LTC -- how do you plan on covering this risk?

[bingybear]

Quote:

Originally Posted by mathjak107 if we did not have total asset protection i would have not done it . that makes the policy worth it for the perks and not just the payout amount of the insurance. i tried to see what other states offer total asset protection and not just a dollar for a dollar but couldn't find a list .

NY and IL are the only states that have total asset protection as an option for the partnership policies. To keep the TAP, you need to qualify for medicaid in one of those two states. If you go to one of the $/$ states, that is all you will get. Reciprocity will not give you the TAP in a $/$ state.
I think the TAP would have made the LTCi something I likely would seriously consider.

[ChrisC]

Quote:

Originally Posted by audreyh1 The problem with transferring the financial responsibility to an institution/corporation, is that after taking all your money, they are likely to fight you paying out. Is it more convenient to pay the facility yourself, or fight with the insurance company to get them to pay out? I think your assumption of LTC insurance being more convenient or lowering the hassle factor may be naive. People have had real tough experiences with this very issue. I, personally, don't want to be fighting the insurance company. I don't trust health insurance companies.

Well, I have my eyes wide open about insurance claims, since my wife and I are both lawyers and one us has experience with personal injury claims, insurance claims and adjusters, disability and insurance settlements. And we read the stories about the nasty treatment that Jim Cramer's or Nord's father had with LTCi claims. We are also aware of stories that go in the other direction, as well.

I don't have great confidence that insurance companies will always see things the way I see them, but I have confidence in myself to know that if they really try to screw me over and there isn't any justifiable legal reason for them to do so, I (and other members of my family) will hold them accountable, as we would for any other service provider that jerks us around.

I recommend that if you don't trust health insurance companies, you should not buy any of their products. You certainly would be saving yourself some personal angst.

[ChrisC]

Quote:

Originally Posted by audreyh1 There is a huge difference between an assisted living facility and a nursing home. I think a lot of folks confuse the two. I tend to believe that by using an assisted living facility you may be able to really limit the time in the more expensive nursing home. If you are counting on your LTC to cover the cost of a facility, you have to "proove" that you need help. Here is the first round of arm wrestling with the insurance company, and many folks report difficulty with this stage. If you are self-pay, then you can take advantage of the assisted living option whenever you feel ready, or your loved ones encourage you . And hopefully avoid issues living alone (falls, etc.) that might otherwise push you towards a skilled nursing facility. There are also options of hiring care in your own home. Although this can also be tricky, because unsupervised care givers can take advantage of their clients so you have to be super careful about whom you hire.

Many LTCi policies cover home care, assisting living, and skilled nursing care, as long as one qualifies for LTCi coverage, typically the inability to meet 2 of 6 basic activities of daily living. Of course, if you self pay one can also pick and chose any level of care, just as you can for many LTCi policies. I think many facilities have graduated levels of care, from independent living (not covered by LTCi policies), assisted living (which could include memory/dementia care) to skilled nursing care.

My plan is to stay in my home as long as we can. If I need long term care assistance under my LTCi policy, I have the option of remaining in my home with family members taking care of me and my family members can receive compensation for the care giving they provide. Of course, this all sounds good until you have to actually use the policy!

[Tailgate]

here's the link to Elderlawanswers ...I have found this site to be helpful about many elder issues, including LTC...

[mathjak107]

Quote:

Originally Posted by bingybear NY and IL are the only states that have total asset protection as an option for the partnership policies. To keep the TAP, you need to qualify for medicaid in one of those two states. If you go to one of the $/$ states, that is all you will get. Reciprocity will not give you the TAP in a $/$ state. I think the TAP would have made the LTCi something I likely would seriously consider.

i knew out of state we revert to a dollar for a dollar but we ain't leaving ny so not a problem.

i thought more states would have taken part in the total asset protection plans .

i can't say without it i would have been so quick to get a plan.

those perks after the insurance runs out are priceless.

[Fermion]

What is prison like for LTC? Is that an option that is better than one of these "hellholes?" I would guess there is significant government oversight at a prison facility for criminals that need assisted living care.

[Nunthewiser]

My very limited experience with the ALF around here was that they were far too "nice" for my 95 year old mother. They had all kinds of shopping and entertainment trips and activities lined up and were very short on the "assisted" part. Their idea of "assistance" was for her to put a card on the door in the morning to signify that she was alive. They were comfy living, even by my standards, and not all that expensive IMO , at $2k/mo. But they were lacking in "eyes on" help and assistance. Probably much more suited to someone far younger.

The nursing homes were all pretty grim in atmosphere and in attendees. Most of the folks using them were really in bad shape, though many were far younger than my 95 year old mom. She really didn't fit well with either for much of the last few months. She really just needed someone to "babysit" her. One or two dedicated people that were FAMILIAR WITH HER would have been the ticket. Theproblem with the nursing home is that the staff was constantly changing, never seemed to be around and really didn't seem to care much when I saw them.

[wesnyc]

I'm self-insuring; and actually while I still have an LTC policy, I will be abandoning that policy at year's end (I started another LTC post about a rude surprise from Genworth, hiking rates in NY State by 60%....). I've decided to cut my losses and forego LTCI. I'm not sanguine about future rate hikes and what my policy will resemble if I don't keep ponying up the dough. Not so happy about this to be sure and wish there were a better solution, but I will not pay for a policy which will now become $8,000 a year--I just don't think this is a good investment. My plan is to take this money I had been paying for this policy, invest and set it aside for future LTC needs.

One more thing--all this talk about a magic pill--if you haven't already seen it, do watch the great flick "Still Alice" (Julianne Moore won an Oscar for her role). There is a "magic pill" moment in that movie which I won't give away....but worth watching to see how that plan sometimes turns out....

[ChrisC]

Quote:

Originally Posted by Nunthewiser My very limited experience with the ALF around here was that they were far too "nice" for my 95 year old mother. They had all kinds of shopping and entertainment trips and activities lined up and were very short on the "assisted" part. Their idea of "assistance" was for her to put a card on the door in the morning to signify that she was alive. They were comfy living, even by my standards, and not all that expensive IMO , at $2k/mo. But they were lacking in "eyes on" help and assistance. Probably much more suited to someone far younger. The nursing homes were all pretty grim in atmosphere and in attendees. Most of the folks using them were really in bad shape, though many were far younger than my 95 year old mom. She really didn't fit well with either for much of the last few months. She really just needed someone to "babysit" her. One or two dedicated people that were FAMILIAR WITH HER would have been the ticket. Theproblem with the nursing home is that the staff was constantly changing, never seemed to be around and really didn't seem to care much when I saw them.

Hmmmm, what you describe as an Assisted Living Facility appears to correspond more with a facility that houses some people for Independent Living -- there's a huge difference. This place has folks in different stages from Independent Living, to Assisted Living, to Memory Care/Dementia Care -- just short of Skilled Nursing Care facility. Singh Senior Living - Redefining Retirement Living My mother has resided in a nursing home since 2007. It's a depressing place to spend any time.

[akck]

If my experience with stays in nursing facilities and LTCi is any indication of what will happen, I'd come to the conclusion that it isn't needed. First, my father, who didn't have LTCi, spent 2 months in a facility, so he wouldn't have made it out of the 90 day deductible period. My mother, who had LTCi, ended up dying at home. My FIL, also didn't have LTCi, passed away on Friday after a 3 month stay in a facility, under the 90 day period again.

So, LTCi did not or wouldn't have helped in these situations. This should be a good reference point for those. Who are self-insuring. The only thing self-insurers need to be aware of, is that 3 year average stay in a facility is made up of a lot of short stays offsetting longer stays. Even though my FIL wasn't there long (it felt like an eternity), we did get to know some of the other guests. Some had been there for 5 years. An Alzheimer's guest had been there for a year, but she is healthy enough to last for several more years. So, we are insuring against a longer stay. LTCi will help preserve assets which are available when the LTCi runs out and allows the spouse not under care to live comfortably.


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[REWahoo]

Quote:

Originally Posted by akck If my experience with stays in nursing facilities and LTCi is any indication of what will happen, I'd come to the conclusion that it isn't needed.

OTOH, I've seen something quite different:

MIL - 3+ years
Mom - 2+ years
Dad - 9 months
FIL - 7 months

Note the above were their final stays in nursing homes prior to their deaths. Both my MIL and my mom had short-term prior stays.

I'm not saying anyone does or does not need to self insure or take out LTCi. But there is no way to predict whether or not any of us will spend an extended time needing care based on what happened to our parents or in-laws. We're all different.

[Amethyst]

It is probably asking a bit much of anyone to actually "care" about a dilapidated old person who is not even a relative. People are not too fun to be around, at that stage, and also aren't "cute" the way seriously ill kids can be. The most you can hope for is that the "caregivers" aren't actively mean, don't steal your stuff (on the assumption that you don't need it any more and wouldn't notice if it disappeared), and don't forget to feed you.

Quote:

Originally Posted by Nunthewiser The nurses were indifferent, IMO and it would have been a very depressing experience, for me anyway. .

[ChrisC]

Quote:

Originally Posted by Amethyst It is probably asking a bit much of anyone to actually "care" about a dilapidated old person who is not even a relative. People are not too fun to be around, at that stage, and also aren't "cute" the way seriously ill kids can be. The most you can hope for is that the "caregivers" aren't actively mean, don't steal your stuff (on the assumption that you don't need it any more and wouldn't notice if it disappeared), and don't forget to feed you.

That is so true. The caregivers in many cases aren't nurses, but at best are certified nurse assistants. I rarely see a nurse on my mother's nursing home floor, and if she's there, she's generally busy in some emergency situation. Collectively, the elderly residents at nursing homes are physically and mentally challenged, frequently difficult to manage, and their behavior would try the souls of even the most saintly of caregivers. You're lucky if you have primary caregivers who aren't insensitive and mean and who will help feed you, help shower or bathe you, help toilet you, help diaper you, and help change linens so you don't get bed sores -- getting old ain't for sissies, but neither is taking care of cantankerous, physically and mentally impaired adults who also frequently fight among each other! If caregivers at my mother's nursing home do their jobs, I really don't care if they have a scowl or smile on their faces -- they can be indifferent all they want about how they feel toward residents.

[bclover]

I find it a bit amusing that folks are complaining about the staff at nursing homes. How about the relatives. My second year of college I was a front desk receptionist at a nursing home in Pittsburgh, people put their relatives in nursing homes and then forget about them. I can't tell you how many patients I would talk to that would surprise me because no one would ever visit and then you'd find out they had 4 or 5 children, grandchildren.


So we expect the staff to show the residents respect and compassion when we ourselves treat our elderly so poorly?

[Fermion]

The relatives will show up in a heartbeat after the person dies, if there is money to be inherited.

[akck]

Quote:

Originally Posted by REWahoo I'm not saying anyone does or does not need to self insure or take out LTCi. But there is no way to predict whether or not any of us will spend an extended time needing care based on what happened to our parents or in-laws. We're all different.

That's the point I was trying to make. You can't assume you'll be in for the average because it is made up of both shorter stays under one year and longer stays over 3 years. If you really are planning for a 5+ year stay, it will greatly delay your retirement.


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[akck]

Quote:

Originally Posted by bclover I find it a bit amusing that folks are complaining about the staff at nursing homes. How about the relatives. My second year of college I was a front desk receptionist at a nursing home in Pittsburgh, people put their relatives in nursing homes and then forget about them. I can't tell you how many patients I would talk to that would surprise me because no one would ever visit and then you'd find out they had 4 or 5 children, grandchildren. So we expect the staff to show the residents respect and compassion when we ourselves treat our elderly so poorly?

We noticed that too as we stayed with my FIL 2-4 hours on either side of lunch and dinner. Being there that long for 7 days a week, you see who has visitors and how often they visit. The range included a wife who was with her husband every day like us, a son who'd drop by for 15 minutes each week, a family from out of town there once a month, to those who had no visitors. We were told that some with no visitors were the last surviving family member and were placed there by a guardian, but many others never had family visit them.


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[ChrisC]

Quote:

Originally Posted by bclover I find it a bit amusing that folks are complaining about the staff at nursing homes. How about the relatives. My second year of college I was a front desk receptionist at a nursing home in Pittsburgh, people put their relatives in nursing homes and then forget about them. I can't tell you how many patients I would talk to that would surprise me because no one would ever visit and then you'd find out they had 4 or 5 children, grandchildren. So we expect the staff to show the residents respect and compassion when we ourselves treat our elderly so poorly?

I think it's very hazardous to speculate about family dynamics without getting a 360 degree assessment of the situation. Many patients have been estranged so long from their children or other family members. And some family members aren't capable of visiting. Of course, there are children and family members who are uncaring except when they have their hands out for money.

We visit frequently (and some would say excessively) for comfort to our mother and, quite frankly, to appease our own sense of guilt for not being able to take care of her ourselves. But a major reason we're there is to put the staff on check and to show the staff that we expect them to do their job. When there, we will feed and toilet our mother if staff is not doing it. We recognize that staff has many other mouths to feed and asses to wipe. We respect the staff and expect the staff to respect our mother. And during the holidays, we give generously to the staff. There a number of other families that operate in this manner at my mother's nursing home.

[NW-Bound]

Quote:

Originally Posted by Amethyst What is this magic pill people keep talking about, and how does one get it? Not talking rat poison, are we?

Hopefully, we will be able to book a one-way ticket to the Netherlands. I have read they are willing to help our exit from this world and make it as nice and humane as possible.

Quote:

Originally Posted by Amethyst It is probably asking a bit much of anyone to actually "care" about a dilapidated old person who is not even a relative. People are not too fun to be around, at that stage, and also aren't "cute" the way seriously ill kids can be. The most you can hope for is that the "caregivers" aren't actively mean, don't steal your stuff (on the assumption that you don't need it any more and wouldn't notice if it disappeared), and don't forget to feed you.

+1

My FIL was in a nursing home for 3 years. During that time, my wife and her siblings, who happened to be all living in town, took turn to come visit him during dinner time to feed him, and to bring home cooked meals. It would be a real burden for a single offspring to do this. I admire people who do.

My FIL was in overall reasonable health for his 90s, and had to go in a home because of severe loss of mobility. He finally died of pneumonia. He outlast several roommates who were much younger than his 90s. Many were lonely and did not have any visitor. I remember one who was in his 60s, a former colonel. A tall guy, he screamed murder when the female orderlies tried to move him: "You are dislocating my shoulder!". It is sad to see a once proud man in such physical deterioration.

[DEC-1982]

Quote:

Originally Posted by NW-Bound Hopefully, we will be able to book a one-way ticket to the Netherlands. I have read they are willing to help our exit from this world and make it as nice and humane as possible.

+1

And America is changing (and continues to change) in many ways.