LTC Financing Strategies
10 Things You Should Know Before Becoming A Parent’s Caregiver
Reprinted from Dakota Travel Nurse Home Care Blog
If you’re trying to decide whether or not to move your aging parent in with you, you aren’t alone: One out of every four caregivers lives with the elderly or disabled relative he or she cares for.* An in-your-home arrangement can have many positives. If your parent is still relatively healthy, she may be able to help around the house, contribute financially, and get to know your children in a way that could not be possible with only occasional visits. It might be easier to care for her in your own home rather than from a distance. It could be less expensive than putting her in a nursing home or an assisted living facility, but you also could pay a price in terms of necessary remodeling, time, stress, fatigue, and strained relations.
This arrangement can be great for some but not right for everyone. Before you make such a momentous decision and present that option to your parent, it is very important to take an inventory of not only of your living conditions and your support system, but of your own health and ability to take on what is likely to be a demanding role, perhaps for a very long time!
We think these 10 personal inquiries will help you begin to gain the knowledge you need to make the best decision for you, your parent and your entire family. We’ll use a mother as the example:
- Is your home safe and accessible for your mother, now and as she ages? If not, do you have the resources to remodel?
- Is your mother able to contribute financially, and are you financially prepared for the extra costs of caregiving?
- How do your spouse and children feel about the move-in? How well do all of you get along with your mother now?
- Have you discussed the lifestyle changes involved in having an elderly person in the house? Does the family agree to these changes?
- Will your mother be able to live by the rules of your house, support your child-rearing decisions, respect your values?
- What kind of care will your mother need, now and possibly in the future?
- Do you have the time to take this on? How much supervision and assistance can you and family members provide?
- Will you be able to cut back on work responsibilities during those times when you need to be home to care for your mom?
- Are you and your family capable of taking care of your Mom’s special needs? Do you need to hire outside/skilled help or consider assisted living?
- Will you be able to make time for yourself and your family? Do you know how caregiving will affect your physical and mental health? Will you be able to allow yourself to accept help and take breaks when needed?
None of these questions really take into account the physical, mental and emotional condition of your parent. Be sure to do some research on the special needs you will have to meet and cope with. For example, if your loved one has dementia and can no longer filter their behavior, will you and your family be able to cope with potentially hurtful words or actions? If your mom is diabetic and needs help checking and managing her blood sugar levels with injections, are you comfortable taking on that responsibility? Is your mom able to be left alone, and is she still able to enjoy social interaction? If so, will she be close to friends and other family members?
There are many strategies that can help with the costs of Long-Term Care, whether a parent’s or your own. Contact TheLongTermCareGuy.com at (920) 884-3030 or (800) 219-9203 for more information.
Resources: The 10 questions above were adapted from two articles–*Moving Elderly Parents Into Your Home and 8 Questions to Ask Yourself Before Becoming Your Parent’s Caregiver. Click on the links to read more. Another helpful article is When Your Aging Parent Moves into Your Home—Deciding If You Can Do It.
If you are especially concerned about the financial aspects of becoming your parent’s caregiver, these two articles explain key factors you should consider: Aging Parents Moving In: Can you afford to have Mom or Dad move into your home? and Moving Aging Parents Into your home. How to handle renovations, taxes, and dealing with your sibs.
More Bad News in Long-Term Care
The numbers of seniors who need personal care help is increasing, says the CDC. The data released last Tuesday by the CDC’s National Center For Health Statistics shows that 7.2% of seniors require help with activities of daily living in 2015, compared to 6.6% in 1997. This includes eating, bathing, dressing and getting around as personal care needs.
Seniors over age 85 were twice as likely as adults between 75 and 84 to require personal care help, and were 5 times a s likely as adults age 65 to 74. The report also found 6.4% of white seniors required personal care help, compared to 9.6% of black and 11.3% of Hispanic seniors.
Not only do we have more seniors, especially those over the critical age of 85, but their rate of needing care is increasing as well. A dangerous combination!
“Nursing Home Evictions Strand The Disabled In Costly Hospitals” was a recent article by Ina Jaffe of National Public Radio.
Quote: “What if you had to go to the hospital, and when it came time to return home, your landlord said you couldn’t move back in? Across the country, thousands of nursing home residents face that situation every year. In most cases, it’s a violation of federal regulations. But those rules are rarely enforced by the states. So, in California, some nursing home residents are suing the state, hoping to force it to take action. … Chicotel [a staff attorney with California Advocates for Nursing Home Reform] says the residents most likely to be refused readmission fit a particular type. First, they’re all on Medicaid, which pays nursing homes less than they get from Medicare or private insurance. Second, he says, these are patients who are behaviorally difficult to manage – for example, ‘residents with mental health issues or significantly advanced dementia, or maybe traumatic brain injury.’ They’re undesirable, says Chicotel, ‘because they might take a disproportionate amount of labor time.’”
State budgets are getting stretched thinner and thinner as seniors continue to accelerate passing through age 65. Most of the newly 65 year olds do not need any Long-Term Care services, but as they continue to age, as you can see from the article above, the incidence of care needs is increasing.
Medicaid picks up much of the cost of Long-Term Care for those who have run through all of their savings, homes, and other assets. Medicaid is half federal money and half state money, so everyone is sharing the pain equally. We are now faced with only 3 workers for every retired person and the ratio continues to get worse. Where will the money come from when you need care?
Just like responsibly planning for the time an automobile accident occurs, I have insurance for Long-Term Care as well as my auto insurance. When I need care someday, I will simply notify my Long-Term Care insurance company. As they receive copies of the bills for my care on a monthly basis they will send me a check each month to reimburse that cost.
I don’t have to worry if the Medicaid reimbursement rate is so low that the facility will be trying to get rid of me. My money will come in each month, in addition to my Social Security check. If I do not like the care I am receiving, I will find a better facility or home care agency and make changes. When you pay for the care you want, you get the care you want.
How will you pay for your care when your health changes? If you want to explore options, contact The Long Term Care Guy at (920) 884-3030 or (800) 219-9203.
More Care At Home Being Paid By LTC Insurance
Many people still think of Long-Term Care insurance as only for nursing homes. For many years, these products have been paying for in-home care, adult day care, and assisted living facilities as well, and we now have figures to back that up.
The people who purchase LTC insurance must be healthy to do so, and thus there is a long tail on this product. Claims may not come in until 15-20-30 years or more after its purchase. Thus it can take quite a while for purchasers to use their coverage.
Reports are now starting to come in that people are paying for care at home with LTC insurance. In fact, up to 10% of home care is being covered by LTC insurance that was purchased some time back.
Most people want to stay at home if at all possible. However, they do not wish to be a burden on their family to provide that care. More home care agencies are opening up every year, it’s actually getting to be quite a competitive market. Having the cash flow to pay for this care is what LTC insurance policies provide.
Family gets worn out trying to provide all the care a loved one may need. A recent report claims that compared to people who do not provide support, caregivers who did were 79% more likely to experience emotional difficulties and more than twice as likely to experience physical problems as well as financial difficulties.
Dementias like Alzheimer’s Disease are the hardest situation for family caregivers. You may have promised to provide the care, but at some point it may simply become impossible. You may remember your promise, but your loved one probably does not. Dementias can entail a host of caregiving concerns, not the least is that the one cared for may not want to get into the water to bathe, resulting in a struggle every time.
Now we hear on the news that people over age 75 who use heartburn medications have a much higher incidence of dementia.
What does all this mean to you? If you are healthy yet, do not delay – investigate LTC insurance for yourself so you do not end up putting family in such situations. I got mine at 52 and I am thankful I did. Even though I am very active with work and travel, I could never qualify to purchase the coverage I have today at 66.
If you are in Wisconsin, give us a call at TheLongTermCareGuy.com and lets schedule a time to investigate. Dial (800) 219-9203 or of in Green Bay dial 884-3030. We will be glad to sit down and offer idea so you can decide what to do.
LTC Planning, No Matter The Situation
If Long Term Care (LTC) is needed, but not planned for, there are a number of options to make the money last longer or protect some of it. The best and least expensive way to handle this would have been to purchase LTC insurance while still healthy, preferably in your 40’s or 50’s. By the time we’ve hit 60, a fourth of us can no longer qualify to buy this insurance.
I’ll use a recent example where I was called in to a financial planner’s office as his client’s wife was about to exhaust her short duration LTC insurance policy. The client owns a cottage in addition to a house, $200,000 of IRA money in addition to $180,000 of non IRA investments. He owns a life insurance policy with minimal cash value and his wife has one where the cash value is only slightly less than it’s death benefit.
One of the children would like the cottage and may be able to purchase it. Medicaid does not allow two homes, only one, and it must be sold for fair market value so as not to be a gift and disqualify her from receiving Medicaid.
His life insurance policy with a very small cash value but a significantly higher death benefit would be a shame to lose per Medicaid’s requirements. One of their children could purchase it for fair market value (the cash value) and pay premiums to keep it in force until his death. Hers has cash value nearly the same as the death benefit so it could be surrendered and after paying any income taxes on the gain, the remainder could be used to purchase allowed items like plot, marker, vault, casket, etc. This would be in addition to the irrevocable burial trusts they already purchased.
In Wisconsin, the at-home spouse’s IRA accounts are not a countable asset (currently), so we can ignore those for now. This leaves him with some at risk assets, primarily money. If he were to fund irrevocable burial trusts for his children and their spouses now, he would only be allowed to keep half of remaining assets when Medicaid takes their “snapshot” of assets. If he waits until wife is on Medicaid, and the spend down amount is identified, then he can fund those irrevocable trusts for children and spouses of, while keeping his entire half for himself.
A house presents a timing issue as well. If the at home spouse decides to sell the house while spending down to Medicaid (prior to being on Medicaid), the sale price becomes an at risk asset that must be spent down. If the at home spouse waits until the institutionalized spouse is ON Medicaid, and then sells the house, those funds can be retained by the at home spouse.
As you can see, there are things that can be done to protect assets when someone needs LTC. Every situation is different. Knowing what can be done and when to do it can be very helpful. We often have family meetings to simply explain the Medicaid rules. While we can establish the irrevocable burial trusts for you, your children and their spouses, there are no fees for doing so at The Long Term Care Guy.
For more information, visit www.TheLongTermCareGuy.com or give us a call at (920) 884-3030.
Who Are The Caregivers?
Let me start with a study done last year which said: By 2020 (now only 4 years away) there will be more people in the US working as caregivers than working in retail.
This will be true not only because everyone shops on Amazon now, but because we did not have enough children to take care of us in older age and must hire this done, at home or in a facility. Where will all these workers come from?
Most caregiving jobs do not require a college degree. I am getting bulk mail from facilities begging me to come work for them, all training provided, no experience needed. Of course they are minimum wage mostly, and few offer much for health benefits, but the jobs are plentiful. That is because we continue to pass through age 65 at the rate of 10,000 per day. You read in many places, but we are also turning 85 in record numbers as well.
Who are the caregivers that we will hope to find available for our care when needed? There are currently 43.5 million caregivers in the US according to the USA Today newspaper. Their average age is 49, but 24% are between 18 and 34. 19% are over age 65, and 60% are female. Some of them are taking time away from high paying jobs, or turning down transfer or promotions to continue the work they do for loved ones.
Caregivers help with day to day tasks that we healthy people do for ourselves. 78% of caregivers provide transportation. 76% shop for groceries. 72% do housework and cleaning. Meal preparation is done by 61%, while 54% manage finances for another, and 31% arrange other outside services.
They help with daily activities like getting in and out of bed and chairs (43%), getting dressed (32%), getting to and from the toilet (27%), bathing and showering (26%), eating (23%), and dealing with incontinence and diapers (16%). A whopping 57% deal with tube feedings or injections.
How well will your family or children be prepared to take over such duties? Stress is a huge challenge for 26%, not enough time for self affects 16% and 11% find themselves financially burdened by providing care to a loved one, probably because 49% go to work late, leave early, or take time off.
It’s going to get worse. There are currently about 6.7 caregivers available for every boomer who turns 65 in 2016. by 2031 there will be 4 and by 2045, when today’s 51 year old turns 85, there will be just 3 caregivers available for each of them.
It appears that depending on family might not work out so well. I doubt the people who tell me they plan to die peacefully in their sleep might find that plan stymied by their health as well. Those who say the government will provide forget the government is us, and there are too many who will need care for the healthy ones trying to hold down a job and care for us at the same time.
My Long-Term Care insurance policy is getting larger each year by 5% compounded (a built in benefit). I will have the cash available each month to pay for whatever care I might need. Those with the money to pay for such care will always get the best care in the nicest settings. Have you actually thought about what your plan is? By age 60, a fourth of us can no longer buy this insurance. How long will you wait before investigating it? Do you feel lucky this year?
More information is available at www.TheLongTermCareGuy.com
Do Wealthy People Need LTC Insurance?
Some financial planners might say that if you have enough savings, why insure? While that might seem like a fair question, let’s put something in perspective: There is a 1 in 1800 chance of a claim on your homeowners insurance in any given year. HHS says once you’ve reached 65 there is a 70% chance you will need LTC. So which one do they say you don’t need (which can cost many hundreds of thousands) and which one do they make sure you have (which might cost $100,000 to $300,000 – and rarely happens)?
There are several other reasons for wealthy people to insure for LTC. When care is needed, which accounts will be tapped first? Which stock will be sold (or maybe we should wait until next year)? Is it the right time to liquidate bonds? Which real estate should we sell, and what will the capital gains taxes be?
A stream of tax free money (another good reason to insure) that comes every month can leave investments in place to mature. No family fighting over which assets to liquidate. Remember, your children who are arranging all this for you, will be liquidating their inheritance.
Today’s Wall Street Journal had an article on curbing elder abuse. It happens. Someone “borrows” from mom or dad’s estate while they are getting care. If Medicaid is needed when assets run out, these “borrowed” amounts may be counted as gifts making Medicaid unavailable.
” Elder financial abuse is expected to grow dramatically” says the WSJ. The articles suggests financial advisors might soon be expected to report suspected financial abuse. Such abuse is up over 12% in just the past two years. Having a regular stream of insurance payments to cover the costs of LTC means less likelihood of anyone needing to invade savings and investment accounts.
Lastly, the return on LTC insurance, if it is needed, is huge. If you never need to use it, wouldn’t that be wonderful. However, if it is needed, $60,000 of tax deductible premiums over a lifetime can yield nearly a million dollars. And that is not dependent on stock or bond market returns.
So, do you plan to simply spend all those assets down when care is needed? Or will you at lest investigate the insurance that can pay for LTC and leave your assets to go to those you want them to go to? Do so while you are still healthy enough to have this option available.
For more information visit www.TheLongTermCareGuy.com
Long Term Care In The News
Yesterday’s Wall Street Journal had some interesting statistics on labor growth predicted for the next decade. The article stated that 95% of new jobs would be in the service sector.
Previous articles have noted that the fastest growing service profession is caregiving. Earlier this year the New York Times estimated that by 2020 (four years from now) there will be more people working in caregiving than work in retail.
Where are all those low wage workers going to come from? And speaking of low wages, the minimum wage is increasing, in many locales doubling to $15 per hour. Since most Long Term Care (LTC) is minimum wage labor, what will this do to the cost of such care?
Currently $3000 a month is the base cost at many assisted living facilities, assuming you really do not need any help. A median cost is $4500 a month and dementia often goes for $6000 a month. Nursing homes often are $10,000 a month. Costs have been increasing at a rate of over 5% per year (the past 8 years of recession excepted). Now with interest rates having risen, inflation will increase, and minimum wage earners will be demanding higher wages.
How many of you can afford to pay for LTC for very long out of your current savings when your health changes? Many people tell me they plan to die in their sleep, a noble hope, but not likely to work out for you. Can your children leave their jobs, children, homes to come care for you? I doubt it.
The baby boomers continue to pass through age 65 at 10,000 a day. Some of them (like myself) have LTC insurance. The facilities want people like me as they lose money on the low Medicaid reimbursement levels. When there are enough people who can pay for their LTC because they purchased LTC insurance (or the few who are rich), the facilities will start declining to accept people on Medicaid.
I don’t want to think about the day when I can no longer properly care for myself either, but I know I will not become a burden on my children and will have ready access to the care I want, in a nice place I can afford. I no longer stay at Motel 6, even if they do leave the light on for me. I have become accustomed to nice surroundings and have little interest in changing. If home care can work, my policy will pay for that too.
You know the day is coming, are you going to investigate what you can do for yourself, or ignore it until it happens? You don’t need a lot of money to get LTC insurance. Since the fall back option is to sell everything, including the house and your life insurance to go on Medicaid, you might use some of that house equity to get coverage so you can stay home if you want, to or stay in a nice place (not your children’s basement).
For more information visit www.TheLongTermCareGuy.com You can email me questions at [email protected]
How To Care For Two Parents at Once Without Going Broke
“The biggest challenge of all is holding onto your patience.”
Reprinted from Money Magazine
For years, Madeleine Smithberg has been at the forefront of American comedy as co-creator of “The Daily Show” and a talent coordinator for “Late Show with David Letterman.”
That sense of humor was especially handy during the last few years. That is because Smithberg had to cope with not one, but two elderly parents in rapid decline.
“It’s heartbreaking,” says Smithberg, 56, who heads a production company in Los Angeles. “And yet it’s invisible, because nobody talks about it.”
“It’s like having toddlers,” says Smithberg, whose father passed away in 2014 after she moved her parents to Los Angeles. “They’re hot, they’re cold, they’re hungry, they ask repetitive questions, and their needs become the most important thing in the world at that second… The biggest challenge of all is holding onto your patience.”
According to a new study by Northwestern Mutual, the childrearing comparison is apt: 59% of Americans feel that taking care of two parents between ages 85 and 90 would be even harder than handling two kids between ages 3 and 5.
Caregivers may also have kids of their own. In that case, it’s not just the “Sandwich Generation” – it’s a Triple-Decker.
The Northwestern Mutual report found that 38% of those surveyed have not planned at all for handling the financial burdens of caring for elderly parents.
The costs can be gigantic: National median costs for an assisted-living facility are now $43,200 annually, according to insurer Genworth Financial in its annual Cost of Care study. A private room in a nursing home? $91,250.
That is more than enough to blow up any financial plan. The following is advice on how to care for your parents without going bankrupt yourself.
Long-Term Care
“Long-term care, long-term care, long-term care.” That’s the simple advice from Smithberg. Her father had taken out coverage for himself and his wife, which she calls “the best thing he ever did.”
Long-term care insurance covers expenses for nursing home or home care if you become incapacitated – most of which is not covered by Medicare. The coverage, like the care, can be extremely expensive, and to be sure, it did not cover all of Smithberg’s parents’ assisted-living costs. But, combined with their own life savings, the policy has meant that she has not yet had to dip into her own savings to pay for their care.
Have the Talk
With the holidays right around the corner, it is one of the few times of year when far-flung families tend to gather in one place. Don’t let the opportunity slip by to discuss your parents’ expectations, should illness arrive. Find out if they have advance directives – documents that spell out what treatment they would and would not want during a life-threatening health crisis. Make sure you establish who has power of attorney, should they need someone to make important decisions.
“It’s the perfect time to have this kind of conversation,” says Kamilah Williams-Kemp, Northwestern Mutual’s vice president of long-term care. Her spouse’s grandmother lived to 102, and her mother-in-law has been diagnosed with Parkinson’s.
Consider a Reverse Mortgage
Reverse mortgages allow homeowners aged 62 and above to borrow against their home equity and to receive either a lump sum, a series of monthly checks or a line of credit that can be tapped as needed. The upside of a reverse mortgage? With the bank paying you every month, instead of the other way around, that check can help cover costs for in-home caregivers.
Tom Davison, a financial planner in Columbus, Ohio, is working with a 90-year-old woman whose daughter moved in with her as a caregiver. “A reverse mortgage could help (the daughter) pay her the wages she has given up,” Davison said.
Be sure to have proper documentation that the child is actually employed by the parent. If not, and later Medicaid is needed, Medicaid will count each payment to the child for care as a gift, disqualifying the parent from Medicaid. rraabe
The downside, of course: The family home will eventually become property of the bank.
The proceeds from the reverse mortgage can also be converted to an income for life – but NOT like an ordinary annuity which uses your average life expectancy. When health is not good and life expectancy is less than “average” then a company that takes that poor health, and “shorter than average” life expectancy into account gives a much larger monthly payment. rraabe
Get Help
Your first instinct as a child may be to drop everything and handle all your parents’ needs yourself. But if it comes at the cost of your own career, think about the ripple effects – on your retirement savings, on the needs of your own kids, even on your own sanity.
With Americans extending their lifespan – 76.4 years for men, 81.2 years for women, according to the National Center for Health Statistics – this is a family challenge that won’t be going away anytime soon.
Denver financial planner Kristi Sullivan recommends hiring a case manager to do the heavy lifting.
“For an hourly fee, these people can handle tasks quickly that it might take you hours to do – scheduling doctor’s appointments, handling medical payments and dealing with insurance, helping find a good nursing home or in-home care,” Sullivan says. “Spending this money may seem expensive, but it’s less than putting someone’s career on hold to become a full-time caregiver.”
For more strategies, financing options, or ways to deal with the costs of Long Term Care even if not planned for in advance, contact www.TheLongTermCareGuy.com
Private Industry Has Solutions For Funding Care At Home That ADRC’s Do Not
I attended a dementia hearing recently. Eight Wisconsin legislators were listening to ideas and problems in dealing with dementia in Wisconsin. Many of those testifying spoke of how people will not accept home care because they think they cannot afford it.
People rely on family for help and care because they cannot afford home care. The most common advice these people receive from social workers and ADRC’s is to spend down to impoverishment and end up on Medicaid. In many cases, this means selling the home and moving to a facility with absolutely nothing left at death to pass on. No wonder people are terrified of needing Long Term Care someday.
Private industry has solutions as well, and often times they are completely overlooked. I am not speaking of LTC insurance here, once care is needed it is way too late to be trying to buy insurance. Let me give you an example.
Imagine you are an older American, living in your home (the only real asset you have) with very little money in savings and trying to get by on Social Security. You know you cannot afford to pay $1000 to $2500 a month for home care and so you just try to get along by yourself or with the help of family or friends.
Someone in this position often does not realize they can utilize the one remaining account they still have – Bank of House. A reverse mortgage is not something to go into frivolously, but as a last resort, it can keep you in your home.
You could take out the available money from a reverse mortgage and spend it for care until it is gone, but wouldn’t it be much better if the money lasted as long as you did? There is a way to convert the equity in your home into an income for life – a monthly check to use for home care that continues until the day you die, no matter how long that is.
If you used the proceeds from a reverse mortgage to buy a regular life income annuity, that would probably be a very bad idea. A life income annuity is based on how long the annuity company thinks you will live – based on age and gender. Remember, your health is not the best, you need care, and may not have as long a life span as others of your chronological age who are healthy.
There is one company that takes your poor health, and thus your shorter than average life expectancy into account, and will require far less money in return for that income for life -based on your shorter than average life expectancy – than a regular annuity would. Many times I have been able to convert the equity from the reverse mortgage into enough monthly income to pay for home care and keep people in their homes for the rest of their life.
So, often it comes down to this choice: Sell the house, spend down the money until impoverished, apply for Medicaid, and end up in a LTC facility with nothing left over. Or, take the equity in the home out through a reverse mortgage, and convert it into a life income, paid monthly, for as long as you live. By taking into consideration that your life expectancy is less than other healthy people of your chronological age, you get a bigger income and can pay for the home care you thought you never could afford.
For more information visit www.TheLongTermCareGuy.com or call me at (920) 884-3030 or (800) 219-9203
Being Stuck In Sandwich Generation Is No Baloney
Reblogged from CNBC
One-time real estate agent Evelyn Rehg was showing a house to a prospective buyer four years ago when an alarming phone call came from the retirement facility where her mother lived.
“They told me I either had to get my mother immediately into a mental hospital or she would be evicted,” said Rehg, 48, of Crestwood, Missouri. “I panicked,” she added. “I didn’t know how to handle it insurance-wise, what hospital to take her to or anything like that.”
Rehg’s mother, 80, suffers from mild dementia, severe anxiety and manic behaviors that now are treated properly. But prior to the phone call, her mom’s anxiety had become so debilitating that she began calling Rehg’s cell phone upward of 200 times a day.
In desperation, Rehg, then still working in real estate, changed her number because she needed her phone for work. So instead, her mother started incessantly calling the front desk at the retirement facility. “They put up with it for about a day and a half,” Rehg said. “Then they called me.”
Rehg also has two children, who were then 12 and 9 and needed supervision and care. That meant that her husband, Jon, had to adjust his work schedule to tend to their needs.
Financial advisors say that in addition to the emotional drain, “sandwichers” may also face a financial burden if they haven’t taken an interest in the steps parents have put in place to ensure they receive proper care.
“It’s important to talk about financial things, but allow your parents some space,” said Rita Cheng, a certified financial planner and chief executive of Blue Ocean Global Wealth.
“You don’t need to be completely involved in their business, because they still want to be independent and in charge,” she said. “But ultimately, if they want to be in charge of how they are cared for, they need to be proactive and plan for it.”
After the call that made it clear that her mom’s condition had deteriorated, Rehg checked her into a mental health facility. It was the first of a handful that Rehg had researched before her mother received a diagnosis and effective medication.
But then her mom fell and broke her arm and spent several months in a rehab center. She then lived in Rehg’s house for about six months, until the situation became too challenging for the whole family.
Rehg, who by then had given up her real estate license, eventually found a suitable assisted-living facility and moved her mother there.
Gregory W. Edwards, a CFP and partner at Lawless Edwards & Warren Wealth Management, is also in the sandwich generation. His father, who had lived next door to him since 2001, died in 2011 after losing his battle with Alzheimer’s disease.
His dad was financially well-equipped to pay for his care, but Edwards organized it—and it was complicated, because his father’s wishes stated that he never wanted to be put in a nursing home.
During the last two years of his dad’s life, the cost to care for him in his own home was $7,000 to $8,000 monthly.
Additionally, Edwards and a brother each now give their mother, who was divorced from his father years ago, about $1,800 a month toward her various expenses, medical and otherwise. “People have no idea of what’s coming down the pike when it comes to the cost of care in the last months of life,” he said.
For many sandwichers, the pressures from the parent side outweigh those from the child side.
“The hardest part is feeling overwhelmed and overworked. Sometimes you have to make hard choices and you have to be patient with yourself.”
Rehg said that without her husband, she doesn’t know how she could have managed the situation.
“It was the hardest thing I’ve ever been through in my life,” she said. “At the height of it, I was probably spending 40 hours a week on my mom—paying bills, talking to doctors, visiting her, medicines—and trying to work 30 to 40 hours a week and take care of the house and two kids.”
Cheng at Blue Ocean Global Wealth said that it is a difficult balancing act.
“The hardest part is feeling overwhelmed and overworked,” she said. “I have to give myself permission that I’m only one person and this is stressful. Sometimes you have to make hard choices and you have to be patient with yourself,” Cheng added.
There are strategies that can help no matter what your current situation dealing with LTC. In some cases, even if someone is on Medicaid already there may be ways to help improve the financial situation. Of course, owning a good LTC insurance policy is the best way to have the cash flow to pay for the help you need. For more information visit www.TheLongTermCareGuy.com