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Cost of long-term care a burden, especially for the middle class \\ By Emily Micucci S hrewsbury resident Ann Masiello knows a thing or two about the business of caring for the elderly. At 68, she's been a caregiver to three elderly relatives, including her mother and her uncle in the past, and now her aunt. Masiello also struggles with her own chronic health issues, and she lost her 39-year-old son last year. She doesn't have brothers or sisters, and admits that the stress has been difficult to cope with at times. "I sometimes crumble," she admitted. Like many Americans with aging relatives, Masiello is driven largely by a desire to do right by her aging family members. But she's also learned that arranging care can be a tremendous burden — mentally, emotionally and financially — for the elderly and their loved ones. PAYING FOR THE GOLDEN YEARS These days, Masiello spends much of her mental energy ensuring that her 98-year-old aunt is well cared for at a long-term care facility in Worcester. A former Spag's employee who worked until she was 85, Masiello's aunt paid to live in assisted liv- ing until she became too ill and required regular medical care. Meanwhile, her savings were run- ning low. Luckily, Masiello's aunt qualified for a subsidy from MassHealth, the state's Medicaid insurance program, in December, but that was only after her application for coverage was rejected five times. Masiello couldn't believe how difficult it was to get her aunt covered, given her many years of working and paying into the system. "I wouldn't know, as a layperson, where to begin," Masiello said. That's why she hired an expert to help with her aunt's case. Deborah Fins, of Deborah Fins Associates, a Worcester-based geriatric care man- agement consultant, has worked in the field for 30 years. Fins provides guidance to the elderly and their family members on planning and financing care and living expenses, and she said Masiello's astonishment at their complexity and cost is quite common. A middle-class problem "What people are shocked about is (learning) Medicare is not going to pay for them to be in a 14 HEALTH • Spring 2015