Navigating through the Maze of Long Term Care Options

Decisions are usually made quickly, and the final outcome may not be as planned.  These characteristics sum up what most people find when they are thrust into decisions regarding long term care without a prior plan in place.

"Long term care options can be very confusing," explained Debbie Turner, RN, certified long term care planning specialist.  "It can be difficult for people to plan for the future, especially for a decrease in health.  No one wants to think about that."

We're all living longer, but that doesn't necessarily mean our later years will be in perfect health. Turner said many Americans are not financially or emotionally prepared to deal with the issue of long term care.  It raises several thought-provoking questions, such as:

  • Who will make decisions for my health care if I am unable?
  • How can I make sure I'm not a burden to my family?
  • How can I take care of my aging parents?
  • What options are available for long term care?

"These options are important to consider before the need arises.  Open discussions among family members help with effective financial planning, and confirms that everyone is on the same page.  It also avoids being caught unprepared.  If a health crisis should occur, it helps tremendously to have at least talked about these issues," Turner said.  "No one can predict exactly what their health condition will be like, but knowing what's available, and having a financial plan will be invaluable should a time come that requires further care."

Turner's background gives her a unique perspective for helping her clients as they make preparations for long term care.  As a nurse, her clinical background is utilized as she works with families who are in the process of finding an appropriate residence for a loved one.  Her years as a nurse on a cardiac care unit, and later, as the Nursing Director of a long term care facility, are helpful as she provides direction for her clients in the various options available locally.  She recently became certified as a long term care planner, and she is an independent agent for LTC insurance policies.

"Many of my clients simply need a plan of action for what they would like to do should they need assistance in the future.  Maybe they would like to have someone to be with them during the day, helping with errands, shopping and cooking. Later, they may require more skilled nursing care," she said.  "I am a resource for them to utilize as they face each stage."

Most people prefer to remain in their home as long as that is a safe, healthy option.  "If the person is able to do many things on their own, but needs help in light housework and medication management, for example, then at-home care makes good sense.  Finding a reputable caregiver can be a challenge.  Dependability and trustworthiness are a must," she said.

For those clients who are interested in long term care insurance, Turner said the most common obstacles for people are assuming Medicare will pick up the tab or that their own nest egg will be enough to cover the cost of long term care.

"Medicare does not pay for most types of long term care.  Medicaid, state administered public insurance for low-income people, will cover certain kinds of long term care, but only for those with limited assets.  Medicaid covers nursing home care, and limited at-home care, but does not cover assisted living," she explained.  "A family nest egg will quickly get wiped away due to the high cost of extended care. Looking into insurance is a worthwhile investment of time.  Your money will be there for you when you need it."

Today, people need it more than ever.  Statistics show that at least 6 million people aged 65 or older need long term care.  Because we're living longer, the number of people in the retirement age is increasing rapidly.

There are a variety of options available for individuals who need assistance, or in some cases, total care. They are:

  • sitters providing care in the individual's home
  • adult day care
  • continuing care retirement communities
  • assisted living communities
  • nursing homes

There are also programs that include meal delivery, home health services, phone calls or visits during the day, and errand and transportation services.  Depending on the type of need, there is probably a service to fill it.  "The main obstacle in finding what you need is knowing what's out there," said Turner.

The cost for all this care is high.  According to AARP, most home health aides charge about $200 a day.  "In the Lake Charles area, most sitters charge about $8 an hour. If you figure the cost of an 8 -10 hour day, seven days a week, it adds up to between $450 - $560 per week.  That's for someone who has family to stay with them at night. If they need 24 hour supervision, the cost grows quickly," said Turner.

Assisted living communities average about $2,200 a month. They usually include round-the-clock assistance, if needed, as well as three meals a day, transportation and activities.  As the level of care increases, however, so do the added fees.  "These communities accept residents who may need some assistance during the day, but not total care," explained Turner. Nursing homes offer total care, and cost about $52,000 a year, a national average.

"As a nurse, I have worked with many families as they've faced the challenge of finding a long term care answer for their loved one.  I've seen first-hand the difference it makes when they already have a plan in place.  The worry and strain of dealing with this emotional issue is eased because they already faced the 'what-if' aspect, and they aren't bothered by the financial burden it can cause," she said.  "Having a plan in place helps tremendously."

Most people put off long term care planning as long as possible because it can be uncomfortable.  "It forces us to deal with difficult issues we may not feel ready to confront, such as the realities of aging, a decline in health, and a possible loss of independence," said Turner.  "But," she said, "now is the time to place these on the table when they can be dealt with, instead of waiting until it's too late."