Critical Conversations about Long-Term Care

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What is involved in longterm care planning?

• Plan
• Act
• Evaluate

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Reasons some people say why they were not
prepared for later life

• I never expected to live this long.
• We didnt think it would turn out this way.
• We planned for a healthy retirement.

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Financing Longterm Care Dilemmas and Decisions

• Major gap in financial planning throughout life
• Gap in laterlife financial security
• Few of us have done any planning
• Wont admit we might be affected personally

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Financing Longterm CareDilemmas and Decisions

• We think we know more than we do!
• Gaps in knowledge make planning for longterm
  care tough!

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Financing Longterm Care

1. Recognize your risk
2. Understand costs and implications
3. Sort out expectations and goals
4. Understand financing alternatives
5. Take action now

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Longterm Care

• Help with daily living activities and remaining
  independent
• Wide range of personal, social and medical
  services
• Provided in a variety of settings

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Most who need longterm care

• Live in their own homes
• Receive unpaid caregiving from family/friends
• Overestimate the chance of needing nursing home
  stay
• Underestimate need for inhome and community
  services

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Whos at risk?

• 57 percent over age 65
• 40 percent below 65 years of age
• 3 percent are children

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Whos most at risk?

• Individuals 85 years and older
• Individuals with chronic health problems
• Individuals who lack social support and unpaid
  caregivers
• Women

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Prevalence of Longterm Care Need

• Age 65 to74
• In community 11 percent
• In institution 1 percent
• Age 75 to 84
• In community 22 percent
• In institution 5 percent
• Age 85
• In community 49 percent
• In institution 21 percent

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What are the risks?
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Potential Costs Underestimated

• In-home care
• Degree of need and health status
• Type of service used
• Visiting nurse 100 per visit (Kiplingers,
  2004)
• Home-health aide 15 or more/hour (Kiplingers,
  2004)
• Community services
• Adult day care 60/day (15,000/year)
• Assisted living - housing with services (common
  meals, housekeeping) in North Dakota rent -
  15,720/year basic services - 7,284/year
  (NDLTCA, 2005)
• Skilled nursing home care
• One month average in U.S. 5,500 (66,000/year)
• (Metropolitan Life Insurance survey, 2003)
• Northeast and West highest
• North Dakota 144.48/day (52,735/year) (NDLTCA,
  2005)

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Sort Out Laterlife Financial Goals and
Expectations

• Multiple/competing goals behind our decisions
• Make goals known
• Goals provide direction
• Goals can be prioritized

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If I would need longterm care, I would expect
to

• Remain financially independent
• Maintain control of my finances
• Keep my financial affairs private
• Involve family members
• Utilize government services
• Leave an inheritance

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Oklahoma Longterm Care Survey

• Findings of an AARP study Fall 2004
• 1,146 respondents over age 60

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Can We Talk?

• Goals can be a common source of conflict
• Between spouses/partners
• Across the generations
• Who needs to be involved?
• Spouse or partner?
• Adult children?
• Identify areas of agreement and/or disagreement
• On the meaning of goals, priorities, concerns

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Understand Financing Alternatives and Consequences

• No one financial answer
• Laterlife goals should influence which
  alternatives are most appropriate
• Consider a combination of alternatives

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Who does
pay for longterm care?

• Income and life savings of elders and family
  members
• Sell home and use equity
• Unpaid family caregivers provide majority of
  longterm care

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Who pays for longterm care?

• Medical Assistance (Medicaid) is a critical
  safety net

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Who pays for longterm care?
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Who pays for longterm care?

• Longterm care insurance will pay
• Longterm care insurance is NOT for everyone

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Why plan now?

• Peace of mind
• More choices and options
• Increases likelihood your goals and wishes will
  be followed
• Reduces burden for others
• Reduces misunderstandings and conflict

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References

• American Association of Retired Persons. (January
  2005). Oklahoma longterm care A survey of AARP
  members. Available from www.aarp.org
• Consumer Reports. (November 2003). Do you need
  longterm care insurance?, 68(7), 20-24.
• Kiplingers Personal Finance. (February 2004). If
  your parents need HELP, 58(2), 76-79.
• North Dakota Long Term Care Association (January
  2005). Issue and Data Book. Available from North
  Dakota Long Term Care Association, 1900 11th St.
  N., Bismarck, ND 58501. Telephone (701)
  222-0660. Web site www.ndltca.org
• Stum, M. S. (October 2004). Financing longterm
  care A resource for families. Available from
  www.financinglongtermcare.umn.edu