Last summer a friend of mine’s grandmother died after receiving 24 hour at home care for two years. Although she had advanced dementia and her mobility was limited, she was about as comfortable as you could be in her condition. I’ll go back to her in a moment.
When talking to clients about long term care, I like to start the conversation by asking them questions to get them thinking. For starters, when you get the flu, where do you like to be? If you answered, “Sharing a room with a stranger in a hospital-like environment being cared for by a nurse who is also caring for a dozen other patients” then I’m afraid to tell you that while no answer is the wrong answer, you’re not part of the 99% and probably should check yourself into a hospital for other reasons. Naturally, when you are sick you want to be, “At my home, in my own bed.” If you were to be sick (or disabled) for an extended period of time this wouldn’t change.
Let’s consider some additional questions. How many things can you think of that could make it difficult to care for yourself? And I’m not just talking about getting dressed, but when you’re worried that you’ll slip in the shower when you’re by yourself. Or that difficulties with memory could cause you to forget an important medication. Plenty of other things can happen, strokes, aneurysms, advanced diabetes, severe arthritis, Alzheimer’s, dementia, etc. One more question, do you know anyone who has gone into long term care? Statistically 70% of people do at some point in their life. Although I’m sure some people could say “no”, I’ve never had a client say it.
Long term care will be a reality for most of us. Added to this is that technology is making all of us live much longer into old age. I’ll contrast two generations from my family. My great-grandfather died at age 76. He was walking across a lobby, had a heart attack and died before he hit the ground, literally. My grandfather inheriting the same heart condition, but he took medication and instead died at 89 after being in long term care for four years with severe dementia (it would have been seven years had my aunt not lived with him). The baby boomer generation will follow this same trajectory of seeing technology prevent them of dying from what killed their parents, but probably having a more medically intensive later years; perhaps even more so that what their parents experienced.
Considering the monthly cost of long term care – the last average I heard for Denver was around $6,000 and we’re probably about average for the country (Source: http://www.prudential.com/media/managed/LTCCostStudy.pdf). This is a very real risk of depleting your nest egg, let alone forcing your to make decisions you don’t have to make. When meeting with clients we’ll have this discussion and I’ll go back to their assets and ask them, “If you were to go into long term care, which of your accounts would you use to pay for it?” This is at least the beginning of the conversation of how to plan for long term care.
Going back to my friend’s grandmother, because I help people plan for retirement expenditures I couldn’t help but worry that she was paying for the 24 hour long term care helpers out of pocket (imagine the cost of fully employing three medically trained staff!). I was relieved to hear my friend tell me that her grandfather had been very smart about money and had bought good long term care insurance and it was all completely paid for by the insurance company! I can hardly imagine how different her situation would have been without that insurance. I can tell you she probably wouldn’t have had 24 hour at home care and probably wouldn’t have been able to peacefully pass away in her own home last summer. But again, where do you want to be when you’re sick? There is a sensible way to plan for this and to me it’s really an at home health care plan.
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