CHAPTER 7 LONG-TERM
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):
During my IBM
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.
###
Contact information:
Diane R. Beggin, RN
40 Sycamore Drive
Montgomery, NY 12549
Our book is available from amazon.com, bn.com, and OutskirtsPress.com: How to Manage Nursing Care at Home
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