| Long-term care: Should we worry about it or make plans? By Paul Kusuda |
| In the June 2006 issue of Asian Wisconzine, I discussed graduation, students becoming seniors, and then about people becoming senior citizens. As people become older and in the workforce for a period of time, some think about saving for their future or their children's future. They often think about both anticipated and non-anticipated expenses such as extended illness or long-term care when they become older. What if? What if I get injured and am not able to earn a living for a long period of time? What if my spouse or I should suffer a debilitating heart attack or a stroke and have to be bed-ridden for months or even years? What if? As married folk grow older, questions many ponder include, "What if my spouse or I can no longer live independently because of age or another reason? Will we be able to handle the financial costs without being burdens to our children or relatives? Will we have enough saved to cover costs and yet have enough left over for inheritance funds for our children? Will we have to depend upon public funds to pay for long-term care? The questions are not those raised only by worrywarts; they are realistic and should be faced carefully and rationally. According to the University of Wisconsin-Madison Extension's Wisconsin Family Impact Seminars, "In 2002, Wisconsin ranked 8th in the nation for the percent of people aged 85 and older. In 2003, Wisconsin ranked 11th highest in the nation for the percent of elderly in a nursing home. The elderly without family caregivers are seven times more likely to be in a nursing home. In Wisconsin, three main programs provide support to the family caregivers for adults (excluding those with developmental disabilities): the Family Caregiving Support Program, the Community Options Program/Waiver, and the Alzheimer's Family and Caregiver Support Programs. According to the Wisconsin Family Impact Seminars newsletter (Family Matters, Vol. 5 Issue 1, May 2006) expenditures in Wisconsin in 2003 for family caregivers totalled almost $150 million, of which $144 million were from federal funds, and the remainder from state and county funds and Older Americans Act funds. Expenditures included much more than respite costs, including, education and training, case management services, counseling, home modification and repairs, support groups, and payments to family members for purchase of goods or services. Caregiving by spouse, other family members, or relatives, or friends provides the largest part of the response to need. Understandably, caregiving takes a heavy toll on caregivers. They put their own physical, mental, and emotional health at risk. They must have financial resources and emotional support in addition to some kind of regular respite from their grueling responsibilities. Without such support, damage of one sort of another can occur; divorce, abuse or neglect, just losing it, etc. Medicare Part A covers part of hospitalization costs up to 150 days; skilled nursing facility care (under certain conditions) up to 100 days; limited home health care; hospice care; and blood (after first three pints). Medicare Part B covers part of outpatient medical costs; clinical laboratory costs; medically necessary skilled home health care and durable medical equipment; some outpatient hospital services; and 80 percent of approved cost of blood starting with the fourth pint and after a $124 deduction. Long-term care is not covered; it is covered under Medicaid, a financial means-test federal and state program. Thus, concerns about long-term care costs are present for many as they worry about their plan for the future. Many consider getting some form of long-term care insurance to ease possible later costs for nursing home or expenses of special care services at their own home. They think about possibly needing help bathing or going to the toilet, getting out of bed, walking about from one room to another, or even eating. If the anticipated need is for a short period of time, such as recovering from an accidental fall, most people can handle the inconveniences and financial costs. However, long-term care can become quite costly. Even though most people will never need nursing home care or will need such care for only short periods of time, some may need personal assistance care in their own home for reasons such as accidents, acute illnesses, or infirmities related to aging. The concerns are valid, but they differ considerably from one situation to another, depending on such factors as age, physical or mental condition, savings, spouse's ability to provide ongoing care, and geography (that is, how close children or other potential caregivers live). To be remembered is that the average stay of persons who enter a nursing home is about 2 ˝ years. Some people have enough in savings to handle the possibility of such expenses. On the other hand, some people will want to think about buying long-term care insurance anyway. If so, age of oneself and spouse should be considered. If young, the premiums will be lower than if older; however, the chances are good that they will have to be paid over a longer period of time before any need occurs. So, even though costs may be higher, persons planning to buy a policy probably should wait until they are in their sixties. Persons definite about not wanting to become a Medicaid recipient, and subject to financial means testing, may want to buy a policy. My personal opinion is that persons 75 years of age or older should not even consider getting a policy. |
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