Friday, May 04, 2012 A Veteran’s Benefit Is Available To Help Pay For Care.
By Susan M. Graham, Certified Elder Law Attorney, Senior Edge Legal, Boise, Idaho
If you are a Veteran who served 90 days on active duty, one day during war time, and were not dishonorably discharged, you may be able to access a government benefit to help you or your spouse pay for caregivers in your home, or help pay for assisted living bills. The benefit is called a non-service connected pension called aid and attendance. To qualify it is necessary to pass a number of tests. These include income and asset tests.
What is the benefit? The maximum pension rates for “Pension plus Aid and Attendance” are as follows:
Single Veteran $1703 per month or $20,447 per year
Married Veteran $2,019 per month or $24,239 per year
Surviving Spouse 1,094 per month or $13,138 per year
Veteran married to a Veteran $2631 per month or $31,578 per year.
Who can help a Veteran or the Veteran’s spouse apply for this benefit? In Idaho, we have the Office of Veteran’s Advocacy, which is part of the Idaho Division of Veterans Services. They will help you complete the forms for FREE. Their address is 444 W. Fort Street, Boise, Idaho 83702 and their phone number is 208-577-2300. An assisted living or nursing home or any other facility or other organization that is paid out of the VA benefits is considered an interested third party and cannot charge or pay for the preparation, presentation or prosecution of a claim.
Friday, March 16, 2012 Hope is not a plan. Is it OK to have two house fires?
By Susan M. Graham, Certified Elder Law Attorney, Senior Edge Legal, Boise, Idaho
I talked to a wife this week who has been a caregiver for her demented husband for years. Recently he has taken to getting up in the night and using firewood stored by the fireplace to start fires on the hearth and in the firebox! Fortunately, his wife noticed both times and put the fires out. She is grateful for these miracles but sees no need to change how they live.
Her desire is to continue to care for and keep him at home with no help. This is a dangerous plan for both of them.
Fortunately, their children and doctor have taken notice and are working to make changes that will result in a safer environment for each of them with plenty of help.
Hope is not a plan. That approach is living in a fantasyland unrelated to real world events associated with ageing.
Saturday, December 17, 2011 There Go The Social Safety Nets (to help pay for catastrophic long-term care!!)
by Susan M. Graham, Attorney at Law, Senior Edge Legal, Boise, Idaho
We have no money in this country. We all know that. How does this impact on you if you need to pay for residential long-term care in a nursing home, assisted living or in your own home?
There are two government programs that are available to seniors to help pay for care - Medicare and Medicaid.
Medicare is a national health insurance program for people 65 and older. Medicare will help pay for a maximum of 100 days of care. To access this benefit a few requirements must be met. First, a person must be admitted to a hospital and stay there at least three days. Then, when they are discharged to a rehabilitative facility, such as the Boise Elks, if that person is improving, Medicare will pay 100% for the first 20 days of care. If the person continues to improve, Medicare will pay part and the individual or their supplemental insurance will pay part of the expense for the next 80 days.
What are the holes in this "safety net"? First, the Medicare recipient must be ADMITTED to the hospital and not there for OBSERVATION. The difference is huge. If a person is not admitted, Medicare will not pay a dime toward the rehabilitative care. If Medicare does not pay, then in most cases the supplemental health insurance coverage will not pay for the care as well. This problem is happening here in Idaho as well as nationwide. The bills for the first 20 days that I've seen range from $6,000 to $30,000. This is a huge bill for most individuals and families to absorb.
The next hole in the Medicare safety net requires that the person be "Improving" during their rehabilitative care. My cousin, Kathie, at age 98, went to the hospital for three days. She was admitted. They discharged her back to her nursing home and I was called two days later saying Medicare would not pay for her care because she was not "improving." She was old and could not follow instructions. I was not surprised that she failed this second test.
Another "safety net" is the federal and state Medicaid program. Part of this program helps to pay the long-term residential care expenses for people 65 and older who meet a list of criteria. The cost for privately paying these bills ranges from $20 per hour for a bath aide to $8,000 per month for skilled nursing care. To access this benefit, it is necessary to complete an application form and submit it to the Idaho Department of Health and Welfare. The last two application forms we submitted on behalf of a married couple were approximately 400 pages each.
There were at least six more inches of back-up information. It took hours and hours to sort out and complete the application and deal with the follow-up issues. All of our Medicaid applications have been approved in the past 5 years, but remember I have a law office. The process is onerous and next to impossible for regular families in crisis to complete on their own. That is not fair, but it is the real world.
We have no money in this country to continue to provide the safety nets that have been available.
What can you do to protect yourself and your loved ones?
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Make certain you have up-to-date legal documents that include your Living Will, Health Power of Attorney and Financial Power of Attorney.
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Let the people you plan to rely upon in a crisis know you have nominated them to help.
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If you need help, seek it out. Your failure to make informed decisions may cost you and your family thousands of dollars and unnecessary worry.
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Contact your government representatives and let them know you want honest safety nets that really work, not ones that exist on paper and are not really accessible to regular people.
Thursday, August 18, 2011 The National Senior Citizens Law Center Issues an Updated "20 Common Nursing Home Problems"
Susan M. Graham, Certified Elder Law Attorney
The average consumer knows more about credit cards, cell phones or renting an apartment or movie than they do about nursing home regulations. This great guide is available by going to the NSCLC website. This guide spotlights some of the most common illegal practices and explains strategies that residents and family members can use to avoid or reverse illegal procedures.
For example, being "difficult" is not a sufficient basis to evict a resident from a nursing home.
To access this helpful guide go to the NSCLC website and click on "Publications." You can print one copy for free.
Friday, June 17, 2011 Who Plans on Being a Caregiver? You?
Remember we all have a 70% chance of needing care before we die. Not a pleasing thought.
The number of adult children over 50 who are caring for their parents is estimated to be 10 MILLION in 2008.
What does it cost the caregiver to provide this service to their parents? A Wall Street Journal article on June 14, 20111 estimates the cost to the care providers who are 50+ averages over $300,000. This comes from lost wages, pension and social security benefits. There is no measure for the increased stress, depression, and other physical ailments experienced by the caregiver.
If you plan to be the caregiver, understand the personal, financial and physical cost to you.
There are planning options that may lighten the burden for a family caregiver. Discuss your family situation with a Certified Elder Law Attorney to explore ways to make the best of a difficult family situation.
_______________
1 "Toll of Caring for Elderly Increases," by Kelly Greene, The Wall Street Journal, June 14, 2011 page D3.
Friday, June 03, 2011 New Report Reveals Over-Use of Anti-Psychotics in Nursing Homes
This spring, a family reported to me that a loved one in a nursing home had trouble getting her medications in balance. She was placed in a hospital to help sort the problem out and after her stay, she was even worse and never spoke again. What a tragedy.
This summary of a national report reflects the same experience is happening all over.
"When a loved one moves into a nursing home, the support of family and friends is particularly important. This is especially true when the nursing home patient has dementia and can't adequately advocate on his or her own behalf. A newly released report from the Office of the Inspector General for the Department of Health and Human Services makes clear just how crucial it is for families to monitor and ask questions about medications that such patients receive."
Source: CNN Opinion (May 31, 2011) and the National Academy of Elder Law Attorneys
Full OIG report
Friday, April 22, 2011 Are there steps you can take to reduce your chances of getting Alzheimer’s?
This week there was an article in the New York Times[1] that indicated if people receive treatment for their medical issues such as diabetes, high blood pressure and cholesterol they may be less likely to progress to full- blown Alzheimer’s. I am providing the full article below.
Older people suffering from mild memory and cognition problems may be less likely to progress to full-blown Alzheimer’s disease if they receive treatment for medical conditions like diabetes, high blood pressure and cholesterol, a new study has found.
In 2004, researchers at Daping Hospital in Chongqing, China, began following 837 residents ages 55 and older who had mild cognitive impairment but not dementia. Of these, 414 had at least one medical condition that can impair blood flow to the brain.
After five years, 298 of the participants had developed Alzheimer’s. Subjects who had had high blood pressure or other vascular problems at the beginning of the study were twice as likely to develop the dementia, compared with those without these risks, the researchers found. Half of those with vascular risks progressed to Alzheimer’s, compared with only 36 percent of those without.
Among those with vascular problems, those who received treatment were almost 40 percent less likely to develop Alzheimer’s than those who did not, the study also reported. The researchers suggested that vascular risk factors may affect the metabolism of beta-amyloid plaque, which accumulates in the brains of Alzheimer’s patients and seems to play a pivotal role in the disease.
The study was last week in the journal Neurology.
[1] Patterns: Treating Other Conditions May Stave Off Alzheimer’s, Study Finds, by Roni Caryn Rabin, New York Times, April 19, 2011 page D6.
Friday, August 27, 2010 HOW TO PAY FOR LONG-TERM CARE? - THE MEDICAID PROGRAM CONTINUED - What if you have excess non-exempt assets
To meet the asset test it is often necessary to “spend down” excess non-exempt assets before applying for Medicaid. How can a single or married person “spend down” or make the excess non-exempt assets go away? There are four methods: 1) pay the bills for the Medicaid applicant, and the applicant’s spouse, if they are married, 2) purchase exempt assets 3) gift and 4) list non-exempt assets for sale.
1. Pay the bills.
• Pay the regular bills for the Medicaid applicant (and their spouse.)
• Pay off the house mortgage or other loans.
• Enter into a written “service contract” that meets the Health and Welfare Regulation standards that allows the Medicaid Applicant (and their spouse) to pay designated family members at a market rate for their help.
The family member is paid after the services are provided.
The income is taxable to the family member.
If there is no written contract, then the payment is a gift.
• Go on a nice trip and pay for 1 child to go along if you need a traveling companion to travel safely.
2. Purchase exempt assets
• Buy a more expensive home
• Remodel the home. Make the home handicap accessible.
• Buy a more expensive car
• Buy stuff: TV, mink coat, dining room set, computer, chair, bed and other household items.
• Prepay the funeral with an irrevocable funeral fund
• Pay for dental and eye care and hearing aids
• Purchase an Annuity that is paid out in equal monthly installments over the life of the single person or the life of the healthy spouse. Purchase the annuity from an insurance company that pays all the funds out in a time period that is less than the actuarial lifetime of the owner.
For a single person, name the State of Idaho as the beneficiary to be reimbursed for the Medicaid benefits paid on behalf of the Medicaid applicant.
For a married, healthy spouse, name the spouse first as the beneficiary and the State of Idaho as the contingent beneficiary to be reimbursed for the Medicaid benefits paid on behalf of the Medicaid applicant.
To my knowledge the first such annuity was approved by Health and Welfare in February 2010.
3. Make Gifts of assets
Understand there is a five (5) year “look back” for gifts. That means if you apply for Medicaid, Health and Welfare will “look back” to see if any gifts have been made during the five (5) years prior to applying for Medicaid.
If a gift was made within this five-year period the applicant will be assessed a penalty period. A penalty period means that even though a person meets all other tests to qualify for Medicaid, they must wait out the penalty period before they can reapply and qualify for Medicaid. The penalty period is calculated by dividing the amount of the gifts made in that 5-year period by $200 for a daily calculation. For example, a $13,000 gift will result in a 65-day penalty period. This means that the applicant must wait an additional 65 days before they can reapply for Medicaid.
One solution is to give back the gifted funds, and there will be no penalty period.
Another solution is make large gifts, and put them in an irrevocable trust to protect the assets, and retain sufficient funds to pay the bills for a least five years.
There is no penalty period if a home is gifted to:
• A child who has resided in the home for two years prior to the first time the Medicaid applicant went into a facility for 30 continuous days or more. The child’s care is expected to keep the parent out of a care facility for part of this time.
• A sibling who lived in the home for one (1) year and also has an ownership interest in the home.
• A disabled child.
4. List a non-exempt, real property or other illiquid asset for sale.
If the Medicaid applicant owns real property that is not a primary residence, this property can be listed for sale and will no longer be counted as a non-exempt asset.
Procedure for applying for Medicaid
Once the “spend down” is accomplished and the asset and other test requirements are met, then it is possible apply for Medicaid the next month.
Get Help!
The Medicaid rules are complex and change often. The information provided in this article is general information and not intended as legal advice. If you want to investigate whether you or a loved one may benefit and qualify for the Medicaid program to help assist pay for the cost of long-term care in the home, in an assisted living facility or in a long term nursing home (skilled nursing care) facility, it is recommended that you seek the advice of a Certified Elder Law Attorney or other professional.
Friday, August 13, 2010 HOW TO PAY FOR LONG-TERM CARE? - THE MEDICAID PROGRAM
Medicaid is a State of Idaho and Federal government program that helps people with long-term care costs. The laws and regulations in this area change often so this article will just cover the high points of what it takes to qualify for Medicaid to have the government program pay for long term nursing home care costs.
There are many tests that need to be passed before a person can qualify for Medicaid.
• The Medicaid applicant must be age 65 or older, or blind or deemed disabled according to the Social Security standards.
• the applicant usually must be a citizen.
• the applicant must have a medical need.
• the applicant must past the income test.
• the applicant (and their spouse, if any) must pass the asset test.
What are the benefits of receiving Medicaid?
Medicaid will pay 100% for residential nursing home care and all prescription drug costs in facilities that participate in the Medicaid program
Medicaid will pay 100% for residential care in assisted living, but will not pay for drugs. There are a few Assisted Living facilities that participate in Medicaid because the facilities are often reimbursed at below their break-even point.
Medicaid will pay $16/hour for a maximum of 8 hours per day for in home care by a certified caregiver.
Income Test
Single Person
If the applicant’s gross income is more than $2,022 per month, then the applicant fails the income test. If there income is less than $2,022 per month they will pass this test. Income is usually from social security and pensions, but there are other sources of income that can be considered.
Income for a Married Applicant’s Spouse.
If the income of the healthy spouse [called the “community spouse”] is less than $1,821.25, she can get additional funds from her husband’s social security and pension to bring her up to $1,821.25 and if she has excess shelter costs, she can have a maximum of $2,739 per month. If she needs even more monthly income, she can petition the court for a greater income. There is no limit on the income received by the healthy spouse, so she can have income from her social security, wages and pension of more than $1,821 and her husband may still qualify for Medicaid.
Solution to failing the income test.
If the Medicaid applicant fails the income test by having too much income, that person can set up an irrevocable “Income Qualifying Trust” which is often referred to as a “Miller Trust.”
How does this “Income Qualifying Trust” work? The Trust creator is the Medicaid applicant. The Trustee of the Trust is that person’s spouse, a child or some other trustworthy person. Often the entire amount of the Medicaid applicant’s social security and pension are automatically deposited in the old checking account. The Trustee then sets up a new checking account and every month transfers all the social security and pension to the new account. Then the Trustee makes monthly checks: one for $40 for personal needs, one for $25 for Trustee fees and the balance to the facility.
Next week we will address the Asset Test requirements to qualify for Medicaid.
Friday, July 23, 2010 HOW TO PAY FOR LONG-TERM CARE? - VETERANS BENEFITS CONTINUED: THE ASSET TEST
Last week, July 16, 2010, I wrote about some of the tests that must be met to qualify for a Veterans Administration “non-service connected pension” benefit that can help provide added funds to pay for care in your home or in a facility. These tests included 90 days of military service, one day of service during war time, having the right discharge papers, and having reoccurring monthly medical expenses that were more or somewhat less than your monthly income.
An important additional test to qualify for the VA benefit is the asset test. The Veteran (and their spouse) is allowed a number of assets that are not counted by the Veterans Administration. These include:
One house
One car
“Stuff” in the house.
The instructions for VA Form 21-526 define net worth as follows:
Net worth is the market value of all interest and rights in any kind of property, after
subtracting any mortgages and other claims against the property. List all assets
except the house in which you live, any reasonable area of land on which it sits,
and those items you use everyday, such as your vehicle, clothing and furniture.
Clearly indicate if you and your spouse jointly share assets (such as money in a
joint checking account). Report the value of farms or buildings that you or a
dependent owns as “real property.”
You must disclose all financial transactions that involve a transfer of assets, even
if the transaction occurred prior to the date of your application for VA pension. A
gift of property or a sale below the property’s value to a relative residing in the
same household does not reduce net worth. Likewise, a gift of property to someone
other than a relative residing in your household does not reduce any net worth
unless it is clear that you have relinquished all rights of ownership, including the
right to control the property
The “other assets” become the area of focus. Other assets include a second home, rental, cabin, bare lot, other cars, bank accounts, certificates of deposit, stocks, bonds brokerage accounts, Individual Retirement Account (IRAs), 401(k), other retirement accounts, cash value of life insurance, annuities, partnerships, and the list goes on.
The old rule used to be if the “other assets” were less than $80,000 they would be ignored, and the claimant (and their spouse, if any) could keep up to $80,000. That rule has changed. Now the total amount of the “other assets” that you can keep is dependent on the claimant’s life expectancy. If the “other assets” are over $50,000, it may be best to consult with a VA Accredited Attorney, VA Accredited Agent or the Idaho Veterans Service Office.
The value of the other assets is based on the current fair market value of the assets owned by the claimant (and their spouse). If an asset is owned by someone in addition to the claimant (and their spouse), then the value of the asset is considered proportional to the number of owners. For example if you have a single claimant, and a few years ago he put his three children’s names on his Certificate of Deposit valued at $100,000, the VA would treat his interest in the Certificate of Deposit as $25,000.
Unlike the Medicaid rule, the VA rules do not penalize a claimant if they have given assets away in the years before applying for the VA benefits. So, if a grandparent has helped a grandson by paying $10,000 for his school expenses and then the Veteran grandparent goes into an assisted living facility, there is no penalty for the gift. Under the new VA Form 21-526, it is necessary to disclose each gift, but there is no penalty imposed.
Watch out for irrevocable trusts. If the creator of the trust retains any “strings” of control, it is likely the VA will pull the asset back and treat it as if it belongs to the Veteran or the Veteran’s spouse.
What is a “string” of control? Examples include: Substitute assets, change trustees, change trust protector, change beneficiary, or income from the trust is distributed to the creator of the trust and a 1099 is issued in that person’s name.
Being able to receive the Veterans non-service connected pension is a great help to many so they can stay in their home or afford to pay for an assisted living facility.
One last great feature of the VA pension - there is no “Estate Recovery.” The VA is not a “loan” program. The VA does not want to be paid back after the death of the claimant.
Friday, July 16, 2010 HOW TO PAY FOR LONG-TERM CARE? - VETERANS BENEFITS
In the last Blog we discussed Medicare as a first government program that can help with the costs of long-term care. Now we will discuss a second program, available through the Veterans Administration that can help certain Veterans with the costs of paying for care in their home, assisted living or skilled nursing homes,
VETERANS ADMINISTRATION (VA) BENEFITS
The Veterans rules are complex and do not always follow common sense guidelines. The information about the Veterans programs presented here are general in nature. If you are interested in pursuing Veterans benefits, you are encouraged to contact the Idaho State Division of Veterans Services to find the contact information for your local Veterans Service Office, 208-577-2300, or contact an Attorney or Agent Accredited with the Veterans Administration.
When to use this program?
It may be possible to use the VA “non-service connected disability income” (called “pension” by the VA) to help pay for care in the home, assisted living or skilled nursing home facilities. The VA benefit is sometimes referred to as “Aid and Attendance.”
The VA has a number of programs available to Veterans, but the only one addressed here will be the “non-service connected pension.” Veterans who are disabled as a result of their military service have other benefits available.
What does it take to qualify for the Veterans “pension” benefits? There are a series of tests to qualify for this benefit.
The simple tests are listed below:
• Are you a Veteran, Veteran's spouse, widow or widower of Veteran
• Was the Veteran in the military for 90 days
• Was one day of the military service during a defined Wartime. The war periods recognized by the VA1 are:
WWII December 7, 1941 through December 31, 1946;
Korean: June 27, 1950 through January 31, 1953;
Vietnam: February 28, 1961 through May 7, 1975 for Veterans who served in Vietnam during that period and August 5, 1964 through May 7, 1975 inclusive for all others;
Persian Gulf: August 2, 1990 through (no one knows since the war on Terror continues and is part of the Persian Gulf War)
• Other than dishonorably discharged
• Is the Veteran age 65 or older? There is no age limit for the Veteran's spouse.
The tests that can be more difficult to measure are concerned with the applicant’s income and assets.
Income Test
The income test compares the gross income of the veteran and the veteran's spouse to their repeating monthly medical expenses. Gross income is defined as the income from social security, pensions, dividends and interest and other sources of regular income, before any deductions are taken out for taxes, Medicare Part B premiums, other health insurance premiums, etc. Repeating monthly medical expenses include, but are not limited to Medicare Part B premiums, health insurance premiums, Medicare Part D premiums paid for prescription drug coverage, prescription drugs, the cost of care givers coming into the home, if the physician declares him or her housebound and in need of assistance from another individual, which may also include services offered in assisted living. If the physician states the applicant needs to live in a “protective environment” then 100% of the assisted living expenses may be deemed a reoccurring medical expense for VA purposes.
What does it really mean to be in “need of assistance from another?” These are some of the categories.
Blind
Living in a nursing home
Unable to
Dress/ undress or keep oneself clean and presentable
Attend the wants of nature without assistance
Have a physical or mental incapacity that requires assistance on a regular basis to protect the claimant from daily environmental hazards.
What is the maximum the VA pays in 2010 for Aid and Attendance Pension on a monthly basis?
For a single Veteran, $1,644
For a married Veteran $1,949
For a widowed spouse of a Veteran $1,056
For a Veteran married to a Veteran $2,540
Calculating the amount of the VA benefit.
Start with the gross Income before any deductions of a single person or both spouses.
Subtract from the gross income all repeating monthly medical expenses, such as insurance, prescriptions, attends, caregivers or assisted living or nursing home costs to come up with “net income”
If the difference is
Zero, the VA will pay the maximum benefit.
Less than zero, the VA will pay the maximum benefit.
More than zero, the VA will only pay the difference between the maximum benefit and the net income.
Here is an example of the calculation for a single vet:
Gross income from Social Security and Pension 3,150
Repeating monthly expenses for Medicare Part B, Medicare Part D premiums
health insurance premiums and the cost of caregivers coming into the home 2,150
Difference 1,000
VA maximum benefit 1,644
Subtract Difference 1,000
VA will pay 644
Next time we will discuss the other criteria needed to qualify for the VA non-service connected pension benefits.
________
1Check the VA regulations for additional war time dates.
Friday, July 02, 2010 How to Pay For Long-Term Care
There are two approaches to paying for care. Assume the responsibility yourself or rely on the State and Federal government to pay for the care.
If you choose to assume the responsibility to pay for your own care, you will use your own assets and income or purchase long-term care insurance to help pay for care in your home, in an assisted living facility or in a nursing home.
If you look to the government to pay for your care, there are three programs currently available to help. Be aware that our government is in the worst financial position ever, and its expenses exceed income, so these safety nets may be diminished in the future. The three government programs that help pay for long-term care are Medicare, Veterans’ non-service connected "pension” benefits and Medicaid. We will consider each of these three government programs. In this article we will discuss the first Government program, Medicare.
MEDICARE
Who is covered? This is a federal health insurance program for people age 65 and older.
What does Medicare pay for?
Part A = Hospital bills.
Part B = Doctor, outpatient, home health and preventative services ($96.40/month premium up to $353.60 for higher incomes)
Part C = Medicare Advantage program, really HMOs
Part D= Prescription drug plan
Does Medicare pay for residential, long-term care in your home, assisted living or a nursing home? No, but with one exception.
If you are admitted to a hospital for 3 days, then discharged to a rehabilitation facility and you are improving, Medicare will pay 100% of the cost for the first 20 days. If you continue to improve, then from day 21 to day 100 the patient will pay $137.50/day [or their supplemental insurance pays] and Medicare pays the rest. How is this safety net disappearing?
WARNING: If you are not “admitted” to the hospital, but there for “observation” Medicare will not pay a dime and your supplemental Medicare insurance will not pay either. Failure to get the first 20 days covered by the Medicare program can cost in excess of $6,000! This is an Idaho and a nation-wide problem.1
THE SOLUTION: Make certain you are “admitted” to the hospital before being discharged. If you cannot get this accomplished, talk to the hospital social worker, or an independent Care Manager.
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1 "Hospital Stays Under Observation," AARP Bulletin, January-February, 2010
HAVE A GREAT 4th OF JULY
Friday, June 25, 2010 The Conveyor Belt of Aging - As People Age They Usually Fall Apart
We all want to just die some day in the distant future. No one wants to be dependent and require caregivers for any extended period before we die. The reality is obvious - as we age we probably fall apart. Just like an older car, the tires get flat or bald, the fender rusts and falls off, the battery dies. What is the progression for people?
Hopefully you started on the conveyor belt of life for seniors as a healthy retired person. As the belt moves along have you found yourself;
• Taking medications
• Having health issues
• In the hospital for a crisis (pneumonia or a fall)
• Experiencing memory loss
• Less mobile
• Signing up for Medicare and supplemental insurance to help pay for all of this.
At this point care becomes an issue, care in the home is needed and a new concern becomes how to pay for that care. Is the care paid for “out of pocket," with long-term care insurance, Veterans Administration benefits, or Medicare? As the conveyor belt keeps moving, staying in the home may no longer be possible, so you move to an assisted living facility (where you can do a few things for yourself) or you become a fragile senior and need to be in a skilled nursing home. Again, the concern is what funds you will use to pay for that care – your own money, VA non-service connected pension benefits, Medicare, Medicaid or long-term care insurance.
What is the average length of care in facilities?
Assisted Living stays range from 2.5-3 years.1 To qualify to stay in an assisted living facility, the residents need some help with what are called “activities of daily living.” These six activities include: medications, bathing, dressing, toileting, transferring and eating.
Skilled Nursing Care (nursing home) stays average 2.4 years. Of course, the average is based on residents who stay for only a few days, and others who stay for a decade or more.
What does it cost for care in southwestern Idaho?
Assisted Living $2,000 to 5,000/month
Nursing Home $6,000 to $8,000/month
At Home $20/hr for a bath aide in the home to
$15,000/month for 24-hour care.
Once the conveyor belt has stopped, after death, are there care needs for the surviving spouse or dependent disabled children?
The issues become frightening when considering this progression. Start planning NOW.
1 Public Policy Institute, Assisted Living in the United States Fact Sheet, AARP, FS62R
Friday, June 11, 2010 Are You Prepared?
"Failure to prepare is preparing to fail."1
Everyone has a 70% chance of needing care before they die.2 If you are unlucky and in that 70% group, how are you going to pay for that care? The costs range from $20 per hour for a bath aide to come to the home to over $6,000 per month for skilled nursing care in a nursing home.
A new Idaho guide addressing the cost of long-term care has been published through the joint efforts of the Idaho Department of Insurance, the University of Idaho Extension Services and AARP. The last guide was published in 2007.
This 2010 guide provides a range of costs for nursing home and assisted living services statewide. The guide also includes estimated monthly expenses for long-term care insurance premiums for ages 55 to age 75. Medicare, Medicaid and out-of-pocket payment approaches are also covered on page 3 of the guide.
To check this out on the Internet go to: The 2010 Price Guide to Long-term Care Insurance and Services in Idaho, or call 1-800-488-5731 at the Idaho Department of Insurance for a copy.
There is no point in “preparing to fail.” What a scary future that projects for the one who fails to prepare and their family!
1 John Wooden, died June 4, 2010
2 "Caregiving in America" National Alliance for Caregiving and AARP 2004
Tuesday, November 24, 2009 Are You at Risk of Needing Long-Term Care?
Most people answer "not me!" and pull a paper bag over their heads. The government says if you are over age 65 there is about a 70% chance you will require at least some type of long-term care services during your lifetime. Over 40% will need care in a nursing home for some period of time.
What is long-term care? Long-term care covers a variety of services and support for health and personal care needs over a long period of time. The help is in six areas of everyday "Activities of Daily Ling" (ADLs). These areas are bathing dressing using the toilet, transferring (to and from a bed or chair), incontinence, and eating.
For more information go to the U.S. Department of Health and Human Services website www.longtermcare.gov,
If you want to explore ways to protect your independence, assets, and family, if you should need long-term care, contact us to set up an appointment 208-344-0375
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