Long Term Care Insurance is Important.....

There are many reasons why people buy long-term care insurance. Do any of these apply to you?

1.    Preserve your independence
2.    Guarantee your choice of care and caregivers (allow you to stay at home as long as possible)
3.    Protect your assets and standard of living
4.    To avoid being a burden to your family
5.    To leave more assets to your family, church, alma mater, or other worthy cause
6.    Peace of mind

Long Term Care Defined

Long-term care is defined as needing either assistance or supervision from someone when you are unable to care for yourself as a result of a disabling chronic illness, physical injury, cognitive or mental impairment, or just due to old age and frailty. This type of care is considered custodial care, or non-skilled care. It is NOT acute or rehabilitative care, which is known as skilled care. When you need long-term care you usually need help with your activities of daily living. These are items such as bathing, dressing, toileting, continence, eating, and transferring. Or, you may be able to do all of your activities of daily living but still need care due to a cognitive impairment (memory loss, dementia, etc.). You may be able to dress yourself, but you may not remember to take your medications.

Types of Long Term Care

Acute Versus Chronic Care

Acute care is the type of care that is usually provided in hospitals and emergency rooms. Your health insurance and Medicare will cover some or all of the expenses for acute care because it is usually skilled care. Acute care is usually for conditions that are treatable and you may fully recover with the right medical attention. Acute care conditions usually develop rapidly and can strike suddenly. Examples of Acute Care: Stroke, heart attack, pneumonia

Chronic care is the type of care that is usually provided in your home, nursing homes, and assisted living facilities. Your health insurance and Medicare will usually not cover chronic care because it is not considered skilled care. Chronic care is usually for conditions that are treatable but generally not curable. A lot of times they are not noticed or are ignored in the initial stages.

Skilled Care

Skilled care is the type of care that is usually delivered in skilled nursing homes, but can be received in the home as well. If the skilled care meets strict criteria set forth by Medicare, then the facility providing it is referred to as a skilled nursing facility (SNF). Medicare defines skilled care as services and rehabilitation that require the skills of technical or professional personnel such as registered nurses, licensed practical nurses, and physical or occupational therapists.

Non-Skilled Care

Non-skilled care is defined as the type of care that is provided to persons who need help on a regular basis with their activities of daily living because of a physical limitation, chronic problem, or a cognitive problem. This type of care can be provided by a family member. It does not have to be performed by a medical professional like skilled care does. Non-skilled care is also known as custodial care.

Settings

Long-term care can be received in a variety of settings. The setting is usually determined by your support system (your family, attending physician, or someone qualified to develop a plan of care) that you have and the reason that you need long-term care. Some needs can easily be taken care of at home, while others would be better cared for in a nursing home.

Skilled Nursing Facilities

Skilled nursing facilities are usually comprised of two separate components. The first component is a unit that provides skilled nursing care that is paid for by Medicare (if the care meets the criteria that Medicare sets forth). The rest of the facility provides non-skilled (or custodial) care. The goal of the “Medicare” section of the skilled nursing facility is to provide services needed to rehabilitate the patient so they can return home. However, many times patients are unable to return home and are moved over to the non-skilled or custodial section of the facility. Usually in these cases the patient may not have any support services or family in the community that would allow them to leave the facility.

Home Care

Home Care is generally considered appropriate at the custodial and non-skilled care levels. Skilled care can be provided in the home, however it can be very expensive. Home care could consist of a weekly visit by a homemaker that performs housekeeping chores, a personal care attendant that provides assistance with bathing and dressing, or it may be a daily visit by a home health registered nurse or therapist. Example: Verna was diagnosed with Parkinson’s disease two years ago. Now she is unable to walk without assistance. She cannot bathe or dress herself. Her daughter, Shirley, is currently helping her with these needs. Her daughter has to go back to work in order to save money for her two children that will be going to college in the next two years. Verna is now going to have to tap into her life savings and pay for a caregiver to come in and help her, instead of her daughter, so that she can stay at home.

Assisted-Care Living Facilities (ACLF's)

Assisted-care living facilities, otherwise known as assisted-living facilities, are also called residential care facilities for the elderly (In California, they are referred to as Residential Care Facilities). These facilities provide non-skilled care for people that need help with their activities of daily living but can also provide a lot of their own care and get through a daily routine with minimal assistance. Usually, skilled care is not provided in assisted-living facilities. These facilities are an excellent alternative to a nursing home. The residents live in individual apartments that they can furnish and personalize to make it seem more like home. Meals are usually provided in a community dining room and there are lots of activities and social events to attend. You can find these facilities as part of a larger independent retirement community, or as a stand alone facility that only offers assisted living. There are also small board and care homes that care for anywhere from 3-10 people. These are homes that have been converted to a board and care.

Adult Day Care

Adult day care is a community-based service that was developed to keep people out of nursing homes and in their homes. Adult day care facilities offer custodial care during the weekdays (some provide weekend service). This care can be provided to people that need minimal assistance and have moderate impairments. Patients with Alzheimer’s or senile dementia are ideal candidates for this program. Adult day care centers offer a form of support for those that live in their own homes, or maybe with their children. Adult day care centers offer family members who are providing care the much needed break during the day to continue to live their lives and provide care for their loved ones. Example: Lyle lives with his daughter, Sandy. Sandy works full time. Lately, she has noticed that Lyle has been forgetting to prepare and eat his meals during the day. One day she was called at work by a neighbor who found him wandering down the street. Sandy wants to take care of her father after work and on the weekends, but she needs help during the day. An adult day care would provide her with the solution she is looking for.

Costs Of Long Term Care Insurance

The costs of long-term care vary greatly depending on where you live and the type of care you receive. Many people think that home care usually costs less than nursing home care. In fact, home care can cost just as much, if not more than nursing home care. It depends on what type of care you need in your home, and for how many hours per day.

Here Are Four Options To Pay For Your Long Term Care:

1.    You can rely on others (spouse, children, etc) to provide the help needed. This option is only available to those with a support system in place and if the amount and type of care required is possible for them to provide.
2.    You can self-insure and pay for your own long-term care with your own assets and income.
3.    You can spend down all of your assets and then qualify for Medicaid. (Medi-Cal in California).
4.    You can transfer a predetermined amount of risk of long-term care to an insurance company by purchasing long-term care insurance.