Long-Term Care Is a Woman’s Issue. Still. And Always.

LONG-TERM CARE

By Wendy Boglioli

Walk into almost any assisted-living community in this country and look around. About seven in 10 of the residents you will see are women. Eighty-four percent are over 75. Hold that picture for a moment, because I want to tell you what is not on the brochure. Assisted living is the good version. Medicaid does not pay for assisted living. It pays for a nursing home. So, when the money runs out — and for most families, it runs out — she does not stay where she is. She moves. To a room that is not her room, shared with a woman she has never met. They share the bathroom too. There is a curtain between the two beds, and that curtain is the only privacy she has left. Her things do not fit; most of them never came. And she sits there — a woman who ran a household, raised children, and held an entire family together for 50 years. She built something. And it ends in half a room, beside a stranger.

Here is the part that should stop every broker reading this: somewhere along the line, that woman was financially stable. She and her husband did most things right. Then one long care event quietly spent down everything they had built over a lifetime, until there was nothing left and the state took over. That is what qualifying for Medicaid means. You spend it. All of it.

I have spent 30 years in long-term care — as an agent, a specialist, a wholesaler, and a national spokesperson for this industry — and if I could leave brokers with a single sentence, it would be this one: long-term care is a woman’s issue. It always has been, and it still is.

Why? Two words. Caregiving and longevity. We give the care. Women are the primary family caregivers in this country, and that has not changed no matter what else has. And we live long enough to need the care ourselves — usually after caring for everyone else first. A married woman often spends years caring for her husband, spends the family’s savings doing it, and then faces her own care needs alone, with a smaller nest egg and no one left to care for her. The women in those assisted-living hallways are not statistics. They are the last chapter of a story that began with love and ended without a plan.

And the caregiving itself carries a price tag nobody puts on a slide. For only the third time in American history, women make up the majority of the workforce — and we did not hand off the caregiving when we took the jobs. When a parent or a spouse needs months or years of care, it most often lands on her, on top of the career she is already holding. Women leave jobs to provide care. They cut hours.

They come in late and leave early, sometimes managing care for someone hundreds of miles away. And they come out the other side with less in Social Security and less in retirement savings. The caregiving ends. The financial hit does not. That is just as true, by the way, for the men who step into the caregiving role — the penalty belongs to the caregiver, and the caregiver is usually her.

Now put today’s numbers against that picture. In this year’s CareScout Cost of Care Survey — Genworth’s survey, the benchmark this industry has relied on for more than 20 years — the median private room in a nursing home runs about $130,000 a year. The shared room, the one with the curtain, is about $115,000. Assisted living is roughly $6,200 a month, and bringing a caregiver into the home, which is what nearly every client says they want, runs about $35 an hour — around $300,000 a year for care around the clock. Every one of those numbers went up again this year. And before anyone files this under “retirement planning,” consider one more figure: Georgetown University tells its own faculty and staff, in its long-term care benefit materials, that 44% of individuals receiving long-term care are under age 65. A stroke, an accident, an early diagnosis. It comes when it comes.

So, what do we do with all of this — those of us who sit across the table from families for a living? I learned the answer in my first months in this business. I would sit with a husband and wife, and almost every time, the husband did all the talking. I would ask a question about long-term care; he would answer it. Every question. And she sat there, quietly listening. One day it hit me: I was talking to the wrong person.

So, I started talking to the woman — and everything in my business changed. Because she was the one who was concerned, and she was the one who was going to make the decision. I would ask her one question, and she would tell me about her mother. Or her sister. Or her grandmother. What she watched. What it cost that family. And then she would tell me the real thing: that she did not want it to happen to her. That is where this conversation actually lives. Not in a brochure. Right there.

I built my entire long-term care business on women, and my advice to brokers and advisors has not changed in 30 years. Talk to the woman. Ask her the questions. Watch her, not just him. You are not selling anything when you do this — you are helping a family protect itself, and that is the right thing to do whether it ever becomes a policy or not.

There is a business reason too, and it is not a small one. When a woman trusts you, she tells people. She tells her sister, her friends, the women she works with. One woman who feels heard will hand you three more clients — and this conversation has a way of opening up the whole family, the generation you already serve and the one coming up behind it.

November is Long-Term Care Awareness Month, and there will be no shortage of statistics in your inbox. Let me save you the trouble of memorizing them. Remember one picture instead: the room with the curtain, and the woman who built something sitting beside a stranger. Then look at your book of business and find the women most likely to end up in that bed — because they are the ones with the most to lose, and the most to gain from one honest conversation. She is waiting for somebody to ask. Be the one who asks.

“When a woman trusts you, she tells people. She tells her sister, her friends, the women she works with.”