Late Life Health Care Myths and Misperceptions

By Robert F. Bornstein, PhD and Mary A. Languirand, PhD

With the start of a new year, and implementation of the Affordable Care Act that much closer, we thought this a good opportunity to dispel some lingering myths-misperceptions that prevent older adults from getting the best care possible, and prevent caregivers from being fully informed. Let's take a look at these myths, and see where they're wrong.

Myth #1:   Dementia is an expectable part of aging-especially in our 80s and beyond

Fact: Almost everyone shows some decline in motor skill and cognitive function in their 70s and 80s, but a relatively small percentage of older adults develop Alzheimer's disease or some other form of dementia. Studies show that about 12% of 84 year olds show significant symptoms of dementia; by age 89 that number rises to about 25%. (Put another way, 75% of 89 year olds are dementia-free.)

Myth #2:   Medicare covers most of the cost for in-home care

Fact: Medicare covers part of the cost of in-home nursing or therapy services for a brief period following hospitalization or treatment in a skilled nursing facility. However, Medicare isn't designed to pay for the kinds of in-home help many people need, such as assistance with bathing, dressing, cooking, or cleaning. These services are sometimes covered by long-term care insurance, but it depends on the policy.

Myth #3:   Assisted living provides round-the-clock access to medical care

Fact: Most assisted living facilities have a registered nurse on premises to respond to residents' everyday medical needs, but there is rarely a "doctor in the house". Even in skilled nursing facilities physicians may be available during the day and on-call after hours, but they are rarely in the facility 24/7. Nursing staff act as the physicians' eyes and ears and make the day-to-day judgment calls (that's why they call them nursing homes).

Myth #4:   Nursing home residents have few legal rights

Fact: Nursing home residents have the same legal rights as any other United States citizen. Unless their medical condition dictates otherwise, a nursing home resident may vote, drive, interact with whomever he or she wishes, own property, and bear arms (it's true).

Myth #5:   Nursing homes offer only basic care-no frills required

Fact: Nursing homes are required by law to offer a safe, homelike environment and to address a vast spectrum of resident needs. The key word here is homelike. Nursing homes must provide entertainment, social interaction, exercise, access to religious services, transportation off-grounds, and privacy for personal matters (including an active sex life).

Myth #6:   Once you enter hospice, there's only one way out-feet first

Fact: To be eligible for hospice care a patient's physician must declare that patient terminally ill-in the doctor's judgment that patient has fewer than six months to live. But doctors aren't perfect, and it's not unusual for someone to enter hospice, get better, and return home (or to assisted living or a nursing home). People really do get discharged from hospice....sometimes more than one time.


Robert Bornstein and Mary Languirand are the authors of When Someone You Love Needs Nursing Home, Assisted Living, or In Home Care, published by Newmarket Press. The second edition, revised and updated, was recently released. Here's the link: