What Is Long Term Care?

Long-term care is a variety of services and supports to meet health or personal care needs over an extended period of time. Most long-term care is non-skilled personal care assistance, such as help performing everyday Activities of Daily Living (ADLs), which are:

·         Bathing,

·         Dressing,

·         Using the toilet,

·         Transferring (to or from bed or chair),

·         Caring for incontinence, and

·         Eating.

The goal of long-term care services is to help you maximize your independence and functioning at a time when you are unable to be fully independent.

As more and more Americans begin to think of retirement and their golden years, the skyrocketing costs of nursing homes and assisted living facilities threaten to financially cripple many Americans who have worked for so hard and so long to provide both for their retirement and for a nest egg for their children. This is one of the many reasons, as you begin to think of retirement, that you should consider owning a long-term care insurance policy.

The statistics are startling. After age 65, most people have a 50% chance of needing long-term care. This is far more than the one-in-1200 chance of needing your homeowners insurance or a one-in 250 chance of using your auto insurance. One-in-two people who have long-term care will use it, and it is the one insurance that you are least likely to have. This is why you should have long-term care insurance, even if you are in good health now

What Are My Risks Of Needing Long Term Care?

How Much Care Might I Need?

It is difficult to predict how much or what type of care any one person might need. On average, someone age 65 today will need some long-term care services for three years. Service and support needs vary from one person to the next and often change over time. Women need care for longer (on average 3.7 years) than do men (on average 2.2 years). While about one-third of today's 65-year-olds may never need long-term care services, 20 percent of them will need care for more than five years.

If you need long-term care, you may need one or more of the following:

·         Care or assistance with activities of daily living in your home from an unpaid caregiver who can be a family member or friend;

·         Services at your home from a nurse, home health/home care aide, therapist, or homemaker;

·         Care in the community; and/or

·         Care in any of a variety of long-term facilities.

Generally, services provided by caregivers who are family or friends are unpaid. This is sometimes called informal care. Paid services are sometimes referred to as formal services. Paid services often supplement the services provided by family and friends.

Who Needs Long Term Care?

Long-term care is needed when you have a chronic illness or disability that causes you to need assistance with Activities of Daily Living. Your illness or disability could include a problem with memory loss, confusion, or disorientation. (This is called Cognitive Impairment and can result from conditions such as Alzheimer’s disease.)

This year, about 9 million Americans over the age of 65 will need long-term care services. By 2020, that number will increase to 12 million. While most people who need long-term care are age 65 or older, a person can need long-term care services at any age. Forty (40) percent of people currently receiving long-term care are adults 18 to 64 years old.

How Do Care Needs Change Over Time?

Many people who need long-term care develop the need for care gradually. They may begin needing care only a few times a week or one or two times a day, for example, help with bathing or dressing. Care needs often progress as you age or as your chronic illness or disability become more debilitating, causing you to need care on a more continual basis, for example help using the toilet or ongoing supervision because of a progressive condition such as Alzheimer’s disease.

Some people need long-term care in a facility for a relatively short period of time while they are recovering from a sudden illness or injury, and then may be able to be cared for at home. Others may need long-term care services on an on-going basis, for example someone who is disabled from a severe stroke. Some people may need to move to a nursing home or other type of facility-based setting for more extensive care or supervision if their needs can no longer be met at home.

Consider These Facts In Evaluating Your Need For Long-Term Care Insurance

CURRENT NURSING HOME COSTS-the average cost of a nursing home, today, is $5,000-$10,000/month. And New York has costs already exceeding $130,000 per year. Married couples are more likely to need the benefit because if you price some nursing homes in your area, you need to ask a serious question of yourself. What would happen to your spouse if they had to pay for their standard living expenses as well as the nursing home costs?

CURRENT ASSISTED LIVING COSTS-to live in an assisted living facility, where the level of care is not as intensive as a nursing home, the costs are still significant and can run up to $50,000 per year for a quality, one-bedroom residence at one of these facilities.

CURRENT HOME CARE COSTS-the national average cost of part-time basic home care runs about $16-$17 per hour. Skilled care provided by a nurse is more expensive than care provided by a home health aide. Both costs vary based on the number of days per week the caregiver visits, the type of care required and the length of the visit.

When Should I Buy A Long Term Care Policy?

The ideal time to buy long-term care insurance is when you are in your late 50’s, even though the average age of entry into a nursing home is age 84. This is because:

·         The costs could be prohibitive later on

·         Your health may prevent you from qualifying later in life for the coverage

·         Once you are in your late 50’s, you will have a fairly good idea of what you are able to afford in retirement

How Will My Benefits Be Triggered?

Depending on the policy, a policy is triggered when a client cannot perform a certain number of the Activities of Daily Living (ADL’s). Some policies trigger when the insured cannot perform 2 of the ADL’s and for others it is more so you need to check with your financial advisor with an elder-care specialty for what would be best for your situation.

·         Bathing

·         Continence-the ability to retain a bodily discharge voluntarily

·         Dressing

·         Eating

·         Toileting

·         Transferring-moving into or out of a chair, bed or wheelchair

What To Look For In A Long Term Care Policy

·         A daily benefit that reflects the cost of managed care facilities in your area. This can be anywhere for $150 per day to $300 per day.

·         An elimination period (the deductible you need to pay before the policy benefits activate) of 60 days or less

·         An inflation option that will take into account the rising costs of long-term care

·         Home health coverage-this is care that is provided in shorter periods while one recovers from an accident or an illness at home

·         That the benefits offered in the policy do not exclude a pre-existing condition

·         Also, many employer-offered policies may be cheaper than individual plans, but they tend to have longer elimination periods, a limited benefits period, poor inflation protection and no spousal discounts

Activities For Daily Living

The basic activities of daily living consist of these self-care tasks:

·         Bathing

·         Dressing and undressing

·         Eating

·         Transferring from bed to chair, and back

·         Voluntarily control urinary and fecal discharge

·         Using the toilet

Long-Term Care insurers use the six guidelines as ‘triggers’, to denote when the benefits of your long-term care policy will kick in. It is important for you to check with your long-term care insurer, or to compare long-term care policies, so that you completely understand which of the ADL’s listed above would trigger your benefits under a particular long-term care policy.