Sunrise Senior Living

Getting reliable advice about estates, taxes, and end-of-life issues can be crucial to your peace of mind and that of your loved one. Finding the right elder law attorney for your needs can be difficult, however.  That’s because so many issues—from Medicare and Social Security claims to disability planning and the establishment of trusts—now come under the heading of elder law.

Sunrise Senior Living

You’ve written a will, completed a durable power of attorney, and filed a set of medical directives with your physician.  As far as you are concerned, your estate is in order.  And from a legal point of view, you are right.  If you have been well advised, your wishes about your estate will be clearly spelled out.

Following them may be another matter entirely.  Tracking down your safe deposit key, insurance policies, and even your estate-planning documents can be a trial if your executors or heirs are not familiar with the way you arrange your records.  For this reason, it is always a good idea to add a letter of instruction to your estate documents.

By Roderick R. Barnes

In the past twenty years, the range of retirement living and long term care options for senior citizens has expanded along with the elderly population. With an eye on senior citizens' preferences and their pocket books, the geriatric care industry now offers a rich continuum of care facilities and services, from in-home assistance, to assisted living centers, to hospice homes.

As so often happens, the innovations of the marketplace have outrun government legislatures and regulators. It is no wonder that there exist gaps in the regulatory framework governing the industry. But consumers should be aware of these gaps, one of the most conspicuous of which in some states concerns “independent living” facilities.

A relative newcomer to the industry, the independent living home or community evolved from the “assisted living” model. Assisted living options are tailored for seniors who need help with daily activities like eating or being fed, grooming, bathing, dressing, and mobility. Such homes do provide residents a modicum of independence, but they are really for very frail or infirm people who cannot survive on their own.

Thus, seniors with active lifestyles and relatively good health are often averse to the assisted living options available. They may be frail, may need assistance now and then, but on the whole they can eat, dress, bathe, and get around on their own. They are mentally sharp, but due to their age are looking to downsize to a single level, low maintenance living environment.

By Jacqueline Marcell, National Speaker & Author of “Elder Rage”

When I suddenly had to become a fulltime caregiver to my elderly parents, both with health problems and starting to develop dementia (namely Alzheimer's), I had never even heard of Long-Term Care Insurance. After we burned through their life savings and started chipping away at mine, I was advised to apply for financial assistance for them through the government's Medicaid system (“Medi-Cal” in California)--a program for those at the poverty level. It was a long process with mounds of paperwork and numerous investigations, but finally my parents were approved.

I was so happy that monetary help would finally be on the way, until I found out that the financial assistance would only pay to place my parents in a nursing home, not even in assisted living, and with very little help to keep them in their own home.

Since their levels of care were so different (my mother needed nearly all ADL's (Activities of Daily Living) done for her, there weren't any facilities that would allow my parents to be together. Instead, they'd be across the street from each other in different wings of the facility. After fifty-five years of marriage, they were adamant about wanting to stay together in their own home, in their own bed, where they could continue to cuddle and kiss--as they so frequently did. And, since my father could be so “challenging” with terrible temper tantrums when he'd get upset, and with quite a long record of manipulative disruptive behaviors--none of the facilities wanted to deal with him anyway.

Had I only known to insist that we buy Long-Term Care Insurance for them prior to their illnesses--their many years of in-home care could have been paid for and I could have saved myself so much heartache, not to mention a small fortune. I encourage you to learn from my mistakes and look into LTC insurance long before you need it—for your loved ones as well as yourself. Like fire insurance, hopefully, you'll never have to use it.

If your loved one is already disabled and LTCi is not an option, be sure to call your local Area Agency on Aging, Department of Aging and Alzheimer's Association, and ask if there are any financial programs, waivers or grants available in your area that you can apply for.

Startling Statistics

• An estimated 4.5 to 5 million Americans have Alzheimer's disease. In a Gallup poll, 1 in 10 Americans said that they had a family member with Alzheimer's, and 1 in 3 knew someone with the disease.

• Increasing age is the greatest risk factor for Alzheimer's. One in 10 individuals over 65 and nearly half over 85 are affected. Rare, inherited forms of Alzheimer's can even strike individuals in their 30's and 40's.

• A person with Alzheimer's disease will live an average of eight years and as many as 20 years or more from the first onset of symptoms.

• More than 7 out of 10 people with Alzheimer's disease live at home, where family and friends provide 80 percent of their care. The estimated value of this informal care is $257 billion annually.

• One half of the U.S. population has a chronic condition. More than one quarter (26.6%) of the adult population provide care for a chronically ill, disabled or aged family member or friend, which translates to more than 50 million people involved with caregiving.

• 37% of caregivers are living in the same household as the person they care for. 54% are between 35 and 64 years of age. 59% of the adult population either is or expects to be a family caregiver, and 2 million more caregivers will be needed in the next twenty years.

• An estimated 43% of Americans age 65 or older will spend time in a nursing home. By 2012, 75% of Americans over age 65 will require long-term care. Long-term care costs are rising at 6% annually.

• The annual cost of Alzheimer's care in the U.S. is at least $100 billion, and it will soar to at least $375 billion by mid-century, overwhelming our health care system and bankrupting Medicare and Medicaid.

• Alzheimer's disease costs American business $61 billion a year, which is equivalent to the net profits of the top 10 Fortune 500 companies. $24.6 billion covers Alzheimer health care, and $36.5 billion covers costs related to caregivers of individuals with Alzheimer's, including lost productivity, absenteeism and worker replacement.

Three Ways to Pay for Long-Term Care

LTC insurance pays for care in the home, assisted living, board & care, and in nursing/dementia homes. Medicare and regular health insurance does not pay for long-term care. The average cost for a person who needs long-term care is $40-$70,000 annually, plus the cost to the caregiver who may have to leave their job. Three ways to pay for long-term care:

1. Pay for in-home caregivers and assisted living/nursing homes out of pocket. This is expensive and can often deplete a family's life savings.

2. Meet a very specific poverty level and qualify for government assistance through the Medicaid program. Options are limited, only paying for nursing homes that accept Medicaid.

3. Buy Long-Term Care Insurance. This protects your family's assets from the rising costs of caring for someone who needs full time care. Your employer might even pay the tax-deductible premiums. Consider buying it at a younger age, when it is more affordable and accessible. It must be bought before a major chronic illness strikes.

Questions to Ask Your Insurance Agent

• Is the coverage comprehensive, covering all levels of care: in the home, assisted living, board & care, and nursing/dementia facilities?

• What is the daily benefit?

• Is there inflation protection/what kind?

• What's the elimination period? Is it a lifetime benefit period or a limited time benefit policy?

• Is there a spousal/partner discount?

• Can you hire caregivers privately as well as from an agency?

• Is the home care benefit based on a daily, weekly or monthly maximum, and if the benefit is not used can it be used in the future?

• Is there a “cash benefit” option?

• Can the premiums be paid with a “limited pay” plan, such as a 10-Pay program?

• Does it cover home care coordination?

• How many ADL's does it take to trigger a claim?

• Is there a time limit for filing a claim?

• Does it cover the cost of Adult Day Care & Adult Day Health Care, hospice and respite programs?

• Is it a tax-qualified plan?

• Is the company highly rated and have they ever raised premiums?

• If you live in CA, CT, IN or NY, does the carrier offer a “Partnership Plan” allowing for retention of assets without spending down for Medicaid eligibility after the LTCi policy expires?

• Can you see the company's published annual audit to check their track record for paying claims?

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Jacqueline Marcell is the author/publisher of the best-selling book, “Elder Rage”, a Book-of-the-Month Club selection, receiving 206 five-star reviews on Amazon.com and being considered for a feature film. Over fifty endorsements include: Hugh Downs, Regis Philbin, Dr. Dean Edell, and the National Adult Day Services Association--who honored her with their Media Award. Jacqueline also received “Advocate of the Year” from the National Association of Women Business Owners at their Remarkable Women Awards. She is a well-known national speaker on eldercare awareness and reform, who also writes an Elder Care Blog on ThirdAge.com http://blog.thirdage.com/?author=12 .

For more valuable caregiving information see: www.ElderRage.com

© Copyright 2005 For permission to reprint all/part of this article, or to interview the author, Jacqueline Marcell in Irvine, CA: 949-975-1012, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

This article was reproduced with the permission of Jacqueline Marcell