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Old 03-02-2021, 04:51 PM   #41
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FWIW, if money is not a real issue, you can get 24/7 care in your own house and die there if that's what you want to do. Lots of outfits out there that specialize in such things.

My brother has a housekeeper and someone else who comes in every other day to help with his showers/bathing. He could get someone to wipe him if he needed that too or whatever else a SNF does.
Someone has to manage and pay for that care. At some point the elderly person really can't manage it. It can work well if good family willing to supervise lives nearby. But otherwise I don't see how to make it work. There is no way DF could have done it.
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Old 03-02-2021, 04:54 PM   #42
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FWIW, if money is not a real issue, you can get 24/7 care in your own house and die there if that's what you want to do. Lots of outfits out there that specialize in such things.

My brother has a housekeeper and someone else who comes in every other day to help with his showers/bathing. He could get someone to wipe him if he needed that too or whatever else a SNF does.
You don't need a SNF for that.

After she was unexpectedly diagnosed with terminal cancer while in hospital for surgery (never took place) my aunt went into a SNF near the hospital.

She had loved that SNF when on the Medicare rehab side but hated the custodial care side (only semiprivate rooms), though we were able to start Hospice for her there.

So after only a few weeks I arranged for her to be moved to a private room in an ALF near me.

Even though she was completely bed-bound by then (from the progression of the cancer) they had no trouble taking care of her...at a cost of less than half that of the SNF.
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Old 03-02-2021, 04:56 PM   #43
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For "youbet" and others who want to go into a CCRC but are not ready to leave their house yet, I know of some folks who have bought into the CCRC , paid the money, have their apartment and are paying the monthly fees but kept their house and are still living in the house for the time being. Costs a lot of $$ but it can be done.

On the issue of the effect of Covid on CCRCs--the one where I am on the waiting list has done a great job of keeping their residents safe from Covid, they have had very few cases and no deaths. They can afford better testing, better paid and more stable employees, etc. Also they were able to work with the local health department and got their residents vaccinated among the first.
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Old 03-02-2021, 06:33 PM   #44
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For "youbet" and others who want to go into a CCRC but are not ready to leave their house yet, I know of some folks who have bought into the CCRC , paid the money, have their apartment and are paying the monthly fees but kept their house and are still living in the house for the time being. Costs a lot of $$ but it can be done.

On the issue of the effect of Covid on CCRCs--the one where I am on the waiting list has done a great job of keeping their residents safe from Covid, they have had very few cases and no deaths. They can afford better testing, better paid and more stable employees, etc. Also they were able to work with the local health department and got their residents vaccinated among the first.
Yep, that's true Harlee. It would be quite expensive, but I'm sure the CCRC would think it's fine if you buy-in, pay the monthly fee but only stop by from time to time.

From time to time, we have seen opportunities where a CCRC will take a deposit (substantial) and charge you a partial monthly fee to cover the insurance component of the Part A contract and let that go on until the type of unit you want is available. If you need NH care prior to your move-in, you're covered. We're looking at that option at one place we like.
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Old 03-02-2021, 07:04 PM   #45
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On the issue of the effect of Covid on CCRCs--the one where I am on the waiting list has done a great job of keeping their residents safe from Covid, they have had very few cases and no deaths. They can afford better testing, better paid and more stable employees, etc. Also they were able to work with the local health department and got their residents vaccinated among the first.
Ditto for our CCRC. We got both our Covid shots done before first week in Feb--well before most of seniors in the state. Walgreens sent a team and inoculated from 8-5, including staff. We had no infections in Independent Living but did have some in the SNF which appears to have come in from the community. As a fairly new property, it still accepts community SNF & AL for short stay (think joint replacement). In two more years, that will not happen.
Harlee comment regarding better staff and less turnover is key as every turnover comes a risk of an outside infection coming on campus. All staff are still be tested weekly. We were told on a new parttime hire in AL that was feeling "bad", immediately tested and sent home. Later came back positive but it appears no infection on campus--vaccine works!
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Old 03-02-2021, 07:35 PM   #46
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Self funded home care.
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Old 03-03-2021, 08:10 AM   #47
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LTCi and CCRC (on the waitlist). Our initial plan was to age-in-place in our home, in which we could bring in home health care if necessary, leverging the LTCi and self-fund any shortage. Then, we had to care for MIL and BIL in our house on an emergency medical basis. And wiping a 97 year old's ass and caring for MS challenged 62 year old for several months made us re-assess our plan. We don't want any of our children to be in a situation of having to carefully monitor our LTC, which would likely be the case if we stayed at home and needed skilled nursing care. Besides, finding suitable home care would be challenging, as our experience with my MIL and BIL demonstrated.

So, we started visiting CCRCs in our community and placed a waitlist deposit on an expensive Type C-CCRC, in which you purchase your residential unit and have equity ownership in the unit. This CCRC has villas/condos in multi-family housing and separate single family homes, and a skilled nursing facility with 60 beds. We're not completely sure the social aspect of the CCRC (more like a country club environment) is a good fit for us, but the life-cycle program and SNF would work exceptionally well with our LTCi.

We've been tracking the Covid-19 report our state puts out. And the data has disclosed outbreaks in a number of facilities. The report, which disclosed outbreaks in the skilled nursing wing of the CCRC we've waitlisted, has caused us to re-assess our preference for units at the CCRC, which initially was for a villa/condo. I might add that there has been no reported outbreaks in the independent living quarters of this CCRC. One thing I have noticed in the reports is that the outbreaks seem to be the result of Covid-19 spreading among the staff. Moreover, I thought I heard on some podcast that the biggest driver of high infection rates in nursing homes is staff turnover.

We're 67 and 69 and perhaps still 4-6 years away from moving into our CCRC, assuming we maintain our good health.
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Old 03-03-2021, 09:39 AM   #48
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Someone has to manage and pay for that care. At some point the elderly person really can't manage it. It can work well if good family willing to supervise lives nearby. But otherwise I don't see how to make it work. There is no way DF could have done it.
Right. I was responding to the poster who was on-site physically and had to do a number of unpleasant support tasks. The poster sort of implied there was no other way (assuming money was not an issue).

Given the choice between 'wiping' someone and managing their money/writing checks for them, I think most folks would choose the latter.
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Old 03-03-2021, 09:43 AM   #49
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LTCi and CCRC (on the waitlist). Our initial plan was to age-in-place in our home, in which we could bring in home health care if necessary, leverging the LTCi and self-fund any shortage. Then, we had to care for MIL and BIL in our house on an emergency medical basis. And wiping a 97 year old's ass and caring for MS challenged 62 year old for several months made us re-assess our plan. We don't want any of our children to be in a situation of having to carefully monitor our LTC, which would likely be the case if we stayed at home and needed skilled nursing care. Besides, finding suitable home care would be challenging, as our experience with my MIL and BIL demonstrated.

So, we started visiting CCRCs in our community and placed a waitlist deposit on an expensive Type C-CCRC, in which you purchase your residential unit and have equity ownership in the unit. This CCRC has villas/condos in multi-family housing and separate single family homes, and a skilled nursing facility with 60 beds. We're not completely sure the social aspect of the CCRC (more like a country club environment) is a good fit for us, but the life-cycle program and SNF would work exceptionally well with our LTCi.

We've been tracking the Covid-19 report our state puts out. And the data has disclosed outbreaks in a number of facilities. The report, which disclosed outbreaks in the skilled nursing wing of the CCRC we've waitlisted, has caused us to re-assess our preference for units at the CCRC, which initially was for a villa/condo. I might add that there has been no reported outbreaks in the independent living quarters of this CCRC. One thing I have noticed in the reports is that the outbreaks seem to be the result of Covid-19 spreading among the staff. Moreover, I thought I heard on some podcast that the biggest driver of high infection rates in nursing homes is staff turnover.

We're 67 and 69 and perhaps still 4-6 years away from moving into our CCRC, assuming we maintain our good health.
I love you. What a great approach.
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Old 03-03-2021, 10:35 AM   #50
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I love you. What a great approach.
The catch being that this requires you to be able to self-insure or that you have LTCi since it's a Type C contract. Since ChrisC does have LTCi, sounds like a winner.
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Old 03-03-2021, 10:40 AM   #51
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Self-fund. I don't trust the policies, the premiums, or the industry.
Ditto !
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Old 03-03-2021, 11:59 AM   #52
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Someone has to manage and pay for that care. At some point the elderly person really can't manage it. It can work well if good family willing to supervise lives nearby. But otherwise I don't see how to make it work. There is no way DF could have done it.

Exactly. In the last two years of my parents' lives I was their full time healthcare coordinator / financial manager / advocate. DM went to a memory care unit, and I had to be her "person" and visited at least weekly to monitor the situation. DF died at home, and though we had lots of caregivers over two years, I still had to orchestrate, interview, and even be the caregiver if the CNA was a no-show. And basically run his household with grocery shopping, etc. And manage their finances (though DF had 95% of his marbles until the last few weeks).


As a solo individual (no close family) this has me concerned: I have the finances for care, but who will run it?
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Old 03-03-2021, 03:58 PM   #53
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Amen. If you do it privately not through an agency you are running your own staffing and payroll service. Finding coverage for late and missed shifts. Buying the groceries, managing the drs office calls and meds. Its a full time job to keep private help in your home. The infirm cannot do it and the family member running payroll/staffing/pharm/logistics is working a fulltime job. Imagine running a rest home with no help. Thats what youve got on your hands 24/7. And its not for a customer so youre entirely emotionally involved with your sole patient with evolving needs almost daily. Diff bandages. Diff diets. Horrific laundry!!! Bonus points if they are grumpy or senile and treat you like sh#t or curse out the hired help. This is no easy way to ease into the inevitable.
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Someone has to manage and pay for that care. At some point the elderly person really can't manage it. It can work well if good family willing to supervise lives nearby. But otherwise I don't see how to make it work. There is no way DF could have done it.
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Old 03-03-2021, 04:14 PM   #54
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Self-fund. I don't trust the policies, the premiums, or the industry.
You and others have indicated sharp skepticism about LTCi and instead say you will self-insure.

But I wonder how many like you for years buy home owners insurance without any thought as to insurers denying claims?

People trust home insurance companies and buy the product, they trust auto insurance companies and buy the product, they trust umbrella insurance companies and buy the product.

But Long term Care insurance, no they don't trust the insurance companies contractual promises (which by the way are regulated by State Insurance regulatory agencies just as home insurance, auto insurance, umbrella insurance, and other types of consumer insurance are regulated), and they say "I will self-insure".

I think a lot of the claims complaints relating to LTCi relate to people not understanding the contractual promises. Usually they revolve around two ADL's (activities of daily living) being compromised to the extent the insured cannot perform for themselves two ADLs. And of course, the inability to perform two ADLs must be assessed by a professional as spelled out in the policy, and people do not get those assessments (such as by the person's doctor, or other professional as agreed in the policy). Also most LTCi policies have a "waiting" period of two or three months, but people are often thinking after one week "Mom's in the nursing home-why isn't her LTCi paying"?

I think a lot of the claims complaints arise from misunderstandings such as this, and failure to "use" the LTCi "when" and "how" the contract specifies. As well, even in the case of real hassles, people do not follow through with available resources to help them resolve claims (State Insurer regulatory authorities).
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Old 03-03-2021, 04:24 PM   #55
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You and others have indicated sharp skepticism about LTCi and instead say you will self-insure.

But I wonder how many like you for years buy home owners insurance without any thought as to insurers denying claims?

People trust home insurance companies and buy the product, they trust auto insurance companies and buy the product, they trust umbrella insurance companies and buy the product.

But Long term Care insurance, no they don't trust the insurance companies contractual promises (which by the way are regulated by State Insurance regulatory agencies just as home insurance, auto insurance, umbrella insurance, and other types of consumer insurance are regulated), and they say "I will self-insure".

I think a lot of the claims complaints relating to LTCi relate to people not understanding the contractual promises. Usually they revolve around two ADL's (activities of daily living) being compromised to the extent the insured cannot perform for themselves two ADLs. And of course, the inability to perform two ADLs must be assessed by a professional as spelled out in the policy, and people do not get those assessments (such as by the person's doctor, or other professional as agreed in the policy). Also most LTCi policies have a "waiting" period of two or three months, but people are often thinking after one week "Mom's in the nursing home-why isn't her LTCi paying"?

I think a lot of the claims complaints arise from misunderstandings such as this, and failure to "use" the LTCi "when" and "how" the contract specifies. As well, even in the case of real hassles, people do not follow through with available resources to help them resolve claims (State Insurer regulatory authorities).
I have said this before, but the problem with any LTCI policy you can buy now is the limit.

Insurance is there to cover what we cannot afford to pay out of pocket. 3-4 years (each), no problem. 20 years each, problem.

I wait for the policy with a 3 or 4 YEAR elimination, then pays for rest of life. THAT would be insurance.
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Old 03-03-2021, 05:01 PM   #56
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Regarding LTDI claims versus Homeowners Insurance claims. I can research homeowners insurance and find out the best company to handle claims--I did this and it is Amica so that is the company I insure my house and car with. If Amica changes and gets bad ratings for claims I can easily change to another homeowners insurance company. Not so for LTCI. It is almost impossible to research and determine if a LTCI is good with claims. If I do find out my LTCI is not good with claims I will probably not qualify to go with a different company and even if I could that premiums would be much greater. LTCI and homeowners insurance are no way comparable.
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Old 03-03-2021, 06:41 PM   #57
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I canceled my LTC this week. I bought my policy 25 years ago. When I logged into pay my quarterly premium they had a notice that they were not enrolling new customers. That their long term investments were not performing well. That they were increasing premiums 50% in July and 25% more the following year. They were offering lower benefits in exchange for lower rates. They did a similar rate increase 10 years before and I accepted a reduction of lifetime benefits to 10 years. At this point now I can’t see accepting two more benefit reductions or the rate increases since I moved to Thailand 4 years ago. The company is not looking like it will survive much longer anyway.
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Old 03-03-2021, 06:55 PM   #58
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After seeing my mom in a memory care unit, my LTC plan has a 9mm diameter. Seriously, I have no intent or desire for LTC, and plan to avoid it at all costs. I just pray I don't have a stroke or anything before I end up on one.
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Old 03-03-2021, 07:40 PM   #59
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We plan to self fund. The look back period for Medicaid in California is 30 months for assets and 5 years for real estate. If we still have our marbles and need care beyond that amount of time, maybe we will give our assets to our kids and go on Medicaid after the look back period is up.
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Old 03-03-2021, 08:47 PM   #60
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I canceled my LTC this week. I bought my policy 25 years ago. ......... That they were increasing premiums 50% in July and 25% more the following year. They were offering lower benefits in exchange for lower rates. They did a similar rate increase 10 years before and I accepted a reduction of lifetime benefits to 10 years. ...........
This is typical of others' complaint about LTCi, premium increase and/or coverage reductions over the years. The other typical complaint is "what if I never use the coverage, then all the premiums I pay were wasted".

I had exactly those two problems myself. I solved it with whole life insurance LTC hybrid.

For my single premium upfront, I got leveraged coverage to provide what I deemed adequate LTC coverage for what I deemed an adequate period of 3 years. For that same single upfront premium I also got leveraged amount of life insurance that goes to my heirs if I never used (or never used all) of the LTC benefits. The One America/State Life policy also covered both my wife and I under one policy with LTC benefits available for either or both of us.

Some seem to want an "umbrella" type LTC policy for catastrophe coverage of paying "after" 3 or 4 years of self-insured LTC need for the rest of one's life. Yes, that would be a catastrophe, and such coverage would be prohibitively expensive. But people already have catastrophe coverage of going on medicaid after depleting their assets.

The "by far most likely" peril is what I worry about, the one "most likely" to occur, 3 or 4 years of LTC need. The whole life/LTC hybrid nicely solves that problem for me---at a price I can afford---to preserve assets for my heirs. And in fact "guarantees" an increase in assets--the life insurance--to give to my heirs if I never need the LTC.
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