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Long Term Care

John MacMillan
John MacMillan
  What is Long Term Care?

First of all, let’s clarify what it is NOT. It is NOT simply about Long Term Care Insurance. What it is… is about long term care planning. Long term care includes a wide range of medical & support services for people (young and old) who have a degenerative condition (eg; Parkinson’s, stroke, etc), a prolonged illness (Cancer) or a cognitive disorder (Alzheimer’s).

Long term care involves custodial care…care that provides assistance with activities of daily living or the supervision of a person who is cognitively impaired. Activities of daily living are best explained by examining what your morning looked like this morning:
  1. you got out of bed (transferring)
  2. you went to the toilet (toileting)
  3. you showered or bathed (bathing)
  4. you got dressed (dressing)
  5. you ate breakfast (eating)
  6. you had bladder & bowel control (continence)

A healthy person takes these activities for granted, however when a loved one has a degenerative condition, a chronic illness or a cognitive disorder some or all of these activities are impossible to perform without the assistance of another person. This type of care is custodial.

Why is the subject of Long Term Care so important today?

In the ‘good old days’ if you had a heart attack, stroke or cancer…you died. Today these conditions are becoming more and more of a treatable nature. So, when you don’t die of the things that would have killed you in those ‘good old days’, what happens?
  • you live
  • when you live you get old
  • when you get old you get sick
  • when you get sick you need care
  • care costs money

What types of care are there?

You have two types of care.
1) Skilled and/or rehabilitative
2) Custodial, or non-skilled

Who pays for long term care?

Many people think that long term care services are covered under their health plan, disability insurance or Medicare. Unfortunately, this is not the case. Skilled care is paid by insurance and Medicare. Custodial care - Long Term Care - is your responsibility.



How is long term care paid?

Long term care is paid for in one of three ways:

  1. Self funding. If you have significant net worth, this may be on option. You must bear in mind however that a home health aid charges approximately $20-30/hour. If they are required for only 4 hours per day, this represents $560-$840/week…or roughly $36000/year. You should triple that figure for nursing home care.
  2. Medicaid. If you are ‘flat broke’ Medicaid will pay long term care costs at a facility of their choice. Trying to give assets away in order to qualify will involve a five (5) year look-back period. Yours and your spouses’ assets are used in calculating eligibility. Even spouses in 2nd marriages who have titled assets in their name only, will have those assets counted in the Medicaid calculation.
  3. Long term care insurance. Long term care insurance has evolved significantly. If designed correctly, the cost of insurance is much more affordable than most people think. By working with the more than ten variables that go into creating a policy, you can customize protection that is both affordable and practical. Today’s policies can pay for custodial care in the
    Adult day centers
    Assisted living facilities
    Skilled nursing facility

  How will long term care impact your family?

Long term care insurance does not replace what families do. It allows them to provide care longer and better by bringing in professionals to handle the types of care children or relatives find the most difficult, time consuming and embarrassing.
Long term care insurance allows your retirement portfolio to execute for the purpose it was intended; generating income to support your lifestyle and to keep prior commitments and obligations to your family and community.

Key point to think about:

The question is not who will take care of you when you live a long life and need care. It’s what providing care will do to your family and retirement portfolio. Also, people do not go to nursing homes when they should. They go when their caregiver gets so sick that the children take the matter out of the caregiver’s hands.


Helpful Long Term Care Links:

Long Term Care Link - The Council and those providers affiliated with us are dedicated to helping the American public plan for long term care.
Elder Law Answers - The combination of an informed consumer and a qualified attorney produces the best legal results for the clients.
Alzheimer's Association - The Alzheimer’s Association, the world leader in Alzheimer research and support, is the first and largest voluntary health organization dedicated to finding prevention methods, treatments and an eventual cure for Alzheimer’s.
Centers for Medicare & Medicaid Services - Everything you need to know about Medicare and Medicaid.
Medicare - The Official U.S. Government Site for People with Medicare
Elder Care Link - Finding the right care for your elderly loved ones can be overwhelming, stressful and time consuming. ElderCarelink eases that stress by quickly connecting you with local care providers who meet the needs of your aging family member - and you.
Senior Resource Alliance of West Central New Jersey - The Senior Resource Alliance concept involves forming a group of senior-focused professionals, who join together with the mission of providing, and gaining a reputation for, the most ethical, competent and trusted source of senior services in the community.

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