Planning For Long Term Care Before a Crisis Hits

If you talk to any competent eldercare professional, they will stress that pre-planning is the key to making good choices when it comes to long term care.  Unfortunately, what generally happens is that family members wait until a crisis occurs, and then, naturally, fast actions lead to hasty, poorly planned decision making.

Now is a good time to take inventory of some of the things you might be faced with when it comes to care options for a family member or yourself.  Ken Dychtwald Ph.D. (of Age Wave fame), an accomplished psychologist and gerontologist wrote a wonderful piece for The Huffington Post recently entitled Long-Term Care: The Solutions You Should Be Talking About Now.  In his post, Ken discusses the decisions he and his wife are making for themselves, as well as some of the issues he faced with his own parents.

Make important long term care decisions now, while you can.

Ken's article is an excellent review of some of the things you can do right now while you have the time to do it.  In addition to the article itself, take the time to read the comments.  You'll hear from skeptics, eldercare professionals, and others… giving you an even greater view of the coming age wave.

We recommend the following when working on your long term care pre-planning.

  • Work with an elder law attorney and financial professionals.  It will cost you a little money up front but will be money well spent when it saves your loved one's time, money, stress, and heartache if/when the time comes to put your plans and wishes into action.
  • Notify key people of your decisions.  If you assign a power of attorney, for example, it is imperative that your representative understands what your wishes are.  The same holds true for financial, medical and end of life decisions.
  • Take the time to research and understand the resources in your area.  Senior housing, community centers, and financial assistance are much easier to access if you understand beforehand the application processes and requirements to receive useful benefits.

Senior Care: Pre-Planning is Key

As I remain closely connected to my local senior care community, I am frequently reminded of how important pre-planning is when it comes to senior care.  I see families caught off guard and overwhelmed when a crisis occurs with no pre-planning in place.  Having legal documents, financial preparations and senior care options explored can mean a world of difference in the journey of senior care.

Poor planning on your part does not constitute an emergency on mine. – My father

Legal Pre-Planning

Legal pre-planning is one of the most important to any senior care plan.  No matter how this journey goes for you or a loved one, at some point, legal issues will arise.  Doctor and hospital visits can become complicated if the proper power of attorney documentation is not in place. Banks and financial institutions will not work with anyone who does not have the legal authority to represent the account holder.  The following are important documents to research and have in place.  Pre-planning is not just for older adults, but adults at any age.  I HIGHLY recommend working with an attorney, and if you can, an Elder Law Attorney in your area to ensure that these documents are correctly administered, signed and notarized if needed.  Consider the money spent an investment in you and your family's future.

    • Power of Attorney– Health Care and Financial- This document(s) allows you to appoint another person to make decisions on your behalf and/or in the event you are unable to make decisions for yourself.  Also called a Durable Power of Attorney in some states.  A person who is incapacitated or cognitively impaired cannot assign a power of attorney (this is where I have personally seen a lack of pre-planning have serious repercussions).
    • Living Will– This document helps spell out healthcare wishes to physicians and family.   This ensures that no one else decides for you how your medical care will be administered, or not.  Remember Terri Schiavo?
    • Will– A legal document that declares how you want your estate and possessions distributed after your death.  Even for those with very few assets, a Will can be an important document to spell out how to distribute personal possessions.

Financial Pre-Planning

Preparing for retirement is one thing, planning to pay for senior care is another subject itself.  As reported by Genworth, the annual cost of home care in 2015 is $44,616 (based on 44 hours/week), assisted living $43,200, and nursing home care is $80,300.  If those numbers are giving you heart palpitations, you aren't alone.  Take the time to understand the following government programs that may be able to help pay for the cost of senior care.  Remember, qualifying for programs like Medicaid and VA benefits do not happen quickly in many cases.  Research these programs before a crisis.

  • Medicare:  Medicare does not pay for any long-term care.  It does pay for short term rehabilitation if specific criteria are met.  Many clients I have worked with in the past were very misinformed or misunderstood the limits of Medicare benefits when it came to paying for senior care. does a great job of explaining what is covered under Medicare benefits.
  • Medicaid: Medicaid is a federal program, but benefits are administered by each state and vary widely in criteria to qualify.  Generally speaking, Medicaid will cover the cost of long term care in certain settings if specific health and financial conditions are met.
  • VA: The VA offers a variety of long term benefits to veterans and their spouses, again if certain criteria are met.  You can find specific information on the VA website about the programs, benefits, and pension options available.  My experience with a family member was that it took 9 months for her application to be approved, so plan ahead.

There are a variety of other ways to pay for long term care (reverse mortgages, long term care insurance, annuities, trusts, etc…).  We will leave those topics to the industry experts and post when they are available.

Senior Care Pre-Planning

I had the pleasure of working as a referral and placement advisor for 12 years and served thousands of clients. During that time, I can count on both hands the number of clients who worked with me in an effort to plan ahead for their senior care options.  Everyone else was in crises mode- they came from a hospital or rehab setting and had anywhere from a few hours to a few days to decide where to place their loved one.  It was stressful and overwhelming and I'm glad I was there to help.  I can't stress this enough- If you or a loved one has a chronic health condition it doesn't hurt a thing to start researching what care options are in your area.

  • Work with a referral or placement agency:  I recommend working with a local company and not an online resource.  You want someone who knows the communities and homes they are representing to you well and who aren't selling your information online.  How long have they been in business?  What is their background?  Are they plugged into the local senior service industry?  What professional associations do they belong to?  How are they paid for their services (typically reimbursed by the senior care communities they refer)?
  • View a variety of different options (if they exist) in your area:  There are different names for senior care and they may be licensed depending on what they offer (retirement living, assisted living, adult care homes, residential care, board, and care to name a few).
  • Understand pricing: Do they charge a flat fee, levels, or points?  Will there be a cost of living increases?  Is there a Medicaid contract available in the event that the money runs out?
  • Have a plan:  Just because you have done the research, does not mean you need to take action right away.  You will be prepared with the knowledge and understanding of what can be provided at what cost and will be able to move quickly in the event of a crisis.

That all being said, sometimes the best-laid plans may not work out the way they were intended, but knowing that plans are in place should a crisis arise is worth the time and energy of planning for the future.

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