Thanksgiving through early New Year is the busiest time of year for long-term care admissions for homecare, assisted living and nursing homes.
Between the holidays, families get together and many are seeing mom and/or dad for the first time in months.
Some will discover that their parent’s health has declined, and he or she should not be left to live on their own any longer.
Here are three key warning signs you should be looking for that will help you recognize when the time for professional long-term care has arrived:
- Physical Deterioration: Look for signs such as significant weight loss, balance issues and falling, loss of strength and stamina, and other losses of “activities of daily living” known as an ADL such as ability to shower or toilet, dress, or eat independently.
- Mental Deterioration: Do not chalk up loss of memory or confusing names, dates and locations as just a “senior moment.” Cognitive deterioration is an important warning sign that you should be on the lookout for dementia and Alzheimer’s. These conditions can worsen quickly and can lead to many physical breakdowns and safety issues.
- Lifestyle Deterioration: Is the home not being kept as neatly as in the past? Are things oddly out of place (a houseplant in the fridge, pots and pans in the bathtub), or do you see signs of physical damage (the car crashing into a fence or the wall of the garage, burn marks on the kitchen wall from a flash fire)? Long-term care is both a matter healthcare and safety.
Most families aren't prepared for this and they don’t have a plan or resources, so the situation becomes traumatic and heartbreaking for everyone.
It doesn’t have to be that way.
Every family should be talking about this now and exploring their options for care and the finances. Families should construct a three-point plan for how they will discuss this matter with their loved one(s) and then act:
- Siblings and spouses need to be on the same page about this situation and next steps.
- Everyone needs an assigned job because “it takes a village.”
- Understand different types of care and how to pay (Medicare v. Medicaid / Private Pay / Insurance options).
Are you prepared for the costs?
The primary ways to pay for care are with Medicare, Medicaid, or private pay through insurance, savings or assets.
- Medicare is an age-based program that will cover the first 100 days of rehabilitation care in a licensed skilled nursing facility upon direct discharge from a hospital.
- Medicaid is a means-based program which means to qualify an applicant must meet both standards of medical necessity and be below set asset and income levels below the poverty line. Applying for Medicaid can be a challenging process that requires the applicant to submit detailed medical and financial records. Medicaid will look back five years at financial records to make sure that assets have not been hidden or transferred to family members.
- Private pay primarily comes from an individual and/or a family’s savings, insurance, assets, and income. People that are private pay can choose any form and location of care that they want.
Here are three tips to help families plan:
- Remember, there are many levels of care available. From a few hours of in-home assistance each week to residential communities that provide daily assistance with meals, laundry, etc., to a nursing home that provides round-the-clock care, there are many options to consider. Generally speaking, finding ways to keep your loved one at home for as long as possible is the least disruptive – and least expensive – option.
- Avoid resorting to Medicaid if at all possible. According to the Genworth 2018 Cost of Care Survey, nursing-home care costs start at $5,000 to $12,000 a month, depending on where the patient lives. It is a price that is often beyond the means of people otherwise considered financially healthy. Many families turn to Medicaid to pay for nursing home care, but it comes with many restrictions, including choice of facilities. In a situation where one spouse is healthy and the other is not, the spouse living independently will also face restrictions on the amount of assets he or she can retain, for instance, as of 2017, a maximum $3,022.50 for monthly maintenance, according to the National Center on Law & Elder Rights.
- Don’t simply stop paying on a life insurance policy to save money. Anyone who owns a life insurance policy could potentially qualify to exchange their policy for a tax-advantaged Long-Term Care Benefit Account, through GWG Life. The Benefit Account is kind of like an LTC Health Savings Account (HSA) funded by the policy settlement. It can be used to pay for any form of care a person wants at whatever amount is needed on a monthly basis for as long as there are funds in the account. It is a tax-advantaged, Medicaid qualified spend down and a much better use for an unneeded life insurance policy than to lapse or surrender it.
Holidays are a time for families to come together in sharing and thanks. For loved ones showing signs that they may need care and support, there is nothing more caring and thankful than a family coming together to help their loved one with what they need.
Chris Orestis, executive vice president of GWG Life, has more than 20 years of experience in the insurance and long-term care industries and is nationally recognized as a healthcare expert and senior care advocate.
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