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Understanding Long Term Care Insurance

When it comes to health and medical situations everyone wants to be covered, which is why people buy and sell health insurance. As adults live longer they typically have a greater need for medical services, as the body inevitably continues to break down and age. For adults aged 55+, it can be difficult to sift through what health care options are available, and which ones are the most affordable.

Long term care refers to seniors who need daily medical or living assistance because of disease, illness, or injury. Medicare does not pay for long term care (LTC) such as time spent in nursing homes, assisted living, or in-home care, even though data shows that 50% of American seniors require this type of care. There is a great probability that you or your loved one will need to pay out of pocket for some type of long term care (LTC), and if you don’t have the savings account or equity in your home to do so, long term care insurance may be the best option.

Breaking down the basics

Here are a few points you should know when it comes to long term care insurance:

  • The two main types of long term care insurance typically offered are hybrid (more flexible and more expensive) and traditional (less flexible and less expensive).
  • The older you are when you purchase a plan, the more expensive it will be.
  • The cost of LTC varies greatly by state, and then again within each state.
  • Most plans include a waiting or elimination period before benefits are paid out. This can be anywhere from 0-100 days. The longer your waiting period, the lower the premium price, but you’ll pay for costs out of pocket until your benefits kick in.
  • Most policies are subject to premium increases and/or benefit changes.
  • There are tax advantages to buying long term care insurance.

It’s a gamble

As stated before, one in every two American seniors will need long term care, but for how long and to what degree varies widely. Almost 50% of seniors who receive long term care do so for less than one year, with only 14% needing it for 5 years or more. If you are on the younger side of aging (say 55 opposed to 65) and are in good health, your premium will be among the lowest offered. In contrast, if you are over 65 or have a history of medical issues you may not even qualify for a policy, or if you do the premium will be very expensive.

Because no one can predict the future, deciding on the plan that’s right for you requires a look back on your medical history, as well as a look forward to try and guess what situations may occur and for how long you or your loved one may need assistance. It also requires a look at your finances. How long can you sustain paying for long term care out of pocket?

What does long term care insurance cover?

This is, of course, subject to what you think you may need, but some typical coverage points are as follows:

  • Stays in nursing homes, assisted living communities, and adult day care services.
  • In home care, including assistance with daily living activities (ADLs).
  • Home modifications: adapting the home for wheelchairs, walkers, grab bars, etc.
  • Care coordination: a trained professional to keep all the information, finances, and care moving along smoothly.

Hybrid plans have more expensive premiums, but they guarantee that an unused portion of the payout goes to your spouse or children should you not need all of it. They are also tempting because the premium is locked in at the beginning of the plan and is not subject to inflation. Traditional plans have less expensive premiums, but should you never actually need to use your coverage you won’t see a dime of the money you have already spent. The premiums can also increase every year.

Federally-funded Medicaid is an option for individuals or couples who have very low income and no other means (such as home equity, retirement or savings account, etc.) to pay for long term care.

If you are generally in good health and can afford the yearly premiums then purchasing long term care insurance may be a good option for you. If you can’t afford the premiums then it may be better to save extra every month, pull from the equity in your home, use Veteran’s Benefits, and have a real conversation with your family members about the future and what everyone will be able to contribute.

If you have questions about long term care, placement options, or have questions about the health of an aging loved one please reach out to one of our senior care coordinators. Our services are always free of charge to you.

Your Guide to Activities of Daily Living (ADLs)

Perhaps you’ve noticed your aging mother has unexplained bruises on her arms or legs, or maybe you found the TV remote in the fridge and the milk in the pantry. Maybe your dad is no longer capable of maintaining his yard or he has been smelling a little off lately, possibly indicating a failure to keep himself clean on a daily basis. These and many other situations are common signs that aging adults may be having trouble keeping up with their activities of daily living (ADLs).

Fender benders, bills that haven’t been paid, and missed medication dosages are more serious signs that perhaps the mental and/or physical health of your aging loved one may not be what it should be to maintain a safe and healthy lifestyle. Here is a basic checklist of activities that seniors should be able to perform on their own.

Bathing/Personal Grooming

  • Can take showers/baths completely on their own with no assistance from someone (grab rails or a seat in the shower can help maintain independence).
  • Can use the toilet completely independently.
  • Maintains daily or every other day cleanliness practices.
  • Nails, hair, and skin look clean, healthy, and well maintained.
  • Clothing is clean and neat, and they are able to dress.

May need support if they:

  • Can only wash hands and face.
  • Cannot shave safely or regularly.
  • Are physically unwilling or unable to take a bath or shower.
  • Are bedwetting at night or incontinent during the day.
  • Are unwilling to receive assistance to maintain daily cleaning standards.
  • Are unaware that days or weeks pass by without maintaining personal cleanliness.
  • Cannot wash or keep clothes clean or need assistance dressing.

Nutrition and Exercise

  • Can safely prepare, cook, and clean up after a meal in the kitchen.
  • Can drive to the store to buy healthy food, or has food delivered on a weekly basis.
  • Is able to comply with any food allergies, sensitivities, or diet restrictions.
  • Can walk, swim, jog, garden, etc. daily or weekly with no assistance.

May need support if they:

  • Cannot safely use the kitchen tools, stove, etc.
  • Let food spoil or don’t notice expirations dates.
  • Cannot drive to the store or don’t have access to healthy food choices daily or weekly.
  • Cannot adhere to any dietary restrictions.
  • Cannot or won’t feed themselves or are constantly dehydrated.
  • Are unable to engage in physical activity, especially having trouble walking or moving around.

Lifestyle

  • Can shop, attend appointments, and find their way around town and back home.
  • Can attend family and social gatherings without assistance.
  • Can drive safely and independently.
  • Remembers names, important dates, and faces, or uses a calendar or reminders to do so.
  • Pays bills on time and in full.
  • Adheres to taking correct medication dosages.
  • Can use a telephone, email, etc. with little or no assistance.

May need support if they:

  • Are unable to drive and run necessary errands or go to appointments.
  • Get lost or cannot remember where they are or where they live.
  • Consistently forget familiar faces, dates, and scheduled appointments.
  • Forget to pay bills, cannot walk to the mailbox, misplace important paperwork, etc.
  • Forget to take prescriptions or take the incorrect dosage.
  • Are unable to use the telephone to communicate or a computer to check email, etc.
  • No longer show interest in social or family gatherings.

Housekeeping/Yard

  • Can keep the inside of their home clean independently or can hire help to do so.
  • Can wash dishes, put things away without assistance.
  • Can maintain the outside yard with little to no assistance or can hire out help to do so.
  • Can fix small problems that arise or can hire someone to do so.

May need support if they:

  • Cannot consistently maintain or clean the interior of their home.
  • Are unable to notice or fix problems such as leaks, pest control, broken appliances, etc.
  • Are unwilling or unable to hire outside help to help manage the issues.

Of course, there are many different lifestyles and standards for what is considered normal and healthy, and this checklist is just a general guide. If your aging loved one is unable to complete most ADLs on their own or almost on their own, their own safety and the safety of anyone who lives with them may be in jeopardy. Often times bringing in an in-home caregiver on a part-time basis is enough support to keep the aging adult comfortable in their own home.

If you notice that your aging loved one needs support in one or more of these areas, it can be a difficult conversation to have. The sooner you talk through these issues with your family, the easier it will be on everyone in the long run.

A senior care coordinator can help smooth out the tough conversations that need to take place, as well as offer outside support and assistance with a gentle and experienced hand. Don’t hesitate to reach out to our knowledgeable and experienced care coordinators, as our services are always free of charge to you and your aging loved one.

How to Pay for Assisted Living

If statistics can be believed, then half of American seniors will need assistance with activities of daily living (ADLs) or long term care at some point in their lives. As the American population continues to live longer, the need for senior medical care has increased exponentially over the past two decades. Assisted living is a popular solution for many seniors because of its flexibility and ability to meet a wide range of needs.

The average cost of an assisted living facility in the United States is $48,000 per year. The actual cost of each assisted living facility depends on the location, amenities, and the degree of senior care needed. According to AARP four out of five seniors will pay out of pocket to live in an assisted living community, and it is currently not covered by Medicare. Each state sets its own regulations for care and cost, so be sure to research all payment options available to you. This is where a senior care coordinator’s knowledge and experience can be invaluable to you.

If assisted living is a very probable part of most peoples’ futures then it’s important that we understand how to pay for it. Whether you’re planning for a loved one’s care or your own future, here is what you need to know about paying for assisted living.

Medicare

Unfortunately, some people believe that Medicare will pay for and cover all or almost all of their healthcare costs as they age. This is not the case. It really only covers your personal health insurance, including doctor’s visits and prescriptions.

Medicaid

Medicaid for seniors is a federally funded program for individuals or couples. The income levels to qualify for Medicaid are extremely low, vary by state, and it’s really only available when you have exhausted all other financial resources.

Veteran’s Benefits

If the senior is a veteran or the spouse or widow of a veteran they may qualify for Aid and Attendance from the government. By contacting the agency directly, you will be provided with someone who can assist you in finding and paying for the care you need, as well as answer any questions you may have.

Privately Funded

Some other options for paying for assisted living and care is to use the income from the sale of the home, renting the home out, long term care insurance, or using the benefits of life insurance or social security. It’s also important to have a family conversation about what (if anything) other family members can contribute. This can be time spent taking care of an aging loved one, financial support for someone else to do so, and even moving the senior in with other family members to save money.

Reverse Mortgage

A reverse mortgage is available for adults aged 62 and older. It basically takes any equity in the home and turns it into cash to help with living and medical expenses. This loan does need to be paid back, and property taxes and house insurance must still be paid every year. These loans can have some potential risks, and aging adults need to be fully aware of all the risks when taking out a reverse mortgage. Find out more detailed information here.

Choosing an assisted living facility for your loved one can seem overwhelming and perhaps intimidating. It is important to schedule a tour of all the facilities you want to look at, bring a list of questions you want to ask, and never sign a contract on the day you tour. A senior care coordinator can also take all of your specific factors (cost, level of care needed, location, etc.) and help you tour, apply for, and manage payment for whichever assisted living facilities are on your list.

How to Find the Best Assisted Living Communities

Making the decision to move your aging loved one into an assisted living facility is not an easy one. Not all assisted living facilities are created equal, and it’s important that you know what services your loved one requires, how much they cost, and the different levels of care that are offered.

When considering senior housing options an assisted living community is one of the most popular choices for families. The goal of an assisted living facility is to maintain as much independence and self-sufficiency as is safe and possible for seniors. It is also the most diverse of all the senior housing options, as it varies greatly from state to state, and the guidelines for what qualifies as an assisted living community are very generous.

Identify your needs

Some senior housing facilities offer 24-hour supervision, simple residential living, memory care wings, or partial assistance with daily living activities. Most assisted living facilities offer a range of senior care choices so that as a person ages they are able to stay in the same community while their level of care changes. To move a senior into an assisted living facility is typically not a short term decision, but instead, a long term solution that will work for everyone involved for the years to come.

It is important to first identify the needs of your aging loved one and then look for communities that satisfy all your needs, and then hit on some of your ‘wants’ as well. Take some time to read online reviews and do as much research as you can so that you know what you’re walking into when you tour. A senior care coordinator can be an invaluable asset in this process, as researching, touring, and wading through the contract paperwork can be overwhelming for family members.

For a more comprehensive list of what services and amenities assisted living communities offer click here.

Location, Location, Location

Location plays a large part in not only the monthly cost of an assisted living community, but it is probably one of the biggest factors when deciding on which community is the best fit for your aging loved one. Can family members easily drop in for visits? Is it safe for residents to take a walk outside, walk to the closest store, or walk their dog?

After you research different communities it is important to tour your top choices and to make sure you tour at different times of the day. Even after you decide on a place, make sure to visit often and drop in at different times of the day and during different events. It is important to see that all parts of the community are working well at all points.

Talk to the staff and the residents when you tour. Asf the staff if they enjoy working there, and ask the residents for their opinion on the care they receive. Elder abuse is a real and unfortunate part of our world, and studies show that as many as 1 in 10 seniors has suffered some form of it. By researching, asking questions, and visiting often you can help prevent elder abuse.

Ask for help

Choosing an assisted living facility for your loved one can seem overwhelming and perhaps intimidating. It is important to schedule a tour of all the facilities you want to look at and bring a list of questions you want to ask. Ask the community representative for a clear list of fees, as well as any ‘extras’ that are not listed in the paperwork. Make sure you understand every part of the contract before you sign, and never impulsively sign a contract on the day you tour.

A senior care coordinator can also take all of your specific factors (cost, level of care needed, location, etc.) and help you tour, apply for, and manage payment for whichever assisted living facilities are on your list. Our team of senior care coordinators are available to help you and your aging loved one find a new home to nest in. As always, our services are completely free of charge to you and your family so don’t hesitate to reach out for a consultation today.

How Assisted Living Can Breathe New (Social) Life Into Seniors

In the senior community sometimes the words, ‘assisted living’ or ‘retirement community’ can breathe a negative connotation. It is true that years ago most senior housing facilities’ primary purpose was to meet the declining physical needs of the aging adult population. In fact, most of the general population would lump assisted living communities and nursing homes in the same group, thinking they were basically serving the same purpose. In more recent years, however, we find that assisted living communities provide much more than just physical support to seniors and their families.

In a recent study on assisted living communities done in California in 2016, it stated that staff members working in assisted living facilities, current residents, and family members with loved ones in those facilities reported a very positive impact on the seniors’ quality of life. If you are currently thinking about placing your aging loved one in an assisted living or memory care community, here are a few positive benefits that might help you make your decision.

Relationships

All human beings want a connection with another person. Seniors aging in place at home may have lost a spouse or live far away from family. As retirement sets in their circle of friends and coworkers certainly diminishes, and physical limitations may prevent driving and attending social outings. Moving into a community with other adults in the same age group and dealing with similar situations in life can be just what the doctor ordered to renew much-needed relationships.

Staff members and other residents are easily accessible, and knowing another person will be there to check in on them brings many seniors comfort and their families peace of mind. Even if your aging loved one is more of an introvert, there is still ample opportunity to maintain friendships within a senior community.

Social Events

Any good assisted living or memory care community will offer multiple social events throughout the week. Staff members will organize and implement senior-friendly events such as bingo, movie night, gardening class, musical performances, religious services, exercise classes, art classes, and even video game tournaments! These events are typically optional and seniors who prefer to interact a little less with others are more than welcome to skip. There are always ample opportunities to socialize within assisted living communities.

Field Trips

This benefit is especially wonderful for those seniors whose minds are still wonderfully sharp but whose physical limitations prevent them from walking well or driving a car. Organized trips to the local senior center, grocery or clothing store, library, movie theater, outings to the park or beach, and even sometimes the local casino are all a breath of fresh air to seniors who may have been homebound previously. Most assisted living communities can also arrange transportation to doctor and dentist appointments. These group outings are not only a way to get seniors ‘out of the house,’ but they also facilitate time to bond with others over mutually enjoyed activities.

Moving seniors from their personal residence into an assisted living community may not be the easiest transition, and it will take time for everyone to get used to it. However, after some time has passed most seniors do see an improvement in their quality of life and warm up to their new living situation. This is a big decision and not one to be taken lightly, so make sure and reach out to a senior care coordinator who can help your family facilitate this important move.

Assisted Living vs. Memory Care

Looking for the best placement option for the elderly adult in your life can be an overwhelming and confusing process. There are many different types and levels of care, and sometimes the new terminology starts to blend together making it hard to decipher what is provided at different levels of care. This guide is intended to give you some clarity and hopefully make your decision easier.

Assisted Living and Memory Care often go hand-in-hand. Both levels of care are typically administered in facilities specially designed for aging adults, but sometimes specially trained caregivers can be hired to come to a private residence for care.

Facilities

Oftentimes you will find that an assisted living facility has a special unit or wing of memory care located within its walls. This is very helpful for residents who need to move levels of care as they age, but don’t want or are unable to move facilities. Other times assisted living and memory care are completely separate facilities. It really comes down to what’s available in your area. Memory care units will often have more security features to prevent residents from wandering, as well as security guards or male orderlies for patients who become combative or aggressive.

Cost

Memory care is usually more expensive than assisted living, and it’s because there is more care required in memory care. Staff members are typically paid more because they have more training, there are more check-ins every day, and most memory care patients need much more physical and medical assistance than assisted living residents need.

To see a recent study was done on the annual cost of memory care and how to plan for it click here.

Caregivers

Caregivers who work in assisted living communities can often transition easily to memory care, but there are training courses available to better help caregivers who care for people with cognitive decline. It is important that caregivers working with memory care patients understand the difficulties of the diseases and know how to execute the treatment options that are available. It is equally important that staff members know how to effectively communicate with their memory care patients.

The staff-to-patient ratio is smaller for memory care units, and more safety check-ins are done during the day and evenings. Because of this memory care units tend to have a smaller population than assisted living communities. In either situation, the law requires that a registered nurse (RN) be onsite for a certain amount of hours per day.

Activities of Daily Living

The main difference between assisted living and memory care is that assisted living caters to those aging adults who need assistance with Activities of Daily Living (ADLs), while memory care is for those adults who need assistance with ADLs plus a higher level of medical and personal care because they have been diagnosed with cognitive declines such as dementia or Alzheimer’s Disease. Residents in assisted living are more independent than those in memory care. Some ADLs include:

  • Daily bathing, grooming, and toileting
  • Moving from one place to another and exercise
  • Paying bills, grocery shopping, and running errands (only for assisted living residents)
  • Social events and activities (for memory care these would be held at the facility)
  • Maintaining nutrition

Services

Due to the nature of cognitive decline, memory care units offer more specialized services than assisted living facilities. You can expect to find specially designed services regarding meals, activities, room and facility features, medical needs such as different kinds of therapy, and staff availability and training. Assisted living facilities reach a much broader clientele than memory care and so they can offer more general services that meet the needs of many.

For a more in-depth look at the exact services of both memory care and assisted living to provide read our Guides to Assisted Living Services and Memory Care Services.

If you are unsure about the level of care that your aging loved one needs or you would like to speak with someone who can help answer your questions, don’t hesitate to reach out to a senior care coordinator. A care coordinator can assist you in any part of your journey at no cost to you.