The reality of ending up in a Nursing Home (65+, divorce, long-term)
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What the insurance people would like you to believe:
Today, three out of four people over the age of 65 will need long-term care at some point in their lives. The reality is, the longer you live, the greater the likelihood that you may require long-term care. The costs associated with needing long-term care are significant. While it can take decades to accumulate the assets you’ll need to retire comfortably, just a few years of paying for long-term care may threaten a lifetime of savings.
According to the U.S. Bureau of the Census, slightly over 5 percent of the 65+ population occupy nursing homes, congregate care, assisted living, and board-and-care homes, and about 4.2 percent are in nursing homes at any given time. The rate of nursing home use increases with age from 1.4 percent of the young-old to 24.5 percent of the oldest-old. Almost 50 percent of those 95 and older live in nursing homes.
As some of you may know I work in Social Services and see how it is. I can assure you that 75% of our folks over 65 are not in long tem care. There simply isn't enough bed space to accomidate 75% of people over 65 in our county. None of my friends, who are over 65 reside in a nurseing home. If you want to buy LTC insurance that is fine. Just know the facts.
What a great original post. My father told me when I was a child that a person who has something for sale cannot be counted on to tell the truth about that product or service. I have never seriously considered purchasing long term care insurance because I do not consider it acceptable to live in a nursing home. That would not be "living" in my opinion, but would be death in life. I would find some way to end my life instead of acquiescing to live in a nursing home.
None of the elders in my family (who are now gone) went into a skilled nursing facility. They either died (heart attack) in hospital, or, like my mother, lived to an advanced old age on their own in their own homes. My mother did not need or want medical help of any kind. She died spontaneously (heart) in her own home. Although I know this is far from the norm, I also feel that the spectre of all of us boomers needing LTC is overblown. Despite our joint replacements, we are healthier in general than our parents were. Educated boomers tend to consume wholesome diets and get regular exercise. My guess is that many of us will not need LTC until our 80s. But how long does LTC insurance cover? Five years max? That is not a solution, imo. We have to come up with something better, something viable, based on reality, instead of buying products based on fear marketing.
None of the elders in my family (who are now gone) went into a skilled nursing facility. They either died (heart attack) in hospital, or, like my mother, lived to an advanced old age on their own in their own homes. My mother did not need or want medical help of any kind. She died spontaneously (heart) in her own home. Although I know this is far from the norm, I also feel that the spectre of all of us boomers needing LTC is overblown. Despite our joint replacements, we are healthier in general than our parents were. Educated boomers tend to consume wholesome diets and get regular exercise. My guess is that many of us will not need LTC until our 80s. But how long does LTC insurance cover? Five years max? That is not a solution, imo. We have to come up with something better, something viable, based on reality, instead of buying products based on fear marketing.
You can buy lifetime coverage, at a price, but they've yet to define a "lifetime" other than to say you die at the end of one.
The REAL story might just explain why and how some of our many really (?) elderly (mid-70s to 90s) neighbors are managing just fine in their own homes. Besides, it's nice to read an OP that doesn't send me outside to check on the sky.
In 2009, there were 40-million Americans over age 65. There were also 1.8 million nursing home beds occupied (about 84-percent) by about 1.5 million people. (U.S. Statistical Abstract). So, for people over age 65, one might reasonably estimate that about 3.5 percent were in nursing homes.
Statistically, there are also about 211-million licensed drivers in the U.S., who account for about 6-million auto accidents annually, out of which 3-million involve injuries (2-million of which are permanent) and 40,000 involve deaths. So, from this, one might reasonably estimate that about 3-percent of the licensed drivers in the U.S. are involved in auto accidents annually; or about 1.5 percent in accidents involving injuries.
Statistics without context don't really mean much. But, suppose, for example, someone suggested that auto insurance was unnecessary, because such a small percentage of people were actually involved in auto accidents. Most would probably conclude that it would only take one accident to ruin them financially or health-wise.
Similarly, annual ALF costs are about $40K, with average annual Nursing Home costs at about $80K, could
eat-up a large chunk of one's resources/estate, if they or their spouse required such care.
If nothing else, LTC insurance provides some peace of mind and the cost over 20-years (for both my wife and myself) is equal to today's cost of about 1-year in a Nursing Home for one of us. That's why, even though we may never need it, it makes sense to me to have an indexed LTC policy. Similarly, neither of us has ever been involved in an accident resulting in injuries to us or someone else ... but, we've also continued to carry auto insurance for many years. (It won't prevent an auto accident or nursing home care, but, it will sure help take the sting out of one if it does happen.)
i have no strong feelings pro or con regarding ltc insurance. however, "nursing home" or skilled care is not the only alternative most ltc insurance policies cover. most provide some coverage for in-home care as well as assisted living, both, in many cases, a viable alternative to nursing homes, and in all cases, expensive.
i worked as a social work director at a skilled nursing/rehab facility for a 10 years, and, during that time, was involved with families and staff in facilitating discharge planning . i saw many patients who were no longer elegible for medicare to continue paying for care -days used up, therapy plateau, patient refusal to continue therapy- and plans had to be put in place for a discharge. to the surprise of many families, medicare only provided the minimum short-term therapy and/ or nursing visits at home. in many cases patients had not returned to the level of independence prior to stroke or hip fracture or what- ever event precipitated their in-patient status . therefore money and or family/friends would be needed to allow the patient to return home and continue functioning there. thirty years ago this was less of a dilemma as people lived shorter lives, families were more intact and lived closer, and fewer daughters, daughters-in-law- the usual caregivers- worked. however, if elderly were to remain at home they needed to have money-theirs or a son/daughter- and a family member to become caregiver. today not everyone aging has some or all of these ingredients -money, family willing/able to be caregiver, proximity to family- and for some people, ltc seems to provide a possible alternative.
in the most recent years before i stopped working as a social worker, i worked as a geriatric care manager out of my home. basically i became the person adult children would call after a crisis or emergency with a parent, and want to know/ explore alternatives for care. those few who had social security and some savings, maybe an annual income of $10-12000, but had ltc insurance- and few people in their eighties had it- had more choices, such as adult day care, in-home companion, assisted living, even respite care to give family caregivers a break. sometimes these alternatives made a huge difference in quality of life for the elderly person but also for their caregivers.
i do not think ltc insurance is golden or "the answer" but for some, it may be one of the answers and provide more choices than otherwise possible.
Both of my parents and my brother ended up in nursing homes. My parents after living a long life and my brother who had health issues related to diet etc etc.
What the insurance people would like you to believe:
Today, three out of four people over the age of 65 will need long-term care at some point in their lives. The reality is, the longer you live, the greater the likelihood that you may require long-term care. The costs associated with needing long-term care are significant. While it can take decades to accumulate the assets you’ll need to retire comfortably, just a few years of paying for long-term care may threaten a lifetime of savings.
. . .
As some of you may know I work in Social Services and see how it is. I can assure you that 75% of our folks over 65 are not in long tem care. There simply isn't enough bed space to accomidate 75% of people over 65 in our county. None of my friends, who are over 65 reside in a nurseing home. If you want to buy LTC insurance that is fine. Just know the facts.
Well . . . one needs to think through what both sides are saying. How long is "long-term?"
For example, many people over 65 break hips or whatever and consequently go into nursing homes for 20 days or so of therapy. Each one of these then qualifies as "needing long-term care at some point in life." This doesn't mean that all of them, or even many of them, stay in the nursing home or LTC facility for any extended period of time. Rather, they go in, they recover, and they are discharged. They count as "having needed care," but they don't count as "residing in a nursing home."
Another thread here talks about the problems with LTC insurance, which include escalating premiums and insurance-company bankruptcies.
i have no strong feelings pro or con regarding ltc insurance. however, "nursing home" or skilled care is not the only alternative most ltc insurance policies cover. most provide some coverage for in-home care as well as assisted living, both, in many cases, a viable alternative to nursing homes, and in all cases, expensive.
i worked as a social work director at a skilled nursing/rehab facility for a 10 years, and, during that time, was involved with families and staff in facilitating discharge planning . i saw many patients who were no longer elegible for medicare to continue paying for care -days used up, therapy plateau, patient refusal to continue therapy- and plans had to be put in place for a discharge. to the surprise of many families, medicare only provided the minimum short-term therapy and/ or nursing visits at home. in many cases patients had not returned to the level of independence prior to stroke or hip fracture or what- ever event precipitated their in-patient status . therefore money and or family/friends would be needed to allow the patient to return home and continue functioning there. thirty years ago this was less of a dilemma as people lived shorter lives, families were more intact and lived closer, and fewer daughters, daughters-in-law- the usual caregivers- worked. however, if elderly were to remain at home they needed to have money-theirs or a son/daughter- and a family member to become caregiver. today not everyone aging has some or all of these ingredients -money, family willing/able to be caregiver, proximity to family- and for some people, ltc seems to provide a possible alternative.
in the most recent years before i stopped working as a social worker, i worked as a geriatric care manager out of my home. basically i became the person adult children would call after a crisis or emergency with a parent, and want to know/ explore alternatives for care. those few who had social security and some savings, maybe an annual income of $10-12000, but had ltc insurance- and few people in their eighties had it- had more choices, such as adult day care, in-home companion, assisted living, even respite care to give family caregivers a break. sometimes these alternatives made a huge difference in quality of life for the elderly person but also for their caregivers.
i do not think ltc insurance is golden or "the answer" but for some, it may be one of the answers and provide more choices than otherwise possible.
catsy girl
Dang, girl! I tried to rep you but have to spread the love around before CD would allow it. Several of my peers purchased policies when they were in their 50's not because they intended to go into a nursing home, but because they wanted to hire a home companion if needed, enabling them to stay at home with their pets.
I knew that if I did not purchase a group policy that did not require medical underwriting, the odds were slim that I would have the opportunity to purchase one at a later date (when a medical examination is required). I held my breath, purchased it about 3 weeks before my divorce (married individuals receive a discounted rate) and am now glad I have the coverage.
The number one reason family puts old folks in nursing homes...is...incontinence. changing Dad's diapers and changing bed sheets becomes a task most people prefer not to deal with. I took care of my Grandmother at home for years. But after her last fall, she broke her hip and needed full time care and advanced chronic pain management, it was too much.
I see things changing. ..long term care is really becoming more like "short term" care...seems to me folks are being assessed, and only last 6 to 9 months at a nursing home. Otherwise, after a stroke or something they send you to 30-90 day rehab and back home if you are doing okay.
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