Caregivers, sex, long term care, and the perfect nap

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Caregiving can create a range of experiences for caregivers.

I can’t believe I’m posting this: Sex positions that won’t inhibit your hip replacement.

Another option to help pay for long term care: cash out your life insurance policy.

Lastly, because it’s important: How to take a perfect nap.

Hospital tips, seniors & therapy, unhealthy old age, and long term care costs

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Tips for staying healthy in hospitals.

Older adults can benefit from therapy just as much as young people.

Do Boomers have to “save themselves” from unhealthy old age?

Americans are in denial about long term care costs.

Apple” © 2012 dhaun, Attribution 3.0 Generic http://creativecommons.org/licenses/by/3.0/

Hospitals & older patients, long term care costs, health care workers, and reputable senior professionals

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Hospitals don’t always provide the best care to older patients.

Long term care costs have increased in some parts of the country.

There aren’t enough home care workers in the United States.

Not all senior housing professionals are alike; a watchdog group is going after less-than-reputable designations.

36/365: The Doctor Will See You Now” © 2009 Sweet Carolina Photography, Attribution 3.0 Generic http://creativecommons.org/licenses/by/3.0/

The Long Term Care Problem

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Long term care is a big deal right now in Congress.  Yet, most Americans don’t really understand it:

…a Thrivent Financial for Lutherans survey about long-term care planning conducted by Ipsos reveals that 51% of respondents think this kind of insurance is “too expensive,” while another 24% don’t even know what long-term care insurance is. (Source)

Is that even possible?  How can 75% of Americans not understand the importance of finding a way to fund long term care?  For those who suggest that long term care is too expensive, here’s something to think about:

  • Insurance reflects the cost of providing the care. How do you think insurance companies price their policies?  Here’s a simple formula: Anticipated cost of providing care + overhead (paying for administration of the policy, etc) – returns on invested premiums.  That’s basically the way that all insurance policies are priced.  Stock market returns aren’t expected to be spectacular in the coming years, and there’s only so much that companies can do to decrease their overhead.  Still, compared to other forms of insurance, most of the cost for long term care insurance comes from the cost of providing care.
  • Care isn’t cheap. Maybe people don’t spend a lot of time thinking about old age because it makes them uncomfortable, but it’s to their own detriment.  If there’s one immutable truth in senior housing, it’s that senior housing isn’t cheap.  Assisted living can run between $40,000 and $75,000 per year (depending on level of care and amenities).  Nursing homes can cost up to $100,000.  If you spend more than a few years needing higher levels of care (like assisted living or nursing), you’re looking at almost half a million dollars on care. Even if you plan to stay home, save a small fortune to pay for home health aides, housekeepers, and assistants.
  • Someone will be paying. Since most people aren’t saying for their long term care needs (either via insurance or their own personal savings accounts), the government or adult children will likely be picking up the tab for care.  This might mean multi-generational housing where granny lives with her adult daughter.  It might also mean that older Americans are forced to move into government-run assisted living facilities (which don’t really exist now, but may become more common as the population ages).  At the end of the day, those who save for their long term care needs will have more choice in who provides their care and in what setting.

Some scholars suggest that long term care is the biggest problem our country faces right now.  As Boomers age, more and more will have to rely on safety nets like Social Security and Medicaid to survive.  The viability of long term care insurance is a big wildcard in our future that, unfortunately, may turn out to haunt us.

G’ma’s hospital bed before she got there” © 2008 dreamingofariz, Attribution 3.0 Generic http://creativecommons.org/licenses/by/3.0/

What is LifeCare?

In case you missed it the first time, here’s an overview of the popular CCRC product, LifeCare:

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LifeCare is a big selling point for communities that have it. Marketing representatives love to portray LifeCare as the choice for responsible seniors, and this is partially true. There is some reason to think that LifeCare is a responsible choice. But, first, what is LifeCare?

LifeCare is one of three types of health benefits that communities can offer as part of their resident agreement:

Type A (LifeCare): LifeCare guarantees that a resident’s monthly fee will never increase beyond their official independent living fee, no matter what level of care he or she receives. In other words, following a permanent transfer to skilled nursing or assisted living, the resident pays no more than the monthly fee he or she paid in independent living.

Type B (Modified LifeCare): Is a contract where residents are offered a discount on assisted living and nursing services. For example: 10% off of higher levels of care or 10 free annual days of nursing or assisted living.

Type C (Fee for Service): The resident receives no discount for assisted living or nursing services and pays the community’s market price for the service.

In my experience, LifeCare is generally calculated as a $30,000 premium above normal entrance fees. This means that, on average, the community expects residents to consume $30,000 in higher-level care over the years they live in the community. Obviously, some residents will consume more, spending more time in nursing or assisted living. Other residents will be relatively healthy and require only limited stays in higher levels of care.

Although some communities do not offer a choice between LifeCare and a modified or fee for service contract, some communities do allow residents to choose. Here are the main considerations when choosing whether or not to purchase LifeCare:

  1. Long term care insurance. Long term care insurance offers basically the same benefits as LifeCare. If you have a long term care insurance policy, check the benefits and compare them to the LifeCare benefits offered by the community. Some communities will negotiate with residents who hold long term care policies. Others will not negotiate.
  2. Age and health. Because LifeCare is a type of insurance, all LifeCare communities require residents to pass a medical exam. This is usually conducted by the community’s head nurse or certified by your doctor. Approval is based on the community’s opinion as to whether or not you will be healthy long enough for the community to make their money back. Thus, the longer you wait to move into senior housing, the more difficult it will be to pass this physical exam. However, the younger you are when you purchase LifeCare, the lower your return on investment. It is a catch 22. If you have health problems (beyond those that are considered normal for a senior), you might have trouble qualifying. Apply sooner rather than later.

A few additional notes:

  1. Some communities call themselves “LifeCare”, but do not have LifeCare in the traditional sense. It is sometimes used as a marketing technique to indicate the presence of multiple levels of care (independent living, assisted living, memory care, and/or nursing) on the same campus.
  2. LifeCare is a type of insurance, so communities offering it are often regulated by the state department of insurance. Check with your state to see what regulations CCRCs must follow and whether or not your community has filed all of their required documentation in a timely manner. Also, you can file an open records request with the department and receive copies of all of their filings.
  3. Some communities offer gradations on their contracts whereby older seniors pay more to live in the community. This is based on the actuarial estimation of cost to the community. As people continue living longer, more communities will likely switch to this type of contract in order to accurately account for resident longevity and its impact on the community’s bottom line.

Biking & Parkinson’s, fighting parents, long term care plans, and hiring the right movers

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Biking has been shown to improve symptoms of Parkinson’s.

When your elderly parents fight: Is it a sign of a normal marriage or that something is wrong?

More than half of Americans aged 45-54 don’t have any long term care plans

Hiring the right movers can make all the difference when downsizing to senior housing.

“Bike” © 2010 Sheffield Tiger, Attribution 3.0 Generic http://creativecommons.org/licenses/by/3.0/

 

Getting more care for less, long-term care policies, colonoscopies, and hospice

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Advice for penny-pinchers: How to get the most medical care for your buck.

The cost of long term care insurance policies is going up!

A Boomer gets a colonoscopy.

Hospice is apparently very difficult to get into nowadays.

Penny from Heaven” © 2008 Caitlinator, Attribution 3.0 Generic http://creativecommons.org/licenses/by/3.0/

“Doctor Dog”, attitudes about aging, planning for end of life costs, and depression

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Dogs as doctors?  As it turns out, canines are pretty good at detecting certain diseases.

Your attitude about aging is closely related to how you’ll actually age.

Planning for end of life care can also help cut costs.

Depression is linked to more emergency room visits for elderly men.

“My Dog” © 2012 ETersigni, Attribution-NoDerivs 2.0 Generic http://creativecommons.org/licenses/by-nd/2.0/