When our advisors meet with families, they are usually in situations of having to make quick decisions relative to assistance for their parents or other loved one. Most families are not prepared when their loved ones need more assistance at home, an assisted living location or even nursing. Following are some common questions we get asked.

Q – How do costs compare in regards to in-home care versus assisted living and nursing homes?

A – According to the 2011 Genworth Cost of Care Survey, median annual costs for various types of senior care:

• In-Home Services (Assistance with Activities of Daily Living, including dressing, personal hygiene, bathing, etc.) – $57,086 annually (based on approx. 6 hours/day)
• Assisted Living Location – $49,500 annually (private/one-bedroom & 24 hour care)
• Nursing Homes – $97,455 (semi-private) and $121,363 (private) annually

Q – My father has had some falls at home and it is becoming too difficult for my mother to continue to take care of him. Her health is declining as well. He refuses to go to a “nursing home.” Are there other options?

A – There would be additional information I would need to know about your father, but there could potentially be several options for him. If both your parents wanted to continue to live together, there are “Assisted Living” options with various services and can range in size from five residents to hundreds of residents. These locations are licensed by each State and residents staying at these type of locations may need care with various activities of daily living (grooming, bathing, dressing, cooking, medication management, transfers, etc.). Nursing homes, on the other hand, are designed mainly for those needing a higher level of medical care and rehabilitation.

Q – Is Assisted Living different than Retirement Homes?

A – Though there are many similarities, there is a difference. “Retirement Homes” is a generic term usually referring to independent or senior communities whose residents are at least 55-60 years of age and are in good overall health. Assisted living, on the other hand, may have many of the same activities as a senior community, but these locations have caregivers on staff 24/7 to assist residents with various care needs. As described above, there are many options available in assisted living including a range from small, adult family homes to facilities with multiple levels of care.

Q – How do you decide which locations are best?

A – What is best for one person may not be best for someone else. However, it’s important to meet and talk with those that run the location, as well as caregivers and residents. Also, it’s imperative to review the reports to see if there have been any citations issued against the location, the severity of those citations and how they were remedied. The questions that need to be asked are too numerous for this article, but please call our office, and we would be happy to provide you guidance in all these areas.

Q – As I age and will need some sort of long-term care assistance, I do not want to burden my children with taking care of the two of us. What are the options to help pay for this type of care?

A – Aside from “private pay,” below is an overview of the options that are available for long-term care assistance:

Medicare/Medicaid
Most private health insurance plans follow the same general rules as Medicare. If any long-term care is covered, it is usually for only skilled, short-term and medically necessary care. Home care is limited only to medically necessary skilled care. Custodial or personal care is not covered by health insurance. The coverage in a Skilled Nursing Facility must follow a hospital stay and is limited up to 100 days.

For long-term care, you must meet Medicaid’s (name varies on state) financial eligibility which is jointly funded by the state and federal governments. Since Medicaid is managed by each state, eligibility varies from state to state. Even if eligible, in most long-term care cases, you may only select a Skilled Nursing Facility that accepts Medicaid.

Long Term Care Insurance
Long Term Care Insurance could be the best investment one can make. Unless medically necessary, you can avoid Skilled Nursing Facilities by residing at an Assisted Living location, Residential Care Home or at your own home with the needed In-Home care. This type of insurance makes it much easier to cope with most otherwise uncovered health issues as you get older.

Life Insurance
There are various ways you can use your life insurance to help pay for long term care, including Accelerated Death Benefits (ADB), Viatical Settlements and Life Settlements.

Veterans Aid and Attendance
The Aid and Attendance pension benefit offered by the Department of Veterans Affairs (VA) may be available to wartime veterans and surviving spouses who have in-home care or who live in Assisted Living Facilities or Nursing Homes. The current monthly benefits are as follows:

• Up to $1,704 per month for a single veteran
• Up to $2,020 per month for a married veteran
• Up to $1,094 per month for widowed surviving spouse

Though there are minimum qualifications, below I have outlined the prerequisites for review:
 Served in the military during time of war (or spouse).
 Have less than $80,000 in investments excluding home/car. Note: There are other options still to consider.
 Monthly income less than the monthly cost of care including prescriptions.
 Need help from others in one or more of Activities of Daily Living.
 If surviving spouse, married to the veteran at the time of death.
 Have sufficient resources to pay for care while awaiting a decision for the VA (may take 3-6 months).