We Are All Vulnerable - Take Care of You
Because those over 65 face a 25% risk (the real %) of an Elder Care Crisis, you need to know about this stuff and how to protect any form of savings and money you or your family now have.
The crisis may come in many forms that we will discuss here. You can choose to take actions to protect your family OR become prey to the system supposedly set up to help you.
You will learn what to expect and how to approach choices that will ease the pain.
"I'm just fine, thank you, and my Parents are fine too". There may be no diagnosis of anything serious yet, either. But that day may well come when the Crisis is real. And you're in "Family Quicksand!"
You may find out suddenly one morning. You were fine last night. This morning you just can't do your usual morning stuff. Many possibilities may be responsible for this.
The cause may be a STROKE or DEMENTIA, both are serious involving years of care. You can't get out of bed and walk to the toilet or get washed up or dressed. Or you can't eat or, you talk funny.
Perhaps you hit your head in a fall yesterday and the slight concussion caused a brain injury. Or maybe a blood vessel popped. Or, maybe OLD just caught up with you.
The first instinct is to call 911 and begin a Cure path at the Hospital. It's a possibility, but after a few days the Doctor might insist a cure is not in the cards, and... you can NOT go home. You will need either "Help at Home care" or Facility care. This is Family Crisis Quicksand Time. With no time to react, "you need to decide today", the hospital clerk says! It is easy to make bad decisions under this kind of pressure.
Pay Attention! Dad is not dead yet! This stuff can bite you and your family bad. We all need to set a Learning Planning Path to help avert this possible crisis. (See printable PDF - Assess Your Family's Status).
I call it "Family Quicksand" time, because once you face the reality of Elder Care you and your family can be pulled down personally, emotionally, your savings and other assets will be quickly drained into bankruptcy. No lie, this is real.
Most folks choose to ignore this crisis until it is too late and they are stuck in the Quicksand of worry, guilt and family squabbles. Who spends time, who spends money, who finds fault or blame and who gets stuck with the work? (And, Aunt Minnie always wants to be in charge from a thousand miles away.)
But if you and your family get on a Learning Planning Path to address this future, you can maintain control, maintain family integrity and save assets and savings. Learn how to consider your alternatives. Alternatives that do not always involve spending money and in fact, may end up saving your assets for your heirs or your spouse.
CURE or CARE – Understanding the "Setup" you will face
The CURE part....
There is an important difference between CURE and CARE. This is a very important distinction for Elder Care LTC. The key term used to qualify for payments and services is the term "Medical Necessity".
It is first determined by a Doctor on the case. If it is not Medical, it's not approved for medical payments, and may also determine if you are eligible for housing and other aid services and supports as well.You will encounter this Medical Necessity term often as it is used by private and government benefit providers to justify actions or non-actions.
America has an adequate health care structure to deliver CURE medical services that most private and public Insurance coverage will pay for it as of 2017.
You go to the doctor or the hospital and they try to CURE whatever you have. If you need to recover in order to complete the CURE, most insurance plans will cover you for a short period of time. Under current 2017 Medicare rules and many private plans, that's 20 days free in patient rehab care, or 80 more days at $160 if you qualify and your doctor orders it. (They ought to call it MediCure Rehab coverage) A very important point is that if you can't go home, discharge clerks will try to "plant" you anywhere so they can "free the bed" for revenue, and... they want you to be quick to approve their choice of where to go.
Where ever it is: Home care, Assisted Living or Nursing Home custodial care, it's a crisis to decide quickly where to go. Your family’s whole world will suddenly change with this new reality, whether it is you or your parent.
If you have a problem that can't be cured, like you can't walk, feed yourself or go potty by yourself? Or you have dementia? Or other non-curable medical problems like stroke paralysis? In that case you need long term CARE / Elder Care. Medicare will not pay for it.
If you need this type of CARE, the cost is paid by you, any insurance coverage, or in the case of Welfare MedicAID, after you are essentially broke.
The CARE part...
Those who need LTC or Elder Care stay in care an average of 2.5 years in what is also called "custodial care". And if you have Dementia and Alzheimer's it's an average of 7 years. That's means an expense devastating to most families.
Top 6 are Stroke, Dementia, Arthritis, Injury and Vascular problems and Accidents.
- Stroke - 6 months and possible recovery
- Stroke - 1 to 5 years
- Dementia - and Alzheimer's 5 to 7 years or more
- Arthritis, Vascular Injury - Depends on severity
It is important to note how scarce formal facility based care is. Most are Privately owned and privately run.
America does not have adequate structure to deliver Long Term CARE for everyone that needs it! Delivering this care is a problem due to the number of approved facilities and the number of qualified trained workers.
And, sadly, what's worse, the means, facilities and care businesses available to deliver this kind of care are lacking in space, understaffed, and lightly regulated by State and Federal agencies.
For these reasons, you and your family need to consider your alternatives that do not necessarily involve spending much money and in fact can end up saving your assets.
Otherwise you will be in "Crisis Quicksand Mode" and will find yourself vulnerable in many cases, to those who offer to help. There is no giving up or ignoring this. But, you and your family can survive if you know what to expect and set a Learning Planning Path to follow and use.
Remember.... The whammy is on you to understand, manage decisions and pay for this care.
There are many different types of conditions and events associated with Elder Care LTC risk.
Remember, there is a 25% care risk for those over 65.
The most important and troubling risk is Dementia.
At age 65 there is a 5% risk of dementia. Sadly, at age 75 there is a 50% risk. And, if we live long enough thanks to medical advances, each of us will probably have Alzheimer's disease.
The top 6 conditions and events that cause a need for Eldercare LTC are Stroke, Dementia, Arthritis, Injury and Vascular problems and Accidents.
The care need lasts 1 year or less for 43% of those in care, but the average need is 2.5 years with 58% staying in care longer due to Alzheimer's and other Dementia. Longer means 7 years or more. It's a gamble you don't want to lose, due to no planning and preparation.
So, what is the real overall RISK of needing LTC? Companies and people who try to sell you insurance for LTC always say the RISK of "some kind of care" is 70% for those over age 65. They include that 20 and 100 day Medicare Cure rehab in the 70% risk quote. It is very misleading because that’s not long-term care, it's recovery care. The real percentage is 20 to 30% for long term care. Knowing the real fact, do you have confidence in other things the sales people want you to believe? What else is exaggerated?
Understanding this stuff is difficult. It's complicated with many moving parts, troubling, with hard to navigate rules and regulations, and extremely expensive with the prospect of ruinous costs.
The average care costs will likely progress from $12 Thousand a year for a DayCare facility, to $24 Thousand for Home Visit Care, to $48 Thousand for Assisted Living and $96 Thousand for Full Nursing facility.
Even the Care by family at home is expensive.
How can anyone afford this? Some Americans are even considering assisted living options in Mexico or Costa Rica that offer very good service at very affordable prices. Setting a planning path can help find ways to face these costs.
Here's the reality.
I've provided a link to "One Page Planning for Elder Care" and "Possible Solutions".
Print them and share them. Use them as talking papers.
These are tools to help you achieve a balance between - What you have, what you will need, and What you want - And many Affordable Options including family care giving and beyond.
Your Path starts with "The Conversation". That's a conversation between you and your Family and/or Parents. No one wants to do it, not you, not your kids, not your parents. It is not comfortable facing reality.
But it will help establish the Status, Needs and Wants. Your Goals and choices too.. Unfortunately, this is hard and most people put it off, and put it off until the crisis is upon them and they have no plan or knowledge to work with. It is too bad with so much money and peace of mind to lose, so many people blow off this process.
If you can afford it you may want to consider developing a relationship with an Elder Care Case Manager or an Eldercare Attorney, especially if out of State situations are involved. These are specialized professionals who are much more focused on care decisions than your financial planner or insurance provider.
The next step is understanding how protection of Savings and Assets fits into your future. Read about how to Protect Your Assets.