Question - What are long term services & supports?

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Answer - the formal name for services a person receives to assist with day to day life functions.

What day to day functions?

  Support to help with eating, dressing, bathing, going to the toilet, or transferring say from a bed to a chair.

      Note: These personal functions are called - activities of daily living (ADLs) in the plan details of what I call Long Term "Health" insurance.


Some points about individuals (Caregivers) providing assistance:

  Over 80% of us have a relative, or know someone, who is now or has received assistance from a Caregiver.  Perhaps because "parts wore out" or because of trouble with mental ability.


  40% of us are now or have been a family Caregiver. 86% of them said their lifestyle was impacted!

Two points - Where is support is received? Who needs these services?

 First —  Where received:

  About 80% is in the home. Support often starts with a family member being the "Caregiver". 

     Note: If a professional is hired it would initially be a Homemaker to prepare meals and provide non medical support. Often called Companions. 


  When the assistance requires "hands on" support a Home Health Aide is hired.


  When medical related assistance is needed an LPN or an RN [like in the picture ] comes to your home.


BTW

   ˃ A person can receive home based assistance a few hours every couple days or up to around the clock. Being able to receive services at home responds to a person's desire to age in place. 

 

   ˃ The 2018 American Association of Long Term Care Insurance study of new long term care claims found 52% started with Home services.


Second —  Who needs support?    Some people think their health won't deteriorate and they will just die one day! It would be nice if it worked out that way for everyone! However:

  No one knows if they will or won't need assistance!  


  By age 75 70% or more of us will need support at some time! 


  People 75 and older have 2 or 3 chronic conditions, on average, and some as many as 10 or 12!


  By age 85 or older 20% are using support services!


  Advanced medical treatments and new medications have increased longevity! But longer life means a much higher chance assistance will be needed and for a longer period.


  Bottom line    80% of people worry about having physical limitations!

Support in a facility:

Adult Day Center:

       ˃ Individuals spend the day and receive support while their Caregiver is working.


Assisted Living Facility (ALF): 

       ˃ Individuals have a private apartment and receive meals in a common area.   

       ˃ The socializing often improves a person's quality of life and their health. 

       ˃ Families report socializing is a big value to them and state safety, or knowing help is there if a fall or sudden illness happens, was a big factor in moving a loved one to a ALF. 

 

Nursing facility: 

       ˃ Individuals with complex needs such as around the clock monitoring receive needed support.


Who is using? — The 2018 American Association of Long Term Care Insurance study found 20% of new claims started in Assisted Living and 28% in a Nursing home.

How does Long Term Care insurance pay for these special services?

  A health care professional (does not have to be a MD ) develops a plan of care describing the support the person needs. The plan is then submitted to their insurance company:     

       ˃ The plan must indicate assistance  is required with two or more ADL's and is projected to last at least 90 days.

       ˃ When the company approves the proposed plan and the waiting period the person selected is completed the first payment is sent to them. Additional payments can be sent direct to the professional.


  Not all assistance qualifies. Why? Assistance after surgery for example is to improve a person's ability to (quickly) get around on their own. Thus, its acute care since it is temporary, not on going or custodial.

What do these special services cost?

Support services in Connecticut have some of the highest costs in the U.S:

  A Homemaker coming to your home in the Hartford area can be up to $26 an hour.


  A certified home health aide who assists say for six hours 4 days a week could be about $675. This could grow to over $5,500 a month in say 15 years.


  Adult Day services: Can be $85 a day in the Hartford area. Thus, about $1,900 a month on a 5 day a week basis.


  An Assisted Living Facility can cost $6,600 or more a month in the Hartford, New London & Norwich area; $6,900 or more in the New Haven area; and around $8,000 in the  Bridgeport/ Stamford area.


  A semi private Nursing home room in CT is $154,000 * a year in 2018. CT's facility costs are next to the highest in the U.S.; have increased an average of 2.1% over the last 5 years; and are up an average of 5% since 1988!

        ˃ * Reported by the Connecticut Partnership for Long Term Care 


     BTW - The chance a person will need on going assistance is significantly higher than for their home & auto coverage! Yet everyone buys home & auto coverage! 

What can be done to avoid paying big assistance invoices?

Everyone hopes help to "get around" won't be needed but there is a very high chance some will! 


Since it most likely will and it's very expensive today and may be three times higher in say 25 years - What to do? I suggest developing a plan TODAY so loved ones won't have to assist you! Planning is better than being stressed over many years about I might "need assistance"

First Think about what would you like if: 

     ˃ An accident happens and you need help for a few months or 

     ˃ On going assistance is needed. 

     Note: The change in health page has some points on planning. 


Second - Buy a Long Term Care insurance plan with coverage for what you would like to happen   even though it will be expensive.

 Buying today means: 

  The cost today will be lower than paying for assistance yourself in the future!

 

  You gain the certainty of paying a known amount! 


Ideas to control the cost of this very important & very expensive insurance:

  Sharing assistance expenses.  

     ˃ Think about how much you could pay using Social Security, other income, or perhaps drawing some from investments. 


     ˃ Buy a plan to pay for some assistance and and you pay some.

 

     ˃ All the advantages of owning a Long Term "Health" insurance plan at a lower cost are gained by sharing.


  Select a higher monthly benefit - to pay projected costs BUT don't include the expensive inflation option.


  Paying for your plan annually. The cost will be lower (8% ?) than monthly.


 Note: The tax advantages  of a qualified Long Term Care insurance plan will help lower costs for some individuals. 


Call John C Parker today at 860.739.0005 for an appointment. We can talk about developing a Long Term "Health" insurance plan to meet your interest & budget. 


I'll get back to you if not available.   You can also send a note to -  Learn@JohnCParker.agency