October is Long Term Care Planning Month. Planning is especially important if you are at least 55 years old, have some home equity, some type of retirement savings, and you hope to preserve your lifestyle in the future. Although planning for long term care is what really excites us at Keystone Elder Law, you’ll notice a few other October awareness issues mentioned in this article.
In honor of Health Literacy Month, let’s begin by defining Long Term Care as “a combination of medical and non-medical care services required for an extended period of time by an individual who cannot do at least two of the following six Activities of Daily Living (ADLs) without the assistance of another person: bathing; dressing; using the toilet; transferring from a bed to a chair; caring for incontinence; and eating.” This definition boils down the technical requirements of insurance companies and government benefit programs. Insurance industry experts agree with it, although some heath care providers combine the incontinence and toileting issues and add ambulation as an issue.
Even before this Positive Attitude Month, I acquired a distaste for the label of “long term.” I prefer the term “extended” to define “care” in the above definition. A fair question could be: “Extended in comparison to what?” The answer is: “Compared to a normal or anticipated recovery period during which uncompensated family or friends take care of non-medical aid, while Medicare pays medical expenses.”
Whether a period of time is short or long can be a matter of opinion. If we think of care as extended, we get a sense that a clock or meter has started to tick. We realize we are in a marathon race and not a sprint, and we have an awareness that consequences and expenses will follow with time.
Because it is Bullying Prevention Awareness Month, it would be wrong to use statistics to scare you into taking action to plan. Therefore, as you consider that about 70 percent of people over age 65 will require some type of extended care services during their lifetime, and more than 40 percent will need care in a nursing home, let’s assume that won’t be you. You might have healthy genes or be one of the lucky ones.
Even though you are probably the exception, since this is Work and Family Month, please consider at least the possibility that you or your spouse eventually could become frail if you live a long life. Without proper planning, the all-consuming tasks of active family caregiving will interfere with your caregiving child’s performance at his or her “day job” after a short period of time. You don’t want your present failure to plan to be the cause of your child having to miss your grandchild’s future soccer game or concert because of a need to be your hands-on caregiver. Proper planning will allow your children to supervise your receiving care provided by others, which they can more easily manage without detriment to their career or your grandchildren.
If you be feel that this focus on extended care is inconsiderate of Emotional Wellness Month or Depression Education and Awareness Month, consider this perspective: What would really be depressing is to realize the possibility of needing to leave your home to go to a nursing home before you die. If you want to have a realistic vision of your desire to spend your final days at home, you need to plan ahead now during Strategic Planning Month.
Although getting care at home can be the most desirable alternative in many circumstances, it is nearly always more expensive. It is easier to get an insurance company to pay a claim for care at home than it is to get government assistance for home care. Some insurance polices offer to pay cash to reimburse your family members for care they provide to you, but government programs do not.
In this Month of Freethought, consider this possibility: If a healthy 60 year old person would invest $2,000 per year at a compounded 3% interest, by the time that investor probably will need extended care at age 81, that amount would have grown to $57,353. However, if that same investment is made to insure against the need for extended care, the amount of insurance available to pay claims related to extended care for that 81 year old would be $407,404, which is more than seven times better than being “self-insured”!
For those of you who want to Gain the Inside Advantage (this) Month, although getting Long Term Care Insurance is a good idea generally, there are some unique twists that can be possible with proper legal coordination as part of your estate plan. For example, trust planning can magnify the benefits of some policies, which will pay a death benefit if there is no need for extended care. Also, most policies include a component of care planning and care management as part of their service or payment.
The opportunities and issues of care management can be tilted to your advantage if there has been adequate advance planning for extended care on more than a financial level. Keystone’s Care Coordinator, who is a regular contributor to this column, has care planning expertise and can help you to understand your future options for extended care from a realistic perspective. Keystone’s Care Coordinator can help you to Organize Your Medical Information (this) Month if you are presently in a time of crisis, but it is nearly always more advantageous to plan ahead.
So since this is Self-Promotion Month, we encourage you to Go On A Field Trip (this) Month and schedule an appointment with us or another extended care planner. Your action now to develop a plan will give you more options, more control and a better future outcome. Wouldn’t it be a reassuring and loving holiday gift to your family for you to show them that you have taken steps to preserve your ability to spend your final years in the family home without being dependent on their constant personal caregiving?
Dave Nesbit
Attorney