When an older loved one needs help and attention, the initial family response becomes a crisis. Who will be the caregiver for a parent who needs long-term health care due to declining health and other aging issues?
Most families have never discussed, much less planned for long-term care. Most assume that health insurance (including Medicare and Supplements) pays for long-term care services. They don't, and now decisions must be made and made quickly.
The Rosalynn Carter Institute for Caregivers released a report that shows that one in five employees serves as an unpaid caregiver for a loved one who is aging, ill, or disabled. These individuals do not have Long-Term Care Insurance and must depend on family, or their income and assets, to provide the care they require.
Dr. Jennifer Olsen, chief executive officer at the Rosalynn Carter Institute for Caregivers, says these family caregivers make up 20% of the workforce. She says the result is that we are all in crisis.
The issues surrounding caregiver employees have been bubbling beneath the surface for decades and we cannot afford to ignore them any longer.
Caregiving Requires Time
Caregiver employees provide an average of 20 unpaid caregiving hours per week. Nearly one-third of caregiver employees have voluntarily left a job at some point during their careers because of their caregiving responsibilities.
The Carter Institute calls for bold steps to improve their employees' lives and benefit the bottom line. Traditional health insurance and Medicare pay a limited amount of skilled care services; without planning, adult children must juggle their jobs and families with caring for an older parent. Many experts say these family caregivers fail to maintain their jobs, relationships, and the job of caregiving as it becomes too much to handle.
Seventy percent of the workers who are also unpaid family caregivers fear they'll have to leave their careers without paid in-home care.
Health Insurance – Medicare – Do They Pay for Long-Term Care?
Part of the problem is few people plan for the costs and burdens of aging, and this lack of planning results in a family crisis. What does Medicare pay for? Few people understand.
The first thing to understand is health insurance, including Medicare, will only pay for skilled long-term care. Most care is help with daily living activities or supervision due to dementia, which is not covered at all by Medicare or health insurance. Individuals must fulfill several criteria to qualify for Medicare skilled nursing coverage.
Medicare will cover a maximum of 100 days of skilled nursing care. To qualify for Medicare skilled nursing care, according to medicare.gov:
A doctor specifies the person needs daily skilled nursing care.
The individual has a medically necessary 3-day-consecutive inpatient hospital stay. The 3-day-consecutive stay count doesn't include the day of discharge, or any pre-admission time spent in the emergency room or outpatient observation.
The person requires skilled nursing services (like rehab) for a medical condition that was treated during a qualifying three-day inpatient hospital stay.
A facility that offers skilled nursing care provides these services:
Medically necessary care provided by licensed medical personnel, including intravenous injections, wound care, and catheter care.
Rehabilitation services, including physical, occupational, and speech therapy, to care for those who have suffered a stroke, broken bones, or a traumatic brain injury. This type of care can also be provided for those who've undergone heart surgery, back surgery, or have had a joint replacement.
Long-term custodial care is not covered by traditional health insurance and Medicare. Medicaid will pay for all levels of long-term health care, including custodial care; however, the individual must have little or no income and assets to qualify.
This leaves Long-Term Care Insurance, but you can only obtain coverage when you are relatively healthy. Many people fail to think about LTC Insurance until their health has declined. Many others believe they don't need LTC Insurance; of course, once the crisis has occurred, they suddenly see the need, but few choices are available at that point.
Initial Responsibility for Caregiving is Daughter or Daughter-in-Law
Since health insurance and Medicare are not options to pay for long-term health care the family becomes the initial caregiver, and those family caregivers are often daughters or daughters-in-law, and they discover it is challenging to do everything.
Professional caregivers are not cheap, and the costs rapidly increase yearly. Some families will get part-time caregivers to provide some relief for the family member who is the primary caregiver.
LTC NEWS offers this guide to help you find appropriate in-home care for a loved one - Finding Quality In-Home Care. A good caregiver will improve the quality of life for the care recipient and ease the stress on the rest of the family.
Another option is adult day care centers. The care recipient is dropped off during the day and returns home in the evening when a family caregiver takes over - Adult Day Care Centers (ADSCs).
Avoiding the Family Crisis
How do you avoid the crisis to start with? Make long-term care planning part of retirement planning. More and more people are adding a Long-Term Care Insurance policy to their retirement plan. Few employers offer this benefit, but you can find very affordable coverage if you do so when you are younger and still enjoy good health.
Most people get their coverage in their 50s, but some do it at younger ages, especially those in states considering the so-called LTC Tax. These states may impose a tax on anyone who does not have a qualified LTC Insurance policy in force.
However, the primary reason to have Long-Term Care Insurance is to access quality care options, protect assets, and reduce the stress and anxiety that is otherwise placed on those you love.
Several top insurance companies offer this coverage, but premiums can vary dramatically between insurance companies. Find a qualified LTC Insurance specialist to assist you in obtaining accurate quotes and affordable coverage.
About the Author
An LTC News author focusing on long-term care and aging.
Contributor since August 21st, 2017
If you are still working, have a family, and have older parents, you can perhaps understand the challenges of trying to be a caregiver for one of your parents. Unfortunately, adult children must often "parent" their parents.
Aging happens, and the consequences can dramatically change a caregiver's everyday life. Now, do you want to place this responsibility on your children decades from now? Most every survey suggests most people do not want to be a burden on their family. However, have you done anything to avoid that from happening?
You deserve quality care, and your family deserves the time to be family instead of becoming your future caregiver. The solution is affordable Long-Term Care Insurance.
You might think it is too expensive. The truth is most people find it very affordable, but most insurance agents and financial advisors are not skilled at finding and designing appropriate coverage. Premiums vary dramatically between insurance companies, and policies are custom designed.
In many ways, LTC Insurance is 401(k) insurance, but it is much more than that. Long-Term Care Insurance shields your loved ones and finances against the expenses and hassles of aging and failing health. Your loved ones can remain family and not become caregivers.
Most people obtain coverage in their 50s when premiums are much lower, and their health gives them more options. An LTC Insurance specialist will work with all the top companies and understands underwriting, policy design, and claims - Work With a Specialist.
Tools and Resources Available on LTC NEWS
There are a variety of tools and resources that LTC NEWS offers that can help you in your research:
The Ultimate Long-Term Care Insurance Guide - If you like details, you will enjoy this comprehensive guide to LTC Insurance.
Long-Term Care Guides - LTC NEWS has several other guides that can help you plan or find quality care.
Cost of Care Calculator - Choose Your State - You can find the current and future cost of long-term health care services where you live.
Frequently Asked Questions - Get the answers to the most often asked questions about long-term health care planning and LTC Insurance.
Filing a Long-Term Care Insurance Claim - Does a loved one - like your Mom or Dad - have a Long-Term Care Insurance policy and need to file a claim to get benefits? LTC NEWS will help. If they don't have a policy, but you need help in getting a plan of care and finding caregivers, LTC NEWS can also assist.
Reverse Mortgages - Learn about reverse mortgages and ask questions about how they work and if you or a loved one would benefit from one.
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