Understanding the Context for Long-Term Care Planning

Abstract

Evolving family structure and economic conditions may affect individuals' ability and willingness to plan for future long-term care (LTC) needs. We applied life course constructs to analyze focus group data from a study of family decision making about LTC insurance. Participants described how past exposure to caregiving motivated them to engage in LTC planning; in contrast, child rearing discouraged LTC planning. Perceived institutional and economic instability drove individuals to regard financial LTC planning as either a wise precaution or another risk. Perceived economic instability also shaped opinions that adult children are ill-equipped to support parents' LTC. Despite concerns about viability of social insurance programs, some participants described strategies to maximize gains from them. Changing norms around aging and family roles also affected expectations of an active older age, innovative LTC options, and limitations to adult children's involvement. Understanding life course context can inform policy efforts to encourage LTC planning.

Keywords: life course; long-term care insurance; long-term care planning; long-term care policy.

Figure 1.

Conceptual model of factors influencing long-term care planning based on life course framework constructs. Note. LTC = long-term care. This conceptual model, developed using constructs from a life course framework (Alwin, 2012; Elder, 1985, 1994; Macmillan, 2005; Mayer, 2009), shows how various factors throughout one’s life course may together function to affect LTC planning. According to this model, LTC planning is one transition that can be shaped by prior experiences, including trajectories (pathways in specific roles) and other transitions, and can occur at any point or at multiple points in one’s life. Sociohistorical context may affect values, norms, and roles as one moves through trajectories and transitions. Linked lives reflects how one’s individual trajectories can be interconnected with and affected by the trajectories and transitions of others.