The time to explore long-term elder care is before you need it, experts say
The
Like many caregivers of people with dementia, he learned a couple of things right off the bat:
* Health insurance won't pay for things like helping Kathy with meals, transportation, grooming, companionship and respite care. Even when she hits the age of
* Residential care is expensive, with the average cost of assisted living being
* The biggest public supplier of residential care for people with dementia is
One day recently, Brandt settled Kathy, who is now 60, into a living room chair with a TV show to distract her while he shared his story at their kitchen table. The 69-year-old retired teacher hopes it can help educate others.
"Russ!" Kathy called from the living room.
"I'm right here!" he replied.
"Russ, can you come in here a few minutes. Will you come? I just want to say hi to you."
"I'll be right there," he said, and then, more softly, "This is the way it is all day long."
Russ said the past two years have given him an education on the financial aspects of caregiving, and shed light on some common misconceptions that also surfaced in a recent
The results, released in March, showed that 28 percent of respondents believed incorrectly that
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After Kathy was diagnosed, Russ sought financial advice. He found out that it was too late to get a long-term care insurance policy for Kathy, since she had already been diagnosed with dementia. But it wasn't too late for him. He bought a policy, which cost
"If something happens to me, they will have something to fall back on."
The long-term care policy industry is in flux these days, with sales of traditional policies falling by 23 percent in the five years that ended in 2012, according to LIMRA, a nonprofit insurance and financial-services research organization. The poor economy is a factor, but rising premiums also play a role. Companies were forced to increase premiums as people lived longer and outlived diseases like cancer and heart conditions, only to be diagnosed with dementia, which tends to have higher long-term care costs.
Hook said people got scared away, worried the premiums would get so high they'd have to drop the policy. Many companies also stopped selling them because they were losing money, or setting premiums so high people couldn't afford them.
Another tool is the so-called hybrid or combination policy, such as life insurance policies with riders that can be used to pay for long-term care. Those are gaining popularity, increasing fivefold in that same time , according to LIMRA.
You pay money upfront to purchase the policies and also must pass some health and cognitive tests. Then, when you need long-term care, you can tap into the funds, and depending on how much is withdrawn for that care, money can still be passed to heirs after your death.
People also can use reverse mortgages, annuities and home equity to pay for caregiving expenses, but they need to make sure to read the fine print of financial policies, and get expert advice on which tool will work best for them. Continuous care communities are another option some people consider, paying money to join a community, along with monthly fees, to pay for care that changes according to the level of care you need.
Hook said veterans should explore what type of benefits are available to them through
For the time being, Brandt can care for Kathy at home. He's following advice from a support group at the
"They say in the meetings you will know when it's time, but that you need to look into it before that time hits -- that most people wait too long."
He thinks he will likely use the "spend down" option so Kathy can qualify for
"It would be an austere lifestyle," he said.
Kathy came into the kitchen as he talked about how her diagnosis at a fairly young age could mean more years of care.
"Do you remember your birthday?" he asked her.
"I don't know ... what is it?" she responded.
"What is red-white-and-blue day?"
"July."
"July what?"
She doesn't know, so he helped: "July Fourth."
Hook said some families are forced into an option he calls "a negative inheritance." That is, adult children pay for the care of their parents. That's an option most families prefer not to use. That's why Brandt purchased a long-term care policy for himself.
Hook said the key points to remember are to start long-term care planning early, by your late 50s or early 60s, because you have more options when you're healthy. Educate yourself on what
Hiring a financial expert who can present an array of options and who isn't being compensated by any one option also is important.
"These are critical financial decisions," Hook said. "You don't want to make beginners' errors. No one wants to do this on your own because the marketplace is not transparent."
Brandt said both of Kathy's parents are still living, 15 years after being diagnosed with Alzheimer's, and that Kathy's sister is the main caregiver for them: "She's my guidepost as to what to expect."
Ironically, besides the dementia, Kathy's health is fine: "Her cholesterol is great, blood pressure is great. My blood pressure is lousy. I'm on medication."
Kathy stood behind him as he talked, and she glanced out the window.
"Look at the red bird," she said.
"What are the red birds called?" Russ asked her.
She shrugged her shoulders and gave what seemed like an obvious answer: "The red birds?"
"Cardinals," Russ said. "Those are cardinals."
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