Jan L. Warner & Jan Collins
Question: Our mother is nearly 83 and no longer able to live at home, but her “long term care options” are very confusing to me and my brother, her only living relatives, and we are in our mid 60’s. Mom has agreed that she needs assistance, but we can’t seem to get a handle on what will be best for her due to confusing alternatives and costs.
Answer: "Long-term care" generally refers to the group of services necessary to adequately provide for a person who is mentally or physically incapacitated to the extent that he or she cannot function without the assistance of others. These services vary depending on the actual needs of the individual. “Long-term care planning” is the process by which families prepare to meet the medical, financial, emotional, and housing needs of an incapacitated individual who cannot function independently, but does not need a hospital stay. While the need for long term care planning is not limited to the elderly, this group is most often in need of such a plan.
A successful long term care plan should address five basic areas: (1) the level of care (physical assistance) needed by the incapacitated individual, (2) how and where that care can best be provided, (3) who should provide that care, (4) the psychological needs of both the incapacitated individual and his or her family, and (5) how the care will be paid for. The creation of a successful plan generally requires an experienced team of legal, medical, and financial professionals who understand the problems and can offer an array of solutions.
Depending on these factors, the basic types of long-term care include “Home care”, Residential Care” or “Assisted Living”, and “intermediate or skilled care” which is traditionally provided by a nursing home. If the individual can afford to pay for his or her care privately or has long-term care insurance, that person – or the family – and his or her care team can determine what level of care is needed or desired. Should Medicaid assistance will be sought for nursing home care, the affected individual will have to meet the "medical necessity" criteria established by the Medicaid Program which is stringent.
Taking The NextStep: Given the recent acts of terrorism in our country, greater defense spending will be necessary to protect us and our families. This, in turn, will adversely impact such budgetary priorities as prescription drugs for the elderly and greater Medicaid funding for long-term care. The retirement plans and incomes of our seniors and the baby boomers will continue to be adversely affected by market conditions for the foreseeable future. Seniors on fixed incomes will be hardest hit. Those who do not begin the long-term care planning process now – including consideration of appropriate long-term care insurance where possible -- will be left with few options. We urge you to take stock of your family situation, to discuss these important matters with your parents and children, and to consult with experienced professionals who can lead you down the proper path.
