Turn on your TV and you’ll hear the rhetoric of the season. “Obama cut $716 billion from Medicare,” declares one political ad. “Mitt Romney: An end to the Medicare Promise,” pronounces another. The future of Medicare is an important issue for seniors, but it’s not the only one.

“There’s a lot being said about Medicare, but not much at all about long term care,” says Howard Bedlin, vice president of public policy for the advocacy group National Council on Aging. Long-term care for the elderly involves more than just access to health care. It includes issues like transportation, housing, and support services that help seniors with daily activities like eating, bathing and taking the proper medication.

“It’s a pretty broad issue that millions of families are facing, but politicians aren’t talking much about,” says Bedlin.

A growing issue

The issue of long term care for the elderly is one that promises to grow. One in seven Americans are 65 or older. By 2030, that’ll jump to one in five. And it’s no surprise that most seniors want to live out their years at home. 

“We’re not just talking about people who currently need it, but people who may need it down the road,” says Bedlin.  

A life coach for seniors

There are some things we take for granted: Walking up steps; getting in and out of the tub; shopping for groceries; remembering what pills to take. But as we age, these things may become more difficult.

That’s where Linda Smith comes in. She’s a private nurse and a geriatric care manager, and she’s part of a booming service industry helping the elderly. Smith meets with families and puts together a care plan for seniors. It all starts with an initial assessment. 

“I assess their whole body—their mind, their cognitive status, their functional status, how are they moving in their space,” Smith says. “Are they unstable? Are they tripping?”

Think of Smith as a life coach for seniors. She looks at her clients’ medications, finds out if they know about the side effects, and if they are making their doctor appointments. She figures out if they have a living will and asks important questions about her clients’ security.      

“Do they need an elder law attorney? Do they need a financial planner? Are they going to outlive their money?” 

Financing long term care

Money is a big issue. For seniors to stay in their home, they may have to renovate. Things like adding grab bars in the bathroom, or removing throw rugs that increase the risk of falling can be relatively inexpensive.  But other things can be costly, like home health aids.

“You know Medicare doesn’t cover these kinds of long-term care services,” said Bedlin. “What happens is you get children of these seniors shouldering what is often times an unreasonable burden.” 

That burden gets worse when seniors run out of money. Then they’re forced to go on Medicaid, which often means moving into a nursing home. 

This isn’t just an issue for seniors. A recent survey by the AARP shows that a lot of baby boomers worry that they won’t have financial security in retirement.  

“Like a lot of issues it’s the middle class that gets hit the hardest,” says Bedlin.      

So what can be done to keep seniors living independently and in their homes? Congress addressed this in the 1960s, with the Older American Act, which provides some funding for long-term care. Bedlin says it’s underfunded, at a time when more seniors need help. 

Unfortunately for seniors, the situation gets worse. Remember the debt-ceiling debate over a year ago? To avoid a government shutdown, Congress agreed for automatic cuts to take effect Jan. 2, 2013. That puts long-term care for the elderly in jeopardy. 

Will concerns about aging Americans affect the way you vote? Weigh in and learn more.