Delphine at meeting hall[/caption]The question is reasonable because even though financial planners advocate long-term care insurance, it’s likely if Grandpa has any real health problems he either won’t get it or will have premiums so high he will have to choose between eating at the present or having a nursing home bed in a decade.
The pitch for a sale sounds good from the insurance agent who gives all good reasons for buying long-term care and buying it early so premiums don’t become high. Still there are enough exclusions to create barriers, even for the young adult. These include using using certain medications over a period of time, for example prednisone, a drug that is recommended for a number of conditions, including asthma and arthritis. But many insurance companies will likely refuse, or seriously rate, the applicant with this situation.
Grandpa is 75. He has ocular myasthenia gravis, a condition that could or could not become systemic for many people, but not if the individual has had the condition for more than a couple of years. Grandpa was diagnosed three years ago and has no issues of balance or coordination that would imply a spread of the disorder beyond the ocular area. Still, Grandpa can’t get insurance from most insurance companies either because he takes prednisone (every four to six months for four to five days) or simply because of the diagnosis itself.
Lillian, a 60-year-old neighbor, is able to buy long-term care but has found it very expensive because she is a diabetic. The diabetes has been well controlled during the five years since her diagnosis, but the rating from a standard policy is 10% higher than others, making it unaffordable for her. Her insurance options are limited, with few companies willing to take Lillian as a customer among the number of companies available.
Medicare doesn’t cover long-term care, and as the recession has taken the savings and jobs of younger folk, the children might not have funds to help. Besides the numbers of baby boomers without children increase the problem as well, as more and more senior assistance centers won’t take Medicaid. This is even more likely to happen with the changes proposed by Republicans to slash Medicaid payments and raise the bar for qualification, as detailed by the American Association for Retired Persons who offer a synthesis of recent proposals.
The problem is made even more difficult by the fact that 40% of the elderly needing long-term care depend on Medicaid, which means the oldest and sickest of the group. And that Medicaid only becomes available after the senior has exhausted virtually all of his/her assets. While the problem of what to do with the great numbers of seniors entering the health care system with complex diseases increased, politicians offer solutions that often don’t offer much hope. The liberal ones avoid the problem altogether, and the conservatives seem to say “tough luck.” The problem, however, is anticipated to become very great with the growing number of seniors needing assistance. It is complicated because of the fact that middle and low income persons have less discretionary income for long-term care insurance or may not qualify for it. Furthermore, the fact that the seniors must exhaust virtually all savings before using Medicaid creates problems for most people as the surviving spouse is virtually impoverished as well.
Some experts have recommended price-rewarded savings, now being used by some states to encourage savings. With this type of program, for every qualified portion of savings one receives a chance at a special prize, usually a substantial amount of money.
The options are few that seniors can use for long-term care as costs increase, restrictions develop and the number of users grows, but one of them is the senior community of people over 55 itself, where in many instances the more active of the group pitch in and help the others. This is true of the community of Ryderwood, for example, a town created for and by senior citizens, following its initial history as a loggers camp for families. As one elder recently said, “Who knows better what it takes to grow old and do it with dignity but people just like us?”
The problem is that because of age restrictions selling the property is said to be more difficult because the pool of buyers is limited. On the other hand, some folks say that the restrictions in many ways increase the number of buyers who seek that mutual support in lieu of assisted living seniors.
In the meantime as seniors explore options for care, the problems multiply as the typical caregiver, ordinarily other family members or children, are burdened with financial and physical demands from the lifestyle needed to keep up with the cost of living and the demands placed on growing families. In addition, there are many seniors who have either never had, lost children or have children with reduced capacity to act as caregivers in a crisis.
Potential solutions may develop as more and more seniors opt for community-based support. These include the Meals-on-Wheels programs, grocery store deliveries and home care assistance on a fee-for-service basis.
While seniors plan for the likely, experts say everyone should plan as early as possible for those declining years and then update those plans periodically as circumstances change. With the quarrel over “entitlements,” it is likely it may soon be time to change one’s plans again, as the changes are likely going to make long-term care more difficult and more expensive. Then what happens to Grandpa and Grandma when their options no longer exist?