you have no personal time. And when you get burned out, the guilt starts."

When Carey was still living with her, people had offered to help, she said. "But how can I justify calling (family members) and saying, 'I can't handle him today. Can you take a day off and come watch Carey?' "

In emergencies, her family would help out. "But it's hard to ask for help from a family member on a daily basis."

Nearly 70 percent of Alzheimer's patients live at home. Many turn to adult day care for relief, said Mary Jo Greenlee, administrator of adult and senior services for Economic Opportunity Board in Clark County, which oversees Holly Hock Adult day care and Lied Adult Daycare.

Seventy-five percent to 80 percent of the clients at the two centers have some form of Alzheimer's or dementia.

"It's a very high percentage of the clients we care for, the reason being is that they are the most difficult to care for."

Because day care is often the gateway to long-term care, it's uncommon to keep Alzheimer's patients in day care long, Greenlee said.

After six years, the stages progress and patients may develop lack of mobility or swallowing problems that affect their ability to eat, she said. It may also become difficult for the family to transport them.

Adult care costs between $40 to $75 a day. Harris' insurance covered 60 days of adult day care. At three days a week, this would pay five months each year. Harris' bigger concern was the cost as his condition worsened.

The Veterans Administration told her she made too much money and had too many assets to qualify for assistance. An attorney at the Howard Cannon Senior Center told her the same.

Legal options were to cash in her 401(k), divide any bank accounts they shared into separate accounts and spend down his money. This would allow her to keep a house and one car.

Another option: Don't split the funds, spend everything, liquidate all assets until everything was gone. Then they would qualify for Medicaid, which pays for long-term care.

Her third option was divorce.

"Not after 35 years of marriage," she said. "If he is placed in a group home, who would see that he gets care? I would be his ex-wife."

Harris sold everything to pay the cost of his care. The group home cost $3,200 a month.

"You work all your life to save for retirement, an illness like this comes along and just wipes it all away," Harris said. "There's got to be a way a middle-income person can get help."

Alzheimer's affects one out of 10 people over age 65, and 40 percent to 50 percent of people over 80.

In 1998, 200,335 seniors aged 65 and older were living in Nevada, according to the Census Bureau; 15,000 were 85 and older.

Given the senior population in Nevada, 20,000 people could be affected with Alzheimer's.

Joanne Wyman, social services manager with the Community Based Care Unit in the state Division of Aging Services, said the fastest growing segment of people 60 and above are those 80 and older. Newly retired people are moving to Las Vegas and bringing their parents with them, she added.

Those who end up in a nursing home, group home or assisted living center may end up having Medicaid pick up the tab.

Medicaid pays up to $35,000 a year for those who need nursing home care.

The state Welfare Division reports that 1,182 aged Medicaid recipients in Clark County are institutionalized.

"Long-term care is a problem, and as the baby boomer generation ages, it's going to be a bigger problem," Perry Comeaux, state budget director, said.

The aged and disabled group is one of the smallest groups on Medicaid, but per participant, it is the most costly, Comeaux said. The budget director said Nevada paid $36 million in 1999 toward its share of the Medicaid coverage.

"Las Vegas is the fastest growing retirement city in the world," O'Reilly said. "There is no way we are going to provide for the care needs of this senior population now or anytime in the foreseeable future. As much as Las Vegas supports, nurtures and develops a positive environment for people to come here, this is not a good town to get sick in.

"If you're going to save for retirement, you should buy a long-term policy."

A long-term care package for someone aged 65 costs $1,000 a year, O'Reilly said.

Policies are best bought when a person is in their 40s and 50s, O'Reilly said.

Not many people have bought such policies, however. The National Association of Insurance Commission reported that in 1997, 4,529 people were covered in Nevada under long-term care.

"There's very few people in the country who buy long-term care insurance and even fewer in Nevada," said Tom Canfield, an actuary with the life and health section of the state of Nevada Division of Insurance. "There's going to be a serious problem if nothing's done."

Nationally, 1.1 percent are insured under long-term care, he said, with Nevada coming in even lower, at 0.27 percent.

Years prior to Carey Harris' diagnosis, the Harrises had their living wills and burial plans taken care of.

"Not in our wildest dreams did I know you could buy a long-term insurance policy," Harris said. "Had I known, I would have done it a long time before."

archive