For many elderly people, one of their greatest concerns is the possibility of needing long-term care. It’s an emotional and unpleasant topic to broach, but at Skeeters, Bennett, Wilson & Humphrey, we know how helping those we serve to plan ahead empowers them. Here’s what you should know to include long-term care in your estate planning to ensure a dignified future.
Understanding Long-Term Care Options
There are several different levels of care available to older adults as they age depending on their need for assistance. Each level of care may include a medical and health component, a personal care component, and a social and recreational component. Keep in mind, cost estimates vary considerably not only based on these factors but also on where you live and the type of facility.
Adult Day Care
This is a supportive group environment for seniors with cognitive and/or functional impairments. Adult day care may include medical and health services, social services, or both. These facilities are regulated differently in each state but aren’t federally regulated. This is the least invasive type of long-term care, with an average cost of over $10,000 per year.
This type of assistance allows a senior to “age in place” as an outside service provider comes into the home to help them. Services consist of either a home health aide or a companion/homemaker. Caregivers are hired through various methods including agency, registry, or private hire. Each state licenses and regulates its home care agency system except for Medicare-certified agencies, which must comply with federal regulations. The national cost for home care is approximately $30,000 per year.
Depending upon the chosen level of care, an assisted living facility or ALF may provide a wide range of services, including:
- Care and medication management
- Assistance with everyday activities, including providing meals and housekeeping
- Social and recreational activities
ALFs are governed by state standards and may be required to follow additional standards for communities with residents suffering from Alzheimer’s or other forms of dementia. ALFs may also have staff training requirements or disclosure requirements relating to these diseases. The national average cost of staying in an ALF starts at $50,000 per year. Medicaid, a federal program administered by the state that assists with long-term care costs, may be available for residents of an ALF.
For older individuals who require the most assistance, these facilities provide a secure environment and various services to meet the cognitive, physical, medical, and social needs of their residents. In addition to the care options found in assisted living centers, many patients in nursing homes may benefit from assistance with bathing, dressing, eating, toileting, and transferring in and out of chairs and beds. Nursing homes, like ALFs, are subject to state and federal regulations. Annual costs for living in a nursing home are approximately more than $70,000. Certain nursing homes also accept patients who qualify for Medicaid.
Long-Term Care Placement Considerations
It’s critical for older adults and their family members to be clear on the services needed and to carefully assess a service provider’s policies on the scope of care. A provider will likely have a basic services contract that lays out primary services, and any that fall outside of this basic agreement will be an additional charge. It’s imperative you or your advocate has a clear understanding of the contract, including who’s obligated to pay for the services provided.
Also, carefully evaluate a facility's staff qualification requirements, continuing education, and training. For example, some providers have staff trained in managing patients with Alzheimer’s disease and other forms of dementia, while others may not.
Another consideration is whether the service provider is a freestanding facility/entity or if it’s connected to another facility. Some ALFs are freestanding, while others are associated with or somehow connected to an assisted living community, hospital, or both. Your ultimate choice for long-term care might benefit from knowing that transferring to a more comprehensive care center can be done quickly if you can no longer live in an ALF environment.
The proper placement is only successful when you evaluate options based on your financial, medical, social, and spiritual needs. Personal preferences also matter, such as the aesthetic value of the facility, proximity to family and friends, familiarity with surroundings, and the overall environment. Prepare a detailed list of questions to ask administrators, staff, and residents, if possible.
Planning for Long-Term Care Provides Peace of Mind
Determining the appropriate level and type of care is one of many challenges facing older adults and their loved ones. Partnering with an estate planning attorney with experience in elder law can make the process far more accessible. This legal advisor can help with your understanding of:
- How to pay for long-term care
- Knowing your rights as a senior citizen
- The guidelines of what Medicare will and won’t pay
- What legal documents need to be in place to carry out your wishes effectively