Helping a couple, who paid for long term care insurance for the last 19 years, it was tragic to see that when it was needed, between the red tape, exclusions etc., they didn’t receive a dime. A combination of Medicare and supplemental policy covered hospice. At the end of the day, the long-term care policy was useless. Money, that could have improved their lives, was wasted.
Fortunately, the couple was able to remain in their home because of dedicated family as well as strong community support, all of which was unpaid. Now that the husband has died, the widow is faced with the challenges that many women find themselves in. Who will take care of her?
Regardless of income, the combination of longer lives and low saving rates are putting many at risk of depleting resources and becoming entirely dependent on social security at the end of their lives. Is long-term care insurance the answer? Are there ways to reduce the need for long-term care?
Today’s post aims to address both of these questions.
WHAT IS LONG TERM CARE: Long-term care involves a variety of services designed to meet a person's health or personal care needs during a short or long period of time. These services help people live as independently and safely as possible when they can no longer perform everyday activities on their own. Most long-term care is provided at home by unpaid family members and friends. It can also be given in a facility such as a nursing home or in the community, for example, in an adult day care center. National Institute on Aging.
NEED FOR LONG TERM CARE: How much care you need and for how long will vary from one person to the next. Today, someone turning 65 will have about a 70% chance of needing some type of help and support as they age. Women, because of longevity and serving as caregivers of spouses who died before them, tend to need care longer. However, a third of those who are 65 will never need long-term support and for those that do, many rely on unpaid care from family and community. US Administration on Aging
The top ten reasons people need long-term care are:
1. Fractures resulting from a fall.
2. Recovery from an illness, injury or surgery
3. Rehabilitation following a hospital stay
4. Alzheimer’s Disease and dementia
5. Multiple Sclerosis
6. Parkinson’s Disease
7. Heart disease
9. Head injury, also related to falls
10. Obesity and other chronic or terminal medical conditions.
Approximately 82% of long-term care is delivered in the home. With the baby boomer generation becoming the “silver tsunami,” many communities have become more aggressive in developing programs to help people age in place.
In addition, there are new housing options being developed including senior apartments; continuing care retirement centers (CCRCs), co-housing and intentional communities .
Some communities have developed a Village-to-Village Network. These are generally grassroots nonprofits that help to coordinate access to affordable services. Not only can you obtain help from such organizations but it also provides an opportunity to volunteer
LONG TERM CARE INSURANCE: Long-term care insurance sounds ideal. As people age, more and more recognize the potential need for home health and possibly nursing home care. However, it’s a field loaded with fraud and deception, with seniors on fixed incomes the biggest targets.
The rising costs of premiums, exclusions, and fewer companies offering such coverage has made long term care insurance less popular. However, there are new trends in the field, such as combining long-term care with life insurance policies, which may make it more feasible for those who can afford the policies in the first place.
While I’m including various articles where you can learn more about trends and policies pertaining to long term care insurance, if you are already on Medicaid or you know you can’t afford premiums, skip to the next section on ways to reduce the need for long term care.
• 5 Things You Should Know about Long-Term Care Insurance: A new breed of policy is taking off, but it can be pricey.
• Why Long-Term Care Insurance is a Bad Idea: While the majority of Americans will need long-term care later in life, there are ways to save for it that have less risk than long term care insurance.
REDUCING NEED FOR LONG TERM CARE: In looking at the top ten reasons people require long term care, numbers 1 & 9 relate can be significantly reduced by avoiding falls in the first place. Check out I’ve fallen but I can get up to learn how to avoid falls and what to do if you should fall.
• Maintain a healthy diet and life style so that you remain as functional as possible. Check out Healing the Whole Person: Ways to Increase Well-Being
• Know your finances and what you can afford to do not just what you’d like to do. Have realistic expectations of family, close friends and your community. Don’t assume your adult children will drop everything and come take care of you. As the expression goes, prepare for the worst and hope for the best.
• Understand what you might need and identify resources that can help you. Use the Getting What you Need Checklist to help identify the types of things you might need and how to locate them.
• Where you live matters: Your state, community and home all can make a significant difference in how you live and your need for long-term care. Don’t make assumptions about what is available, do your homework so you know about benefits, resources etc.
- If you don’t think your home is suitable for your changing needs, make a move to a new home/community that is better for you.
- Your home should be set up so it’s handicap accessible, easy to manage, allows for maximum mobility while reducing the risks of falls. Living on one level, where it is easy to get outside, is going to eliminate a number of potential problems. Every state has an Independent Living Center, which can help make your home handicap accessible.
- Choose a community where many of these components are available: Transportation services for medical appointments, shopping etc.; Good emergency response systems; Friendly visitor/companion services are available; medical services are nearby; home delivered meals are available; a nearby senior center where you can socialize and exercise
- Consider different types of housing such as co-housing; intentional community; senior living facility; continuing care retirement center.
- Look for communities that have established Village to Village Network or something similar
• Live below your means. If you spend less than what you income is you can build up a nest egg to help when you need it the most. Check out Recession Proof Your Life.
• Use Assistive Devices: There are all sorts of tools and devices to help make activities of daily living much easier and allow you to maximize your independence. Condition specific support groups will often have items to make things easier. Check out Gadgets to Make Life Easier.
• Use a Life Alert System: Whether it’s a fear of falling, a sudden onset of a life-threatening symptom, or a charge that wanders, there are ways to reduce and even eliminate concerns using an appropriate life alert device/system. Such items can make all the difference in being able to live independently. Medic Alert Devices/Systems Increase Independence
• Join the local chapter of the condition specific organization you are affected by (e.g. American Lung Association) and become actively involved. These organizations can help in many different ways including recommendations for housing, providing assistive devices, offering a supportive network of people
• Invest in Social Capital: Your social networks have value and importance. By being an active participant in your community, condition specific organization, family, work and other networks, you have an opportunity to give to those in need and in turn, have community you can reach out to when you need help. Check out The Importance of Social Capital for those Affected by Chronic Conditions