December 3, 2020
How to look for the warning signs that your loved one(s) can no longer live alone — and what to do next
The holidays and their aftermath are the busiest time of year for long-term care admissions for homecare, assisted living and nursing homes. Between Thanksgiving and Christmas, 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.
Are you prepared to spot the warning signs?
There 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 blow off 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.
Are you prepared for the costs?
The three 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 improve family plans
- 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. Nursing-home care costs start at $5,000 to $8,000 a month, which 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. Medicaid will look back 5 years at assets and income and the maximum allowable amount one spouse can retain in 2020 is $128,640.
- Don’t simply stop paying on a life insurance policy to save money. Anyone who owns a life insurance policy could potentially qualify for a Long-Term Care Life Settlement to turn their policy into a tax-advantaged Long-Term Care Benefit Account. 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.
~ Chris Orestis
Chris Orestis, CEO of Life Care Funding, is a 19-year veteran of both the insurance and long-term care industries. Chris is a nationally known senior care advocate, author, and frequent expert guest discussing senior issues on national radio programs. He’s been featured in the Wall Street Journal, New York Times, USA Today, Fox Business News and PBS.