Planning Ahead: Demystifying Long-Term Care Planning and Health Literacy

Unlock the secrets to effective long-term care planning with this The Journey Out podcast episode during Health Literacy Month. Can early planning help you manage the stress of potential health challenges? Explore the answer as we debunk myths around long-term care, such as the common misconception that it only involves nursing homes, and reveal the essential role of the Older Americans Act in supporting older adults and their caregivers. With nearly two-thirds of Americans likely needing assistance due to illness or disability, our discussion provides clarity on various care options, including home care and assisted living, and emphasizes the importance of informed decision-making to minimize last-minute dilemmas.

Gain insights into the financial landscape of long-term care planning, including innovative options like reverse mortgages for older homeowners and specialized trusts. Learn about the benefits and practicalities of aging in place, with tips on home safety modifications and accessing community resources. This episode also highlights valuable online tools and local services to aid your planning journey, empowering you and your loved ones to navigate the complexities of long-term care with confidence and foresight.

www.longtermcare.gov

Chapters

• 0:00 Long-Term Care Planning and Health Literacy
• 11:02 Planning for Long-Term Care Options
• 21:19 Early Planning for Long-Term Care

Transcript

Speaker 1: 0:00

Hello everyone, and welcome to the Journey Up podcast, where we were designed to be the helping hand for everyday people who are on their Exodus journey. I am one of your hosts, bree, and this is Antoine, and this month is Health Literacy Month, and so we're continuing to dive into this, but today we will be talking about long-term care planning, what it is, why it matters and why you should start today. What is home care? How do I navigate health care?

Speaker 2: 0:27

What do I do when I feel down and depressed?

Speaker 1: 0:29

I'm stressed. Am I enough? What can I do? What is this going to cost? So long-term care planning. So let's talk a little bit about that, what it is like. We said why it's important. So nearly two out of three Americans will need assistance with activities of daily living, so things like bathing, mobility assistance, walking, dressing at some point in time in their lifetime due to disability or an illness, right? So long term care planning, as defined on my handy dandy note sheet, is a range of services and supports to meet health or personal care needs over an extended period of time. So the reason why long-term care is important is because it provides solutions to unforeseen problems that can happen at a later date in time. Again, I don't know what I'm going to be like at 65, right?

Speaker 2: 1:20

So it's just planning up until that point, I don't know what I'm going to be like at 65.

Speaker 1: 1:24

Well you know that's right around the corner, oh wow.

Speaker 2: 1:27

Yes.

Speaker 1: 1:29

But yes. So I think one of the common misconceptions for me is that you know we can wait till later, but it's important to start now. So tell me what is one common misconception that you have around long term care.

Speaker 2: 1:42

Well, one of the comments is a lot of them.

Speaker 1: 1:45

Right.

Speaker 2: 1:45

But one of them is long-term, care only happens in nursing homes, right?

Speaker 1: 1:48

Right.

Speaker 2: 1:49

Nursing homes is just one of the many options. There's also home care, personal care, where you have a caregiver come in and assist you with activities of daily living. That is considered unskilled care.

Speaker 1: 1:59

Right.

Speaker 2: 2:00

You also have home health and hospice that provides nursing care, which is considered skill adult daycares, and then you have facility-based care, which looks like assisted living and residential home care.

Speaker 1: 2:12

Right, right. And so I can kind of get with you with what you're saying there, because a lot of times people are like I'm not going to a nursing home and they only think that that's the only way or only option to get care, and that's totally not the case.

Speaker 2: 2:25

And the whole nother subject is the reason why they wouldn't go to these nursing homes, so in some cases uninformed, exactly.

Speaker 1: 2:32

And not planning. So that's super important to note there. And I think another common misconception that we hear a lot is my health insurance covers everything, I don't have to worry about anything. And that's totally not the case. So usually when you're 65 or so 64, usually you're going to start enrolling into Medicare and so you think, oh, medicare is going to cover everything, and that's not the case. Usually, medicare is only covering short-term stays at these facilities and we'll talk a little bit more about that. But it's really important to understand what it will and won't cover. So you talked a little bit about, like the nursing homes, residential care homes, assisted living, things like that. Those are really pivotal things for people to know about.

Speaker 2: 3:16

But we have those things due to the Older Americans Act that was passed, and the purpose of the Older American Act is to support older adults and their caregivers. So tell me a little. Tell me a little bit more?

Speaker 1: 3:26

Yeah, so some supports and services that the Older Americans Act have are like information and assistance. There's personal care, so that's again the help with the daily activities of living that we were talking about earlier. There is nutrition services, so like meal programs, meals on Wheels, things like that. There's also transportation, so that way you have access to medical appointments, and then support for caregivers, so things like respite care, training and things like that. Now, being able to access those supports and services is super important that you're contacting, like, your local area agency on aging or going to online resources that are available through the OAA website. With that being said, and trying to access some of the resources from the OAA, it's important to know that you have those services and support, but it's also important to start planning right now, to start planning early. What would you say would be one of your early planning tips, for you know the importance of planning.

Speaker 2: 4:23

Well, early planning helps reduce stress.

Speaker 1: 4:26

Yes.

Speaker 2: 4:27

Stress is a big factor in this right. Having a planning place helps individuals and their families make the appropriate decision when the time arises. So just say, for instance, if you start planning early, what happens is, hey, let's go back. If you know your family medical history, you have your mother or your father has been diagnosed with dementia or Alzheimer's or something like that. You know maybe previous fall risk or, God forbid, but a cancer or something may pop up right. And knowing that you're able to plan early, Knowing that you're able to plan early, and in planning early, if those things arise, you already have a plan of how you will want to be given care or where you will want to go receive care or even if, what facility you want to be in Right, and so that takes the stress away from you not having to figure out in the last minute.

Speaker 1: 5:20

It's already stressful because the situation just popped up on you. So now figure out in the last minute what you want to do. But aside from that, it's really stressful because the situation just popped up on you, so now figure out in the last minute what you're going to do. But aside from that, it's really stressful when you think about the cost, the cost of these things. And so the importance of planning early, right now, for me, I would say, would be cost. Costs are only going to increase, they're never going to decrease, they're only going to go up. So you want to plan now, so that inflation doesn't play a critical role in the care that you or your family member deserve. So you want to start now, you want to plan early, you want to go ahead and figure out is a nursing home best? Is an assisted living best? Is a residential care home best? Is at home best?

Speaker 2: 5:57

And if it is, you figure out and navigate a plan to make sure that your loved one gets where they want to be, plan to make sure that your loved one gets where they want to be, and one of the key things is planning that and, like you said, for residential homes or facilities, it's having an advanced care directive.

Speaker 1: 6:10

Yeah, advanced directive yeah.

Speaker 2: 6:11

Advanced care directive right. The importance of planning early and implementing that advanced directive is for clarity of you or your loved one's wishes.

Speaker 1: 6:19

Yes.

Speaker 2: 6:19

Advanced directives ensure that individuals' health care preferences are clearly documented and desires are met. Okay, right, also with that advanced directive and I'm reading my notes, so forgive me guidance for healthcare professionals Right, it ensures that the healthcare professionals are making the decisions that align with the patient's preferences. Okay, Right.

Speaker 1: 6:40

So that's important because a lot of times we get into a situation and like say, for instance, me and you right, I know, you Right, I know. Like when you're old, I know you want to be creased up.

Speaker 2: 6:53

So you say I'm old.

Speaker 1: 6:54

When you're old. I said when you're old, when I'm old, right, you want to be creased up, you want to be in his J's, you want to be in the sweatpants. I know those things right. But I also know him on a deeper level. You know what does the funeral arrangement look like, all of those different things. I need to know your wishes so that way I can make the appropriate decisions when that time comes and as a parent, I know we don't want to talk about these things but as a parent, it's helpful for you to let your family know.

Speaker 2: 7:22

Like my daughter, hey, I want her to know what my wish is to be right. I want her to be clear in what my wish is to be. So God forbid if something happened. Hey, she knows how to plan. She knows what dad or mom would like. So that's great that you said that.

Speaker 1: 7:37

Yeah, that's super important. I think also another key thing you would want to know, as you kind of progress and start planning early, is what your insurance will and won't cover. Like I said earlier, Medicare there are Medicare coverage limitations. Medicare will only cover a skilled nursing facility at a short term stay. So that means you probably get 60 days, you could get 50, 40, 100, you know if we're capable of doing that, but with those stays that's only what it covers and then after that you have to leave that facility. Where's your loved one going?

Speaker 2: 8:07

Where are they going? What's the next step? Do you know Right?

Speaker 1: 8:11

So understanding what your insurance or Medicare will cover and then planning according to that if there is an issue that comes up With that. We talked about the coverage and everything. So with that, you have to start financing planning early as well. So, finance planning, what does that look like? How can you kind of get something in place already, so that way down the road, when you need these resources, you're able to assess them and you can pay for the care that you need? For financing long-term care, what would be one of your top planning tips?

Speaker 2: 8:45

Well, it's important to assess your current financial situation and explore various funding options. There are a lot of options out there, but by finding the right one for you and your family at this time and even in the future, that'll be helpful.

Speaker 1: 8:59

Right, right, and so I guess most people for long-term care. We are already going to think about long-term care insurance, right? So that's going to be number one. So I'll kind of give you a definition of what long-term care insurance is. So long-term care insurance is specifically designed to cover services that assist individuals with daily activities, which can be divided into two main categories. So we have activities of daily living, which is like the bathing, grooming, mobility assistance, dressing, things like that. But we also have things like meal preparation. There's laundry and transportation and housekeeping. Those things are what we call instrumental activities of daily living, and long-term care insurance does cover that.

Speaker 1: 9:38

Now, long-term care insurance can be used in any setting, so you don't have to just be at home for it. You can be in assisted living, you can be in a nursing home, you can even use it for adult daycare services, so it doesn't have to just be tied to a specific area. But long-term care insurance is there to help pay for people who need assistance with activities of daily living. Of course, there's a cost always associated, and we call those premiums when you're talking about insurance, and the premiums really just depend on when you get started. So if you get a premium. At a younger age it's usually a lower cost. If you get it at a higher age, it's usually a higher cost. But it's really just kind of understanding what you need and kind of going from there.

Speaker 1: 10:17

There's also what we call annuities, and so an annuity is a financial product typically offered by insurance companies that provides a series of payments made at regular intervals. It is often used to accumulate funds for retirement or to provide a steady income stream during retirement. So there's two different types of annuities. There's an immediate long-term care annuity and a deferred long-term care annuity, and so typically how the immediate works is it's an annuity for right now. If you need long-term care right this second, that annuity can be given to you right then. Now for a deferred long-term annuity. It's usually something that you pay on now to use later at a deferred time.

Speaker 2: 11:02

And listen, this is a lot of information, yes, a lot of great information. But don't worry, listen, we don't have all the answers. Right, we introduced some to you, but down the road we will have people with the answers to go and deal with this for you, yeah, the experts, that's what we like to call them, the experts and so they can kind of dive a little bit deeper.

Speaker 1: 11:13

But these are some of the things that you can look into now to kind of find what fits best for you guys. And then we have reverse mortgages. I'm sure lot of us are familiar with reverse mortgages. A reverse mortgage is a type of loan that allows homeowners, typically age 62 or older, to convert part of their home equity into cash without having to sell their home. There's different eligibility requirements for that, but again, there's pros and cons to all of these things. So just making sure that we are doing our research and talking with the professional that can kind of help us do these.

Speaker 1: 11:42

And then, lastly, we have trusts. So there's two trusts that we'll talk about a charitable remainder trust and a Medicaid disability trust. So with the charitable trust, it is a type of irrevocable trust designed to provide income to the donor for a specified period, with the remainder of the trust assets going to a designated charity upon passing. And then we also have a Medicaid trust, and with the Medicaid trust, it's often referred to as a special needs trust and it's designed to allow individuals with disabilities to maintain eligibility for Medicaid and other government benefits while holding assets, which is, like, truly important and you know I'm going to be honest, I don't think I even knew about that type of trust, so that's super important to learn more about. And so, again, you have those type of financial options to help you try to plan for the future. But, again, you've got to figure out what works best for you and your family.

Speaker 2: 12:35

And, as you go down this road, there's a lot that you won't know about, right, and there's a lot that we didn't know about, but we had to go down this journey, right, right, and so this is why we're here, right, to help you start planning as soon as possible so when you, if a situation arise, you'll be more prepared for.

Speaker 1: 12:52

We talked about ways to kind of plan early. We talked about things you want to have when you're looking for some assistance as you get older. We also talked about residential homes. We talked about nursing homes. We're talking about probably staying in the home, and so if staying in the home is something that your loved one wants to do, you have to be prepared for that.

Speaker 1: 13:13

I mean right now, we know 70 million Americans choose to age in place currently. That means they want to stay home, they want to live in their homes as long as possible and receive the care that they need there. There are multiple benefits to aging in place. I mean from it just being a familiar environment for one, but also there's independence and autonomy that still remains when they have care at home. With the care in the home it's more personalized and there's also improved health outcomes when you have a caregiver or some agency coming in and assisting them inside the home. But I think one of the big things that we have to remember is they can stay home. That's important, but the home has to be safe.

Speaker 2: 13:50

Yeah, can they stay home safe?

Speaker 1: 13:51

Yeah, it has to be safe.

Speaker 2: 13:52

So, in order to stay home safely for your loved one, I think you will need home modifications such as ramps, grab bars, improved lighting in the outside and inside, a medical alert chain, necklace or something like that to help if something happens. If that person falls, hey, they can hit that medical alert. And also one thing that we, since they're at home by themselves and say if they're not with their husband, or with their wife or with their kids, what's that Come?

Speaker 1: 14:27

on.

Speaker 2: 14:27

Cameras, camera system. A camera system will be great for you if your loved one is staying at home, because now you can monitor your loved one from a distance. Right? We have had situations and cases where loved ones, people, loved ones have been on the ground for a day or two right, or hours or hours in and they didn't know because, hey, they was trying to call but they was out of pocket. When I say out of pocket, they wasn't around, they was working, they was at home, they was doing other things. But if something like that happened, when you can't get in contact with your loved one, hey, having a camera system at home to to where you can see what's going on, that'll be helpful as well.

Speaker 1: 15:03

Right and of course all things cost right. Yes, but there are community resources that are able to help families, you know, with some of these home modifications. So there's, like I talked about earlier, the local area agency on aging. They're just a wonderful resource. They come out, they can trim bushes, put in grab bars, put in ramps, they've done it all so they can do that for you all. And then federal agencies, kind of like the VA veterans if you're a veteran you can get home modifications at no cost to you and they will cover that for you.

Speaker 1: 15:34

So just knowing again what community resources are, out there and knowing how to access those resources and knowing how to access them can get you the help that you need, especially if your loved one's desire is to stay home and you want them to do so safely. We've discussed a lot, yes, and so I know in the back of everyone's head it's like what does?

Speaker 2: 15:52

all of this cost? No, no, no. Camera zoom in. How much does this cost?

Speaker 1: 15:59

That's our intro. That's our intro.

Speaker 2: 16:01

That's what they want to know. How much does this cost? How much do all this cost?

Speaker 1: 16:06

Right. So it just depends Again, it depends on what you're wanting, right? So if you want to stay at home, right, now and again, let me give you a good resource for looking at cost of care Genworth, again. And Genworth is another long-term care agent, insurance company that gives out policies for long-term care, so they're very qualified for giving information on what cost of care is. If you're looking to stay at home, on average, the 2023 national average for home care is at 33 an hour, right? If you're looking for an adult day service, so say, for instance, you have a loved one and they have alzheimer's or dementia and you need want them to go to a service um, an adult they have and let them, take, take care of them for the day during the daytime.

Speaker 1: 16:54

you're looking at about 95 a day room for the day during the daytime. You're looking at about $95 a day per day. For assisted living, you're looking at about $5,400 a month. For a nursing home and in the way nursing homes and residential care homes too, the way nursing homes work, you have a semi-private or what we call a shared room where you're sharing it with another resident or a patient that's at that facility, and you have a private room where the room is all to yourself. A semi-private room is going for about $8,700 per month and a private room is going for $9,800 per month.

Speaker 2: 17:29

And these prices do vary right, they vary Depending on the state to state and the amenities that you will want that your loved one to have.

Speaker 1: 17:37

Exactly, and so these are just the average. It definitely could. Some in some places could be higher, some places it could be lower, but these are, these are your average costs. So this is what you are expecting to pay right now, right? Well, as I mentioned earlier, it's only going to go up, right? So having a plan for your loved one, for yourself, for your kids in the future, so they know what to do for you, is super important, because when you want to choose what fits best for your family, whether it's a nursing home, a assisted living, a residential care home or aging in place you want to figure out what fits best for them, but when you want to take in the cost, those are some high numbers.

Speaker 2: 18:18

We won't lie.

Speaker 1: 18:19

I mean, and the cost and the numbers will go up and it only will go up, so those are high as they were now, but your first concern should always be care. Yes, I know costs play a significant role in care for your loved one. We all know that, but you could end up spending more money.

Speaker 2: 18:41

And the care.

Speaker 1: 18:42

Putting them in a place where they are not nurtured. You can have hospital visit after hospital, visit after hospital, and it only racks up from there.

Speaker 2: 18:52

If you put your loved one in a place where they're not getting the care that they deserve and the care that you expect them to get, because this is your loved one in a place where they're not getting the care that they deserve and the care that you expect them to get because this is your loved one, right? Not only are you paying for the cost of them living there, what about the hidden costs? If they're not getting turned right and developing bed sores, right, if they not? It's a lot of stuff that goes into this, right, and I'm, I'm and I'm probably not got off topic, but when you're dealing with my mother, right? Or my grandmother or my family member, right? When someone comes into our place of business or they come into our home or we sign them on as a client, that's my loved one.

Speaker 2: 19:37

Right. That's my mother, that's my father, right. So the love and the care that that person get is priceless.

Speaker 1: 19:45

It really is.

Speaker 2: 19:46

So knowing that company, knowing again, we're talking about planning long term, knowing what's going on with different facilities different companies that's priceless because you're putting your love into someone else's hands. Okay, I'm sorry.

Speaker 1: 20:04

No, I think you just hit it on the head Again. Cost matters, but it's really about the quality of the care. That is super important. If you guys don't take anything away from what we've said today, costs are only going to go up. But you want to put you and your family members in a better position so that later all of this can be a breeze. And it won't be a breeze because you're going to be going through something as a family unit.

Speaker 2: 20:33

But at least you're better prepared.

Speaker 1: 20:35

Right, and that's the part, that's the breeze, right, you're prepared. You know well, I have this in place. I know I don't have to worry about that. I can fully give my attention to my loved one in this time who needs me, without having to worry about expenses, not worry about care, not worry about placement.

Speaker 2: 20:50

And I know my loved one's wishes.

Speaker 1: 20:52

Right, right. We have discussed a lot today, a lot We've talked about the importance of long-term care planning. We talked about all the supports and services that come to us. Advanced directives, advanced directives. We talked about financial planning. We talked about OAA. Talked about OAA. We talked about different. Home modifications Right, yes, the whole episode right, right, right, but we talked about a lot of things, but I think, really, what we want to encourage you all is to be proactive.

Speaker 2: 21:19

Yes.

Speaker 1: 21:20

Be proactive in planning for your long term care. It's never too early to start and it's never too late to start, but you have to start, and that's what we want to make sure that you get from all of this. We also want to make sure that you are tapped into the local resources that you have. So make sure you're going on to websites like longtermcaregov for information and planning tools. Also checking with your local area agency on aging for any community specific services that you need. Also going to the OAA website, the Olders American Act website, to get all the other information and planning tools that you need as well, because it's going to be critical as we age and as we continue to age, and that's for all of us. So that's a wrap on today's episode of the journey out.

Speaker 1: 22:04

We pray that the things discussed today have been a helping hand for you and the ones you hold close, positively bringing you out of one season to the next, starting your Exodus journey.

Speaker 2: 22:14

And remember what you have learned today is knowledge, and you can be a resource to your family and your community.

Speaker 1: 22:20

Yes sir, we out. Thank you.