Friday, January 18, 2019
MANAGE NURSING CARE AT HOME, "Long-Term Care Insurance"
Betty Wilson (2014) presented a comprehensive, yet succinct, description of the whys and wherefores of long-term care insurance. She starts: “…ironically, many of us forget about long-term care insurance, even though, according to statistics, 70% of Americans will need some form of long-term care after the age of 65.” As Wilson states, “Long-term care includes services offered to people who are suffering from a chronic disease, cognitive impairment, or a disabling condition.”
While in our forties, Tina and I [DWC] were able to purchase long-term care insurance for both of us (Cooper, 2011):
employment, the John Hancock Insurance Company got IBM
to allow them to offer a special deal for the IBM
employees to obtain long-term care insurance. The options had fixed total
payouts, with the middle option that we chose being a total of $210,000,
several times my annual salary at that time. They could not deny participation
due to prior medical conditions, and we were open about Tina’s multiple
sclerosis, the symptoms of which were mild back then.
Five or ten years later, when we met the disability requirements to qualify for weekly supplementation of our home health aide’s salary, Hancock started paying about $250 per week to reimburse us. This went on for fourteen years, paying about half to two-thirds of the cost of our aides, who typically worked a thirty-hour to forty-hour week.
Home health aides provide “custodial care,” the kind of care a dependent infant or disabled or incompetent person needs, without supplying medical care. They handle the Significant Activities of Daily Living that the patient cannot. Although most people probably get their aides from agencies, we advertised in the paper and obtained aides with certifications that Hancock accepted or had a nurse review their performance and certify that they were qualified without formal credentials.
Medicaid has significant restrictions on paying for such care, and Medicare rarely pays for home health aides at all.
Wilson (2014) describes the following “care choices”:
· Care in the home: “Providers who are eligible to offer home health-care include qualified home health-care agencies or independent care givers who deliver home care, the home of a relative or friend, or a community- based residential facility.” One must assure the agency is certified and the care is provided by one or more of the following: nurses, therapists, social workers, certified home health aides or nursing assistants. Family members can sometimes become deemed to be qualified.
· Care in the community: Various adult day care centers and group programs are used to supplement the care obtained at home.
· Care in an alternate living facility: “An alternate living facility basically offers ongoing care” outside the home. They offer a wide range of services, and selection will depend on the patient’s needs.
· Care in a nursing home: This situation provides living quarters and nursing care on a round-the-clock availability.
· Accessory dwelling units: Second living spaces near the home allow some independence without putting the patient far from the family.
· Continuing-care retirement communities: “CCRCs are retirement communities offering more than a single type of housing. They offer different care levels.”
· Hospice care: for terminally ill patients. Medicare usually covers this.
· Respite care: short-term assistance to allow the primary caregiver to rest. Medicare covers up to 5 days of this if you are receiving hospice services.
· Some states have other programs beyond these.
For more information on long-term care insurance, see Wilson (2014) or obtain information from insurers in your state.