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LTC coverage in all forms has been ravaged by premium increases, limitations on availability, and/or companies are withdrawing from the market. The best deal today can be transformed into a lousy deal tomorrow by premium increases. So your friend "hit the lottery" but the lottery may hit her back...the only sure cure is to accumulate assets and hope they are sufficient to see you through--at least until you are beyond caring what Medicaid provides for indigent long-term care residents.
As you say planning for it is your best bet. Unfortunately even with a plan you may not have the resources to implement it. That is the tragedy facing many. As others have pointed out you need to look at your retirement income/cash flow and see how that compares to LTC and take it from there.
LTC coverage in all forms has been ravaged by premium increases, limitations on availability, and/or companies are withdrawing from the market. The best deal today can be transformed into a lousy deal tomorrow by premium increases. So your friend "hit the lottery" but the lottery may hit her back...the only sure cure is to accumulate assets and hope they are sufficient to see you through--at least until you are beyond caring what Medicaid provides for indigent long-term care residents.
Then there's my mother, who had the assets for LTC and assisted living but adamantly refused to give in to the "crooks." She nursed herself through every illness including pneumonia (over our frantic objections and attempted interventions) and stayed in her own home till the end, fighting everyone off. She wanted self-control, and she made sure she got it. I wonder if out of necessity some of us will go that route. I realize only now how brave (though a bit crazy perhaps) she was.
In these parts, a good grade assisted living/SNF costs appr. $250 – $350 per day. That's about 8 or 9 grand per month. I don't know what happens when the personal assets run out. I do know folks who have found a way to hide their parents' assets. If that's what it costs today, what will it be in 15 years when many of us are 80?
Then there's my mother, who had the assets for LTC and assisted living but adamantly refused to give in to the "crooks." She nursed herself through every illness including pneumonia (over our frantic objections and attempted interventions) and stayed in her own home till the end, fighting everyone off. She wanted self-control, and she made sure she got it. I wonder if out of necessity some of us will go that route. I realize only now how brave (though a bit crazy perhaps) she was.
In these parts, a good grade assisted living/SNF costs appr. $250 – $350 per day. That's about 8 or 9 grand per month. I don't know what happens when the personal assets run out. I do know folks who have found a way to hide their parents' assets. If that's what it costs today, what will it be in 15 years when many of us are 80?
Well, MY MIL wanted to go the route your mother did .... but she/they were SO unsafe - and as you know continued to drive up until a couple of weeks ago...
They only agreed to going into AL because someone other than their doctor and their children told them it was time.
The homecare folks who came in and evaluated them gave them a stark warning.
As for the future - I foresee alternative AL. I see me living with my siblings and spouse.... in a family "group" home - hiring nurses and help - on our own - pooling resources to do so.
There are actually alternatives to LTC and Assisted Living. The new thing now is "Medical Foster Care". Elders live with a family and the family gets reimbursed by Medicare. This can even be your own kin. Cheaper to pay folks to keep Grandpa at home than put him in a care facility.
I see this being quite a trend and we will hear more about this in the next decade.
this kind of program has been around for a long time, 20+ years at least in maryland. one of the problems is, these homes are few and far between, and fill up fast. in maryland, there was a waiting list almost as soon as it started. because it has been a state subsidized program, reimbursement for caregivers is limited; this has caused some to question the quality of care on the part of some providers. i don't know the status of the program now.
the other possibility, relatives getting paid for live-in care for seniors, is that the same problems in assuming this responsibility still exist. in many cases, the amount and intensity of care needed is overwhelming and caregivers, whether they be family-paid or otherwise- burn out and alternatives are needed. one on one caregiving with a person who, as an example, has dementia, is much harder on a caregiver than a rotating group of staff, where no one person has the responsibilty of providing care and ensuring safety. these private homes may seem to provide a more home-like setting, and in many cases- not all- they do. but, it is important to try and match patient needs with staffing in any facility. when there is severe cognitive impairment, having shifts of caregivers, as institutional as that may sound to some, is a better way of limiting burn-out on the part of caregivers. certainly some private homes do a good job and provide an alternative to other kinds of care but my experience has been they don't work for all or the majority of situations.
catsy girl
Last edited by catsy girl; 10-01-2012 at 07:42 AM..
Reason: word change
Well, MY MIL wanted to go the route your mother did .... but she/they were SO unsafe - and as you know continued to drive up until a couple of weeks ago...
They only agreed to going into AL because someone other than their doctor and their children told them it was time.
The homecare folks who came in and evaluated them gave them a stark warning.
As for the future - I foresee alternative AL. I see me living with my siblings and spouse.... in a family "group" home - hiring nurses and help - on our own - pooling resources to do so.
the other possibility, relatives getting paid for live-in care for seniors, is that the same problems in assuming this responsibility still exist. in many cases, the amount and intensity of care needed is overwhelming and caregivers, whether they be family-paid or otherwise- burn out and alternatives are needed. one on one caregiving with a person who, as an example, has dementia, is much harder on a caregiver than a rotating group of staff, where no one person has the responsibilty of providing care and ensuring safety. ...
catsy girl
This is true. We had to move my mom into assisted living in June because of a serious illness (pancreatic cancer that had spread to the liver). There's a huge, dedicated staff who take care of her every physical need - the list of which is growing - and administer 15 or so different meds. Many older people develop cancer or other diseases that can take various courses, depending on the person's condition and age. And they get depressed, and they react in different ways to medicines. One or two people, especially if they are untrained family members, would get burned out and extremely stressed, I think. I know I would. You really have to know what you are doing and think about what you are getting into.
We are very lucky. Of the seven of us siblings - one is a public health nurse (with ALOT of connections) with a son who is a doctor, another is an occupational therapist, and I have a million friends who are nurses.....
We will know how to hire help.
We also talked about going someplace warm and tropical to do this....
this kind of program has been around for a long time, 20+ years at least in maryland. one of the problems is, these homes are few and far between, and fill up fast. in maryland, there was a waiting list almost as soon as it started. because it has been a state subsidized program, reimbursement for caregivers is limited; this has caused some to question the quality of care on the part of some providers. i don't know the status of the program now.
the other possibility, relatives getting paid for live-in care for seniors, is that the same problems in assuming this responsibility still exist. in many cases, the amount and intensity of care needed is overwhelming and caregivers, whether they be family-paid or otherwise- burn out and alternatives are needed. one on one caregiving with a person who, as an example, has dementia, is much harder on a caregiver than a rotating group of staff, where no one person has the responsibilty of providing care and ensuring safety. these private homes may seem to provide a more home-like setting, and in many cases- not all- they do. but, it is important to try and match patient needs with staffing in any facility. when there is severe cognitive impairment, having shifts of caregivers, as institutional as that may sound to some, is a better way of limiting burn-out on the part of caregivers. certainly some private homes do a good job and provide an alternative to other kinds of care but my experience has been they don't work for all or the majority of situations.
catsy girl
i should have added that this program is or was funded by medicaid, not medicare, and therefore there are income limits that a person applying for the program has to meet.
Originally Posted by newenglandgirl
Isn't there a look-back period of some years regarding the spend-down?
When we were making arrangements to have a relative enrolled in a nursing home, this is basically what we were told by the nursing home .... just like explained in this article.
Quote:
The Deficit Reduction Act made two big changes to the qualifications for Medicaid. Previously, if a senior wanted to give away assets to his or her children in order to appear less wealthy and thereby qualify for Medicaid, they were subject to a three-year "look-back period." That meant the assets would need to be given away more than three years before they need Medicaid assistance.
The DRA changed the look-back period to five years, increasing the risk that a senior would need nursing home care during that gap. In addition, the look-back period used to start when an elderly person gave away his or her assets; the DRA changed the rule so the clock only starts once that person applies for Medicaid.
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