Pada tahun 2000, hampir 10 juta orang membutuhkan Long Term Care di Amerika. Dari populasi ini, 3.6 juta (37%) berumur di bawah 65 dan 6 juta (63%) berumur di atas 65 (Roger & Komisar, 2003). Baru-baru ini, riset menunjukkan bahwa kebanyakan orang Amerika yang telah mencapai umur 65 akan membutuhkan Long Term Care dalam hidup mereka. Bagian ini memberi informasi dasar sehingga Anda dapat mulai mempertimbangkan bagaimana Anda akan menangani kebutuhan atas Long Term Care. Pilihan Anda akan unik, berdasarkan preferensi dan keadaan Anda. Mari kita lihat pertanyaan-pertanyaan yang sering diajukan:

Apa itu Long Term Care?

Long Term Care adalah bermacam layanan dan bantuan yang mungkin Anda butuhkan untuk memenuhi kebutuhan pengasuhan pribadi Anda. Kebanyakan Long Term Care bukanlah pelayanan medis, melainkan bantuan untuk melakukan pekerjaan sehari-hari, seperti:

  1. Mandi
  2. Mengenakan pakaian
  3. Memakai toilet
  4. Beranjak (dari atau ke tempat tidur atau kursi)
  5. Bantuan saat mengompol
  6. Makan

Long Term Care  BUKAN layanan kesehatan, melainkan bantuan untuk melakukan pekerjaan sehari-hari bagi yang tidak bisa melakukannya dan membutuhkan bantuan jangka panjang untuk beberapa pekerjaan sehari-hari. Pengasuhan jangka panjang juga mencakup pengawasan yang mungkin Anda butuhkan oleh sebab disabilitas, penyakit kronis, atau penyakit kognitif parah (seperti penyakit Alzheimer’s)

Pengasuhan jangka panjang TIDAK dimaksudkan untuk mengobati Anda. Ini adalah pengasuhan yang mungkin akan Anda butuhkan untuk sisa hidup Anda. Anda dapat memperoleh Long Term Care di rumah Anda sendiri, panti jompo, atau fasilitas Long Term Care lainnya, dengan layanan berkualitas oleh perawat formal maupun informal. Mereka yang membutuhkan pengasuhan kini dapat tetap tinggal di rumah, seperti yang mereka inginkan.

Pengasuhan jangka panjang mencakup: Pekerjaan rumah, Mengelola uang, Meminum uang, Memasak dan membersihkan setelah makan, berbelanja kebutuhan sehari-hari atau baju, memakai telepon atau alat komunikasi lainnya, Menjaga hewan peliharaan, Merespons peringatan-peringatan darurat seperti peringatan kebakaran.

Sering orang tidak bisa membedakan antara Long Term Care dengan perawatan disabilitas atau perawatan medis jangka pendek.

Pengasuhan jangka panjang BUKAN:

  1. perawatan yang Anda dapatkan di rumah sakit atau di kantor dokter
  2. perawatan yang Anda butuhkan untuk pulih dari sakit atau cedera
  3. rehabilitasi jangka pendek setelah kecelakaan
  4. pemulihan dari operasi bedah

Siapa Yang Membutuhkan Long Term Care ?

Siapapun dapat membutuhkan Long Term Care sewaktu-waktu. Kecelakaan saat berkendara dan berolahraga; peristiwa-peristiwa yang menyebabkan disabilitas seperti stoke, tumor otak, dan cedera saraf tulang belakang; dan penyakit-penyakit yang menyebabkan disabilitas semisal multiple sclerosis dan Parkinson adalah beberapa cedera dan penyakit yang dapat terjadi kepada siapapun dan kapanpun.

Menurut U.S. Department of Health and Human Services (HHS), sekitar 70% orang yang sudah berumur 65 akan membutuhkan Long Term Care sewaktu-waktu. Ada beberapa faktor yang ikut dapat menyebabkan Anda akan membutuhkan Long Term Care:

  1. Umur: Makin tua usia Anda, makin besar kemungkinan Anda membutuhkan Long Term Care. Hampir 41% Long Term Care diberikan kepada orang yang belum berumur 65 yang membutuhkan bantuan untuk mengurus diri sendiri oleh sebab penyakit, disabilitas, cedera, masalah pertumbuhan, dan penyakit jiwa parah.
  2. Jenis kelamin: Wanita rata-rata hidup 5 tahun lebih panjang dari pria, jadi mereka lebih berpeluang untuk hidup sendirian saat beranjak tua.
  3. Disabilitas: Mengalami kecelakaan atau penyakit kronis yang menyebabkan disabilitas adalah alasan lain mengapa orang membutuhkan Long Term Care. Secara rata-rata, antara umur 40 dan 50, delapan persen orang memiliki disabilitas yang dapat membutuhkan Long Term Care. 69 persen orang yang berumur 90 atau lebih menderita disabilitas.
  4. Status Kesehatan: Penyakit-penyakit kronis seperti diabetes dan tekanan darah tinggi membuat kemungkinan Anda lebih tinggi untuk membutuhkan pengasuhan. Sejarah keluarga lainnya, misalnya apakah orangtua atau kakek-nenek Anda menderita penyakit kronis juga dapat berpengaruh. Pola dan kebiasaan makan yang buruk dan kurang olah raga juga meningkatkan resiko Anda membutuhkan Long Term Care.
  5. Teman Hidup: Kalau Anda hidup sendiri, Anda lebih beresiko harus membayar untuk pengasuhan dibandingkan apabila Anda menikah atau hidup dengan pasangan.

Medicare dan program asuransi kesehatan swasta tidak menanggung sebagian besar layanan Long Term Care yang dibutuhkan banyak orang. Sangat penting bagi Anda untuk memiliki rencana agar dapat mendapatkan jasa pengasuhan yang mungkin Anda butuhkan.

Siapa yang menanggung Long Term Care?

Survey konsumen menunjukkan adanya salah kaprah tentang program pemerintah yang menanggung jasa Long Term Care. Sangat penting untuk betul-betul memahami apa yang ditanggung dan apa yang tidak.

  1. Medicare:

Hanya menanggung Long Term Care jika Anda membutuhkan layanan tenaga terampil atau layanan rehabilitatif:

Di panti jompo (nursing home) selama maksimal 100 hari. Tapi, rata-rata kunjungan yang ditanggung Medicare jauh lebih pendek (22 hari).

Di rumah jika Anda juga menerima jasa tenaga terampil kesehatan di rumah. Secara umum, layanan Long Term Care diberikan hanya untuk tempo singkat.

Tidak menanggung asistensi non-terampil dengan aktifitas sehari-hari (Activities of Daily Living (ADL)), padahal ADL adalah bagian terbesar dari layanan Long Term Care.

Anda harus menanggung jasa Long Term Care yang tidak ditanggung oleh program asuransi pemerintah atau swasta.

  1. Medicaid:

Menanggung sebagian besar jasa pengasuhan kesehatan. Tetapi, agar memenuhi syarat, Anda harus berpenghasilan di bawah angka tertentu dan Anda juga harus memenuhi persyaratan-persyaratan dari negara bagian (state).

Persyaratan-persyaratan tersebut berdasarkan jumlah asistensi yang Anda butuhkan dengan ADL

Program-program pemerintah federal lainnya semisal Older Americans Act dan Department of Veterans Affairs memang menanggung layanan Long Term Care, tapi hanya untuk populasi tertentu dan dalam keadaan-keadaan tertentu.

  1. Asuransi Kesehatan:

Kebanyakan asuransi yang disponsori pemberi kerja atau asuransi kesehatan swasta hanya menanggung layanan-layanan terbatas yang sama dengan yang ditanggung Medicare

Jika pun mereka menanggung Long Term Care, biasanya hanya untuk layanan terampil, jangka pendek dan yang diharuskan medis.

Ada semakin banyak opsi-opsi pembayaran swasta, di antaranya:

  • Asuransi Long Term Care (Long term care insurance)
  • Reverse mortgage
  • Opsi-opsi asuransi jiwa
  • Anuitas

Fakta dan mitos:

Mitos 1: Saya masih muda dan tidak membutuhkan Long Term Care

Fakta: Pengasuhan jangka panjang bukan hanya untuk orang lanjut usia. Hampir 41% Long Term Care diberikan oleh orang-orang berumur di bawah 65 tahun yang membutuhkan bantuan mengurusi diri sendiri oleh sebab penyakit, kondisi-kondisi kronis yang menyebabkan disabilitas, disabilitas perkembangan, dan penyakit-penyakit jiwa yang parah.

Mitos 2: Keluarga saya akan merawat saya

Fakta: Di masyarakat zaman sekarang, orang dewasa cenderung hidup terpisah jauh dari orangtua mereka. Ditambah, banyak dari mereka berkurang hari liburnya dan bertambah hari kerjanya. Merawat anggota keluarga adalah komitmen yang memakan waktu yang seringkali meminta jam yang banyak dari lebih dari satu anggota keluarga. Kalaupun anggota keluarga dapat menyempatkan waktu untuk merawat anggota keluarga lainnya, seringkali kerugian keuangannya besar, yaitu tidak menerima gaji, manfaat pensiun atau Social Security.

Sekitar 80 persen pengasuhan di rumah dilakukan oleh tenaga yang tidak dibayar dan dapat mencakup jasa-jasa emosional, finansial, pengasuhan, sosial, dan lain-lain. Rata-rata, tenaga pengasuhan menghabiskan 20 jam seminggu untuk mengasuh. Lebih dari setengah (58 persen) dari mereka memiliki tanggungjawab pengasuhan yang intensif, di antaranya memberi bantuan dalam kegiatan pribadi seperti mandi dan makan.

Memang, Anda dapat saja meminta keluarga untuk mengasuh Anda, tapi mungkin susah melakukannya tanpa bantuan tambahan. Kita harus mempertimbangkan aspek-aspek fisik dan emosional dari anggota keluarga yang merawat kita. Mereka juga butuh istirahat, butuh liburan, memiliki kehidupan pribadi mereka sendiri. Kita tidak boleh egois.

Agen-agen tenaga pengasuh menyediakan jasa perawat harian atau bila dibutuhkan. Agen-agen ini dapat menambah perawatan yang Anda dapat di rumah atau memberikan waktu istirahat kepada keluarga Anda.

Mitos 3: Medicare atau Medicaid Akan Menanggung Tagihan-tagihan Saya

Fakta: Secara umum, Medicare tersedia untuk umur 65 ke atas dan penyandang disabilitas. Medicare membayar sejumlah terbatas untuk tenaga perawat terampil setelah dirawat di Rumah Sakit dan tidak dimaksudkan untuk menanggung layanan yang membantu aktifitas sehari-hari untuk jangka waktu yang lama. Secara spesifik, Medicare menanggung 100 hari pertama perawatan oleh tenaga terampil di nursing home setelah dirawat di rumah sakit selama sekurang-kurangnya 3 hari dan dengan syarat Anda memasuki nursing home selambat-lambatnya 30 hari setelah meninggalkan rumah sakit. Medicare menanggung sebagian tanggungan kesehatan untuk pengobatan penyakit atau cedera. Baca selengkapnya mengenai Medicare di www.medicare.gov.

Medicaid (Medi-Cal di California) adalah program berbasis state yang disuplemen oleh dana Federal yang memberikan layanan kesehatan kepada orang miskin dan tidak mampu. Medicaid mungkin menanggung Anda jika Anda memenuhi kriteria garis kemiskinan state Anda dan mendapatkan perawatan yang memenuhi panduan state Anda.

Banyak orang berupaya berpura-pura miskin agar bisa memenuhi persyaratan mendapatkan Medicaid. State sekarang punya kewenangan memeriksa sejarah keuangan lima tahun terakhir pendaftar Medicaid dan dapat menerapkan penalti. (Persyaratan tiap state berbeda-beda, jadi hubungi kantor pelayanan Medicaid di state Anda untuk lebih jelasnya.) Baca selengkapnya mengenai Medicaid di www.medicaid.gov.

Mitos 4: Asuransi Kesehatan Akan Menanggung Tagihan-tagihan Saya

Fakta: Asuransi kesehatan jarang yang menanggung kebutuhan akan perawatan kronis yang sedang berjalan. Kebanyakan rencana asuransi kesehatan, termasuk FEHB, TRICARE, dan TRICARE for Life, dimaksudkan untuk menanggung layanan medis terampil jangka pendek saat Anda sedang dalam proses pemulihan dari sakit atau cedera.

Mitos 5: Tabungan Saya Memadai

Fakta: Membayar dari tabungan pribadi adalah satu cara untuk menanggung biaya Long Term Care. Namun, Anda sebaiknya mempertimbangkan dahulu biaya jasa Long Term Care, sebelum melakukan metode ini. Berikut biaya rata-rata untuk jasa Long Term Care (berdasarkan survei tahun 2016, dan biaya makin meningkat)

  • $21 per jam untuk tenaga kesehatan rumah
  • $79 per hari untuk layanan di pusat penitipan orang jompo
  • $3,922 per bulan di fasilitas assisted living
  • $251 per hari untuk ruang semi privat di nursing home
  • $282 per hari untuk ruang privat di nursing home

Seberapa Pengasuhan Akan Anda Butuhkan?

Durasi dan kadar Long Term Care akan berbeda untuk tiap orang dan dapat berubah seiring waktu. Berikut statistik yang perlu Anda pertimbangkan (semua angka adalah “rata-rata”):

  • Orang yang umurnya mencapai 65 memiliki peluang hampir 70% membutuhkan jasa dan dukungan Long Term Care di sisa umur mereka.
  • Wanita membutuhkan pengasuhan lebih lama (3.7 tahun) dibanding pria (2.2 tahun).
  • Sepertiga dari orang berusia 65 mungkin tidak akan pernah membutuhkan bantuan Long Term Care, tetapi 20 persen akan membutuhkannya selama lebih dari 5 tahun.
  • Tabel di bawah menunjukkan bahwa secara keseluruhan ada lebih banyak orang memakai jasa Long Term Care di rumah dibanding di fasilitas.
  • Distribusi dan durasi layanan Long Term Care
  • Tipe pengasuhan. Rata-rata jumlah tahun memakai pengasuhan ini. Persen orang yang memakai pengasuhan ini (%)
  • Jasa apapun di rumah. 3 tahun. 69%
  • Hanya pengasuhan tak berbayar. 1 tahun. 59%
  • Pengasuhan berbayar. Kurang dari 1 tahun. 42%
  • Pengasuhan apapun di rumah. 2 tahun. 65%
  • Di Fasilitas
  • Fasilitas nursing. 1 tahun. 35%
  • Assisted living. Kurang dari 1 tahun. 13%
  • Pengasuhan apapun di fasilitas. 1 tahun. 37%

Pengasuhan di rumah (yang lebih disukai kebanyakan orang) secara umum lebih terjangkau daripada pengasuhan di nursing home, tapi kadang mahal juga. Kalau di rata-rata secara nasional, tarif kunjungan selama enam jam oleh pengasuh ke rumah adalah $126.3, dengan kata lain $32,760 per tahun untuk pengasuh ke rumah enam jam sehari, lima hari seminggu.

Tahun 2016, biaya rata-rata nasional untuk sebuah ruang semi privat di nursing home adalah $91,615 per tahun. Anda juga perlu pertimbangkan total biaya jika Anda butuh lebih dari satu tahun pengasuhan. Misalnya, biaya pengasuhan untuk tiga tahun adalah $274,845. Anda bisa saja menanggung sendiri biaya pengasuhan bila memang Anda sanggup.

Nominal-nominal di atas adalah rata-rata nasional dan jasa Long Term Care dapat saja lebih murah atau lebih mahal di daerah Anda. Selain itu, keadaan tiap individu berbeda-beda dan mungkin saja Anda dapat lebih menghemat dibanding orang lain.

Oleh:

Riana Atmadjaja

Financial Literacy Campaigner 

(855) 821-2062

 

 

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  94. If you’re still on the fence: grab your favorite earphones, head down to a Best Buy and ask to plug them into a Zune then an iPod and see which one sounds better to you, and which interface makes you smile more. Then you’ll know which is right for you.

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