Long Term Care System Is Failing Those Who Need Care The Most. Have You Ever Needed LTC?

OneEyedDiva

OneEyedDiva

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New Jersey
Eventually many of us will be faced with LTC issues, whether it be due to our parents or ourselves needing care. I've seen statistics, including in the article below that say about 70% of seniors 65 and up will require LTC or some kind of help along those lines. But "The reality is this: Only a modest percentage of Americans have the wealth needed to afford whatever long-term care needs emerge in their later years. For Americans on the opposite end of the economic spectrum, Medicaid will make sure that those who qualify will have a bed, food, nursing care and the levels of support required to live with at least some level of dignity and comfort."
At least recently I've been seeing more articles that give me the impression that at home care will be covered by most (if not all) Medicare & Medigap policies but not live in 24 hour care. When a parent needs round the clock care but can't afford to be in a nursing home, our lives can be severely impacted, especially those who still have to work. The family members are classified as unpaid caregivers in the article but I could swear I read that family members who meet certain criteria can be paid. Our lives are also severely impacted if it is we ourselves who need such care whether we can afford it or not.

I would prefer to be cared for at home and have made provisions to pay for it if necessary. I was deemed ineligible for LTC insurance many years ago. I was iffy about taking out a policy anyway. Right now my Aetna policy pays for 35 hours a week of at home care for an unlimited period but only 120 days of nursing home care per benefit period (benefit period starts again if discharged for more than 60 days).
https://www.aarp.org/politics-society/advocacy/info-2022/jenkins-long-term-care-crisis.html
 

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Great topic. I can relate.

My mother was in assisted living for over 3 years at a cost of $7k per month. The sale of her house basically covered it. It was a JD Power award-winning facility, so I was willing to pay for it to make sure she had the best possible care. She was never eligible for long-term healthcare due to pre-existing conditions, yet she lived to be 89 y/o. I worked as long as I could to make sure the payments could be made, until my company let me go in June 2020 due to Covid. I socked away everything I could into my 401k while I was working to make sure I could support her. She passed away in November 2021.

I now think about what it will cost me to be in a similar facility. I can't pretend that I will not someday be in the same situation and will need assisted living. You are fortunate that your Aetna policy covers time at home. I have no such policy and will be subject to whatever I have in my investments to see me through.
 
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When my Mom turned 85 she started to have health issues she came to live with me. All she could do at that time was pretty much sit in her chair, nap, read or watch TV. I bathed, dressed, cut her hair and nails, cooked all her meals. She was totally spoiled. She deserved it! She was with me for two years until her dementia got so bad I could not keep her safe. At that point she went into care. It was a very nice place 2 miles from me. She worked hard and saved all her life. She had a good retirement that took care of the cost.
 

Blessed said:
When my Mom turned 85 she started to have health issues she came to live with me. All she could do at that time was pretty much sit in her chair, nap, read or watch TV. I bathed, dressed, cut her hair and nails, cooked all her meals. She was totally spoiled. She deserved it! She was with me for two years until her dementia got so bad I could not keep her safe. At that point she went into care. It was a very nice place 2 miles from me. She worked hard and saved all her life. She had a good retirement that took care of the cost.
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You are a saint for taking care of all her needs until she went into more advanced care!
 
My mother went into a comfortable assisted living facility and was able to pay the full cost until her death just months before her money ran out. I had completed the Medicaid application with the facility and was approved, but we never needed to submit a claim.

I'm on my own and have sufficient resources if my needs follow the statistical average for people in independent living, assisted living, and long-term care. If I outlive my assets I will have to rely on Medicaid and the kindness of strangers to cover the cost of my care.

My concern, above and beyond the cost of care is the quality of care provided by entry-level staff in most facilities. I'm genuinely afraid that without a strong advocate I could find myself a victim of serious abuse and neglect regardless of how much money it costs or how pretty the landscaping and common areas of the facility look.

I hope that by the time I need to face those choices an assisted suicide option is available.
sunriseballoons_20201119010448.jpg

"Some glad morning when this life is over, I'll fly away ..."
 
Excellent topic, OneEyedDiva, worthy of discussion.

Long term care over here is a bit different, there is "Home Help", this
can range from getting dressed or undressed, meals cooked in your
home, or perhaps just a cleaner, the cost is also mixed, if you have a
lot of savings, then you pay, if you don't then the Government pays.

Care homes are also different, there are residential homes for the old
who are fit but struggle to cope on their own, they get a room and
their meals are cooked, the staff help where needed and act a bit like
nurses and cleaners,

Care for those who are unwell, are another type, the staff are trained
nurses but also have ordinary carers too, these places are like small
basic hospitals, with an on call doctor available.

The costs for care home is also means tested, depending on your
health and your financial circumstances, if you own your home, then
it will be sold to cover long term residency.

There is "Medical Insurance" available and many people have it, but
still use NHS facilities where possible, like doctors and hospitals to
be assessed before using their insurance, but I am not sure if the
insurance will cover Care Home costs, probably not.

There are many private "Care Homes", for the long term "Sick", but
these are very expensive to use, one has opened next door to the
area where I live and they are charging £1,200 - £1,400 per week
depending on the size of the room, they are fitted out like a side
room in a hospital and the staff are mainly nurses, with catering
and cleaning staff added.

I hope that I have got my facts right, but I have never looked at any
of the above, hoping that I never need it.

Mike.
 
My ex-husband is in a nursing home for the rest of his life. Medicaid/Medicare pays for it. He doesn't like being there, mostly because the level of care is not great. There is quite a contrast, unsurprisingly, between LTC paid for with ample patient funds, and that paid for by the government.
 
I've been personally acquainted with 3 people who got called at work by the nursing facilities their elderly mothers were in to "come get your mother right now, she's being violent and disruptive and if you don't come get her right now, we'll strap her to her wheelchair and roll her out to the curb!" Seriously. (A lot of people don't realize that a LOT of senior facilities are owned by corporations who have found numerous loopholes to get around whatever they want to get around.) So the acquaintances had to take leaves of absence from their jobs and bring mom home and then scramble to find a place that would take her. In one acquaintance's case, she was in denial about how advanced her mom's dementia was; in another acquaintance's case, there was one and only one facility here in town who would take dementia patients and it had a "one-year waiting list." (It turned out to be 2 years in actuality.) So that acquaintance had to take 2 years without pay from her job and stay with her mom 24/7; she tried hiring (out of her own pocket) people to stay with the mom but the mom was violent and ran everyone off.
 
We took out a LTC policy about 25 years ago....when we saw my parents beginning to decline. Fortunately, they were able to use their home equity to get excellent in home care. Personally, I hope that the money we're paying is just flushed down the drain, and we go quickly. But, if we need care in the future, this policy should take good care of us.
I've seen a couple of old neighbors who didn't have such policies get stuck in regional Medicare/Medicaid facilities, and the care they received was minimal, at best.
 
Don M. said:
We took out a LTC policy about 25 years ago....when we saw my parents beginning to decline. Fortunately, they were able to use their home equity to get excellent in home care. Personally, I hope that the money we're paying is just flushed down the drain, and we go quickly. But, if we need care in the future, this policy should take good care of us.
I've seen a couple of old neighbors who didn't have such policies get stuck in regional Medicare/Medicaid facilities, and the care they received was minimal, at best.
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There was a newspaper expose done on the LTC policies here in our state and it turned out that 15 percent of the companies writing the policies were complete scam artists; when people went to collect on their policies, every reason in the world was thrown up for not paying up or the company would completely fold up its tents and slip away into the night. 15 percent may not sound like much, but as the article pointed out, in the case of one elderly lady, who had paid the $600/mo. into the policy for 15 years (IIRC) and then after she went to use it, the company declared bankruptcy and her 6 kids had to pay for her facility until the 5-year look-back period since she had owned a house had passed so she could qualify for Medic-Aid; at least one of the said kids had to sell their home and move into an apt. to be able to come up with their share of the monthly nursing facility's fees. So that "only" 15 percent affected a lot of other people in that one person's case. So that turned me off on LTC policies. Maybe it's better in some states than others, but apparently it's awful here.
 
@OneEyedDiva this is a relevant topic to all of us. A real problem.

I think the problem comes for a variety of reasons, we are living longer and more people are living to need this, there are on a % basis more older people, families are more scattered making staying at home a more limited option, and the overall cost of medical care has risen sharply. So in the end we have fewer working people and more in need of this care all the time.

I know from experience that the hospice care we got for both parents really helped keep them at home, at a much lower cost. One step in the right direction, but not sufficient.

No good solution here, but it is something I know we need to deal with.
 
Aunt Bea said:
My mother went into a comfortable assisted living facility and was able to pay the full cost until her death just months before her money ran out. I had completed the Medicaid application with the facility and was approved, but we never needed to submit a claim.

I'm on my own and have sufficient resources if my needs follow the statistical average for people in independent living, assisted living, and long-term care. If I outlive my assets I will have to rely on Medicaid and the kindness of strangers to cover the cost of my care.

My concern, above and beyond the cost of care is the quality of care provided by entry-level staff in most facilities. I'm genuinely afraid that without a strong advocate I could find myself a victim of serious abuse and neglect regardless of how much money it costs or how pretty the landscaping and common areas of the facility look.

I hope that by the time I need to face those choices an assisted suicide option is available.
sunriseballoons_20201119010448.jpg

"Some glad morning when this life is over, I'll fly away ..."
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Similar situation here. I sold my mother's home in her 55+ community and the proceeds paid almost to the dollar for her apartment in assisted living. I agree with you re: assisted suicide if it ever becomes necessary.
 
WheatenLover said:
My ex-husband is in a nursing home for the rest of his life. Medicaid/Medicare pays for it. He doesn't like being there, mostly because the level of care is not great. There is quite a contrast, unsurprisingly, between LTC paid for with ample patient funds, and that paid for by the government.
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Yes and this is why my response to people who said they were not worried about the cost of care and "let Medicaid pay for it", has always been that I'd rather be prepared to pay myself if it becomes necessary to go into a nursing home. That's the main reason why I've saved and invested aggressively even after retirement.
 

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