Considerations In Long-Term Care

Long-term care refers to a host of services that are not covered by regular health insurance. This includes assistance with routine daily activities like bathing, dressing, or getting in and out of bed. These services can be provided at home, in a community facility, or in a traditional residential center. Whether you are thinking about these issues for yourself or a loved one, it can be challenging to evaluate long-term care options. The best time to think about long-term care is before you need it. Planning for the possibility of long-term care gives you and your family time to learn about services available in your community and what they will cost. It also allows you to make important decisions while you are still able to do so.

Long-Term Care Insurance

First things first. Should you invest in long-term care insurance? Elder care professionals have differing views on this. A long-term care insurance policy can defray the costs when you have a chronic medical condition, disability, or disorder such as Alzheimer’s disease or dementia. Most policies offer reimbursement for care given in a variety of places, such as:

• Your home
• A nursing home
• An assisted living facility
• An adult day care center
• A skilled nursing facility

In principle, this all sounds good. But in reality, many people who are purportedly covered by a long-term care policy have difficulty getting insurers to cover their care. In addition, there is a relatively limited universe of providers. 

In some instances, buying long-term care insurance does not make sense because Medicaid covers some long-term care for individuals who meet eligibility requirements. But it is important to be aware that Medicaid eligibility rules are complex and often raise difficult questions based on unique individual circumstances. Increasing costs in medical, nursing home, and in-home care services mean that older people with health care issues who are not eligible may become eligible later in life after they have spent down their money. It’s important to meet with a Long Island elder law attorney to discuss your situation and determine whether you should have long-term care insurance. 

Home-Based Care

In many cases, long-term care is provided at home by informal caregivers such as family members, friends, and neighbors. Most home-based care services involve help with the so-called seven “activities of daily living.” These activities include bathing, dressing, eating, using the bathroom,  continence, mobility, and transferring. 

Home-based care is often supplemented by paid caregivers such as doctors, nurses, home health care aides, therapists, and others. They can help older people with many aspects of health care, including giving medications, caring for wounds, helping with medical equipment, and providing physical therapy.

Community and Residential Care

Some aspects of long-term care can be provided in a person’s community, such as in an adult day care center or community senior center. Care at these types of places can include meals, social activities, and exercise. Depending on the community, these services may be provided at no cost or for a fee.

Long-term care can also be given in an assisted living facility or a nursing home. Some facilities offer only housing and housekeeping, but many also provide personal care, social and recreational activities, meals, and medical services. There are specialized facilities and programs for people with various diseases, including Alzheimer’s disease or dementia. 

How To Evaluate Care Facilities

It is important that you be diligent in evaluating suitable care facilities. You should focus on both the physical environment and the quality of care. Think about what the person needs at the moment, and what future needs will be. Many people select a residential facility that provides for staged care. You’ll want to understand how well the staff is trained and watch how they interact with the residents. Here are some things to look for:

• Medicare and Medicaid certification
• State licensing
• Accessibility for people with disabilities
• Residents who look appropriately dressed and well cared for
• Warm and respectful interaction between staff and residents
• A clean, comfortable, and well-maintained facility

Paying For Long-Term Care

Long-term care is expensive. People pay for this care in a variety of ways, depending upon their financial situation, their eligibility for assistance programs, and the kinds of services they use. People often rely on a variety of monetary sources, including:

• Savings, a pension or other retirement fund, income from investments, or proceeds from the sale of a home.
• Federal and state government programs, such as Medicare and Medicaid. 
• Private financing, including long-term care insurance, reverse mortgages, certain life insurance policies, annuities, and trusts.

There are many considerations involved in thinking about and procuring long-term care. This can be daunting, but there are many resources available. The federal government’s Nursing Home Compare Website is a certified resource that can be used to evaluate nursing homes. The Eldercare Locator can help you identify resources in your area. This service connects older Americans and their caregivers with local support resources. In addition, your local and state offices on aging or social services can also recommend services. These organizations will be familiar with resources available in your community and may have tips for accessing them.

Local social workers and health care professionals in your area may also have suggestions. If you belong to a religious community, find out whether it offers services for older adults or ask for guidance from your pastor, rabbi, or other religious leader.

Contact Davidow, Davidow, Siegel & Stern, LLP

Considering long-term care costs is an important part of any long-range financial plan, especially in your 50s and beyond. Waiting until you need care to buy coverage is not an option. You won’t qualify for long-term care insurance if you have a debilitating condition, and long-term care insurance carriers won’t approve most applicants older than 75. 

Here at Davidow, Davidow, Siegel & Stern, we help you plan for your future in a thoughtful and thorough way. With over one hundred years of experience, we are a highly focused and experienced team of elder lawyers. Contact us today.

 Save as PDF