Financing long-term care was a nightmare for our family. My
grandparents initially “qualified” for Veterans benefits, as my grandfather
fought in World War II. Initially, my grandfather and grandmother were
receiving the maximum
benefit of $2,019 per month (for veteran and spouse). Thus, the Veterans
Administration was paying roughly 30% of my grandfather’s assisted living home
monthly cost until about a year and a half into his care, when they determined
he actually didn’t qualify for benefits. At this point, the VA began to demand
the $40,000 back that they’d paid out. My mother had to get an attorney and try
to fight the VA to get everything corrected.
The Veterans Administration “does not reveal maximum
allowable assets” and according to a New
York times article, $80,000 (“the house and a car are exempt from this
total”). Yet, what the VA told my mother, was that because my grandparents
owned a house it disqualified my grandfather from getting long-term care
assistance from the VA. (At the time my grandfather entered the assisted living
home, he had a caregiver who filled out his paperwork to help him and
my grandmother enter assisted living. It is likely she left out what assets he
had to make assisted living appear cheaper for him.) Interestingly, it is
illegal for someone to help a veteran fill out the 26-page application.
According to the September
2012 New York Times article, "A Little-Known Benefit for Aging
Veterans," “The department forbids anyone to charge to help veterans
fill out these challenging forms.”
In the end, the VA offered my mother a “bargain” if she
repaid half of what they paid ($20,000 within 60 days) they would never ask for
the final $20,000 they had paid out. My mother took their “bargain” to avoid
paying it all back, but within a couple weeks of paying it, the VA demanded the
full amount. Her attorney had to help her prove, several times, that she was
given a special deal and had met the requirements to qualify for their “deal”.
Their demands for the full $40,000 dragged on for sometime, and caused my
mother a great deal of stress, but eventually the deal of paying back only 50%
of what they paid out, $20,000 stood.
After the VA fiasco, my mother was paying about $8,000/month
for both my grandparents to reside in a very nice assisted living facility with
an integrated memory care unit (for my grandmother who had dementia). My mother
spent all of the money my grandparents had in savings, cashed out her own retirements,
and the stress created a variety of health problems for her. She eventually
left her job to deal with all the complications, taking an early retirement. A
recent segment on NPR,
which interviewed Elder Law attorney, Marielle Hazen, highlighted these
types of sacrifices. As Ms. Hazen described it, “I see a lot of family members
making a lot of sacrifice: leaving the workforce, losing their retirement
benefits, losing health care benefits in order to make sure their parents are
provided the best care.”
During the time my grandparents were in the cohabitation
(dementia care with other residents) assisted living home, my mother kept
shopping around for assisted living homes that wouldn’t charge so much. The
cost savings created other complications however. Some homes were in bad
neighborhoods. Others had the memory care residents locked up in a separate
facility, away from their non-dementia spouses. Eventually my mother met with
an Elder Care attorney, and learned how to qualify my grandparents for
Medi-Cal, and got them into a Medi-Cal
Long-Term Care Provider (a skilled nursing facility). This new facility
cost about 60% less than the assisted living home they had been in. However,
this “solution” was short lived. My grandmother died within 5 days of the move,
and my grandfather died less than two months later.
The skilled nursing facility was filthy, noisy, and
horrible. The staff moved my grandmother’s bed out of the room that she and my
grandfather shared right in front of my grandfather in less than 24-hours after
her death. He was nearly in tears as he said to me, “Where are they taking
that? I bought that bed for your grandmother.” The staff kept coming in and
interrupting my visit with him, their walkie-talkies echoed down the corridors,
and because my grandmother was dead and they needed the room, they wouldn’t
leave us alone until they could move my grandfather to his new room with a
roommate. It was a horrible scene, and when he said to me “I don’t plan to stay
here long,” I didn’t blame him one bit.
I did not agree with my mother in moving my grandparents to
the skilled nursing facility, though I can hardly say I blame her given the
financial situation and costs of keeping them in assisted living. It was not my
money to spend, and therefore it was not my choice to make. Yet, considering
the short time they lived after the move, it would not have cost much more had
they remained in assisted living.
In some ways I do believe that the move killed them. I
believe the strain that my grandmother experienced with having dementia and
being relocated after nearly 3 years in the same place, to an entirely new
place led to her stroke. Her death in turn, killed my grandfather’s will to
live after 50+ years of marriage. His decline after her death was swift and
deliberate. He was ready to go.
Thus, financing long-term care is a definite strain on
families. It can drain their bank accounts, savings, retirements, and tear them
apart in time. There is also guilt involved when money becomes the issue.
Fortunately for “Schnootzie,” the grandmother of the NPR
article on long-term care, her grandchildren were caring for her with resources
her son who preceded her in death left in his will to be used for her benefit.
“But in most circumstances, people don't have that extra set of funding. And so
it could be mom or dad or grandma or grandpa who is paying directly for the
caregiver services” according to Ms. Hazen the Elder Care attorney.
Sometimes what families can afford for care is not the best
place, or where they would wish their loved ones to be. I know in our family
that was the case. The “affordable” skilled nursing facility my mother chose,
was in my opinion, a place to die. It’s
care and atmosphere would kill anyone’s will to live. When we arrived at the skilled
nursing facility, they were removing a resident who had just died through the
front doors. An hour later, as we were leaving we noticed an EMT sitting with
the survivors of the decedent telling them about the death in public view right
out in the lobby. To say the skilled nursing facility was inferior to the
assisted living facility is a massive understatement. The assisted living
facility had fun activities, kind caregivers, warm decor, privacy, and staff
that treated the residents like family. I know where I would want to spend my
last years of life, but where I will be able to afford to live is what will
determine where I go.
I believe if we can carefully plan for our own futures, we
can begin to care for our own successfully. We can purchase long-term care
insurance to cover the costs of long-term care. According to Wikipedia, “Long-term
care insurance generally covers home care, assisted living, adult daycare,
respite care, hospice care, nursing home and Alzheimer's facilities.” Sadly, “Out
of more than 313 million Americans, only about 8 million have any such
protection, according to the American Association for Long-Term Care Insurance”
says NPR in their May 2012 article “Long-Term
Care Insurance: Who Needs It?” In the article, Geneva Hunter, a lady
interviewed by NPR
goes on to say how although her job offered that as an insurance option, she
couldn’t afford the $400.00/month from her salary to pay it. When I consider
the fact that my grandparents assisted living facility cost $4,000/month per
person, the $400.00/month sounds like quite a bargain.
Another benefit of long-term care insurance, according to
the May
2012 NPR article, “Waiting To Buy Long-Term-Care Insurance Adds Up” is that
“all the money you save for retirement, you can actually use it for retirement,
as opposed to having been forced to use that money on your care in a nursing
home.” That unfortunately is exactly what happened to my grandparents. The
younger a person is when they buy the policy, the cheaper the policy will cost
them. However,
in NPR’s interview with Kimberly Lankford, a personal finance writer for
Kiplinger.com, Ms. Lankford says, “In your mid-50's, we say it's usually kind
of a sweet spot. It is, you know, the rates are usually a bit more competitive
then. And also, it's before a lot of people have started to develop medical
conditions which then also make it more difficult to buy this coverage.”
Ms. Lankford also describes how the long-term
care coverage generally gives a person a $150.00 daily care benefit
($4,500/month of coverage) for about 3-years. “A couple could pay about, $3,500
a year for both of them to get these basic benefits.” Although 3 years sounds
like too short of a time to have coverage, it is exactly how long my
grandparents were in long-term care. They moved into assisted living in June of
2009 and died in June and August of 2012. Had my grandparents purchased
long-term care insurance earlier in their lives, their entire care needs during
the last 3-years of life would have been covered. Their retirement savings
would not have been drained. My mother’s retirement savings would not have been
drained. Also, considering how my grandfather thought he had VA assistance, and
ended up losing it, I don’t think we can count on the government to pay our way
in long-term care. We can only rely on ourselves, and it seems that long-term
care insurance is the best bet to cover such financial needs.
Have you been involved with long-term care funding for a loved one? Or do you have long-term care insurance for yourself? Why or why not?
