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Long-term Care Planning

In the year 2000, almost 10 million people needed some form of long-term care in the United States. Of that number, 3.6 million (37%) were under age 65 and 6 million (63%) were over age 65*. What does that really mean? This trend means that almost 70% of people turning age 65 will need long-term care at some point in their lives.

Many of us think the phrase “long-term care” refers to an insurance policy. While insurance may be part of a strategy, long-term care includes everything from long-term services and supports and finances, to where you will live and how you will navigate the maze of legal, family, and social dynamics along the way.

"Long-term care" means helping people of any age with their medical needs or daily activities over a long period of time. Long-term care can be provided at home, in the community, or in various types of facilities. When you look for long-term care, it is important to remember that quality varies from one place or caregiver to another. It is also important to think about long-term care before a crisis occurs.

Making long-term care decisions can be hard even when planned well in advance. Your path will be based on your preferences and circumstances and is unique to you.

Planning Between the ages of 51 and 64

Important Items to Understand

  • Medicare only pays for long-term care if you require skilled services or rehabilitative care and Medicare does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long-term care services.
  • Long-term-care may cost more than you think.
  • There are many different ways to receive care and many different settings in which to receive it.
  • Where you live matters – your ability to stay at home may depend on the layout of your home, especially the bathrooms.
  • Planning for long-term care can protect your family from the financial impact of paying for care and the emotional impact of making decisions for you.
  • By obtaining an Advanced Care Directive you can inform your family or loved ones about how to make important health decisions for you, in the event you are no longer able to make those decisions for yourself.
  • By taking an inventory of your resources, you can determine how you will pay for services and who you can count on to assist.
  • Options exist for pre-funding the care you need such as insurance or savings.

Things You Can Do

  • Make sure you have an Advanced Care Directive.
  • Make a plan for how you will pay for services:
    • Costs of Care
    • Long-term care Insurance
    • Using Life Insurance to Pay for Long-term Care
    • Annuities
    • Reverse Mortgages
  • Consider home modifications to stay in your home

Planning After Age 65

Important Items to Understand

  • Medicare only pays for long-term care if you require skilled services or rehabilitative care and Medicare does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long-term care services.
  • There are many different ways to receive care and many different settings in which to receive it.
  • You may be able to receive care from providers and/or local programs in your community.
  • The need for long-term care often follows a fall. Preventing a fall, may delay your need for long-term care and even prolong your time at home.
  • Being close to children or other family is often important when long-term care services are needed.
  • By obtaining an Advanced Care Directive you can inform your family or loved ones about how to make important health decisions for you, in the event you are no longer able to make those decisions for yourself.
  • If you plan on moving to a facility consider the different types of facilities, their associated costs, amenities, and locations.

Things You Can Do

  • Make sure you have an Advanced Care Directive.
  • Modifying your home may allow you to stay there longer, as you age.
  • Consider different types of facilities.
  • Make a plan for how you will pay for services:
    •      Costs of Care
    •      Long-term care Insurance
    •      Using Life Insurance to Pay for Long-term Care
    •      Annuities
    •      Reverse Mortgages

Again, making long-term care decisions can be hard even when planned well in advance.  But by planning in advance, you will have the peace of mind that you and your love ones are prepared when/if that day arrives.  Remember, your path is unique to you and there is not one right or wrong option.

*Roger & Komisar, 2003