Have you ever wondered….

Do you have questions about the cost of long term care?
Do you have questions about the cost of long term care?

Do you have questions about the cost of long term care?

Do you have questions about the cost of long term care?

Are your clients confused about the many options, how to choose coverage, or if it’s necessary for them?

I’m Romeo Raabe LUTCF, LTCP and I’m known as The Long Term Care Guy–in fact, my website is www.TheLongTermCareGuy.com and I work exclusively on Long Term Care (LTC) issues.  Some examples  include how to get the most from LTC insurance, how to start a claim, what to do if care is needed and there is no insurance—and much more!

I also offer insurance for LTC and have options most financial professionals are not even aware of.  For example, this week I put coverage in place for a couple ages 87 and 84 for less than $90/month a piece.

Even if someone is in care – even if already on Medicaid – I may still be able to help.  If you or your clients have questions, feel free to call me at (920) 884-3030.  I am here to help anyone dealing with or concerned about LTC.

Contact ROMEO RAABE about the cost of long term care!

PS: There can be huge differences in LTC insurance policies—I can help you understand the differences, and probably even set you up with other strategies most other advisors don’t know about!

Happy Holidays – How is Grandma?

Happy Holidays! How is Grandma?
Happy Holidays! How is Grandma?

How is Grandma? Are bills piling up unpaid?  Is hygiene slipping? Are they not eating as well as they should, or is the house unkempt?

While your family was together at Thanksgiving, was there evidence that older family members are not taking care of themselves as well as they could be or used to?

Perhaps your loved one is not driving as much as before, or perhaps should not be driving at all. Are bills piling up unpaid?  Is hygiene slipping? Are they not eating as well as they should, or is the house unkempt?

It is never easy to meet with siblings and parents to talk about how and where they will be helped with future living arrangements.  Then you check into costs at senior living facilities and wonder how can this possibly work.

Hello! My name is Romeo Raabe, and I am a long-term care (LTC) planner at www.TheLongTermCareGuy.com.  I help families learn how to convert homes into income to pay for LTC facilities.

I help families navigate the federal Medicaid programs that can pay for LTC.  I even have ways to help protect the money for family, rather than all going toward LTC costs.

If this discussion has started, or is about to, call me at (920) 884-3030 and let’s schedule a time to visit and see if I can help you and yours.  It’s never too late and you don’t know what you don’t know.

 

 

 

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:

  1. Is your home safe and accessible for your mother, now and as she ages? If not, do you have the resources to remodel?
  2. Is your mother able to contribute financially, and are you financially prepared for the extra costs of caregiving?
  3. How do your spouse and children feel about the move-in? How well do all of you get along with your mother now?
  4. Have you discussed the lifestyle changes involved in having an elderly person in the house? Does the family agree to these changes?
  5. Will your mother be able to live by the rules of your house, support your child-rearing decisions, respect your values?
  6. What kind of care will your mother need, now and possibly in the future?
  7. Do you have the time to take this on? How much supervision and assistance can you and family members provide?
  8. Will you be able to cut back on work responsibilities during those times when you need to be home to care for your mom?
  9. 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?
  10. 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.

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.”

Dealing with one aging parent is challenging enough, whether you are helping navigate the complex healthcare system, paying for an assisted living facility or struggling with cognitive decline as the parent slips away. But the emotional and financial stress can be more than double if you are caring for both parents at the same time.

“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

Do You Know Someone Who May Soon Need Help Managing On Their Own?

We all dread the time when we may need some assistance due to not being able to manage on our own anymore.  It happens to others, but surely, not us.  We are never prepared when a loved one needs help, and then we find out how expensive such care is.   There seems to be no one place with all the information we need to formulate a plan.

Many family meetings occur in my office, trying to figure out how the family will care for Mom or Dad.  The usual questions include: will the VA provide any assistance?  Yes, perhaps, through a program called Aid and Attendance. It is a needs based program (meaning your assets must be somewhat limited) that can be available to veterans and even their spouses to help pay for care.

Medicaid is another possible assistance program.  It, however, requires strict impoverishment, spending down to very low asset and income levels and is a last resort.  There are things a family can do to protect some assets from this spend-down requirement, and this is often a topic of much interest.

If some funds are available from savings or home equity, there are some little known strategies to produce an income for life that requires far less of these assets than a typical life annuity.   When life expectancy is less than “average” for someone’s chronological age, this can seem like a miracle.  Being able to pay for the needed care and never running out of money is a very good thing indeed.

If you or someone you care about is going to need some help with day to day activities, and you have no idea where to start looking for help, call us at The Long Term Care Guy.  We are Wisconsin specialists based in Green Bay, but can help with questions no matter where you are.

Give us a call at (920) 884-3030 or (800) 219-9203 or send us an email at [email protected]

 

Mom Is Entering A Nursing Facility, Can We Still Get Her Some LTC Insurance?

It is often a very sudden thing when we realize a loved one needs care in a long term care (LTC)  facility.  Sometimes it is within hours of a hospital discharge, other times we may have a day or two of advance notice.  This can be a very tough thing to do if there has been no advance investigating of available facilities.  Some specialize in dementia, others are designed for those who at cognitive and somewhat ambulatory.

Then you learn the cost of facility care.  Nursing homes often run $8000 a month in Wisconsin outside of Milwaukee and Madison.  Assisted living or CBRF’s may start around $3000 a month but the cost escalates depending on the cares required.  If your loved one does not have LTC insurance, the assets may be used up in a very short time.

Once a person requires LTC services it is too late to purchase LTC insurance as they have already met the requirements to be on claim.  However, all is not lost.  There are alternatives that can help even if care is already being received.

If the loved one or spouse is a veteran, there is a needs based program called Aid and Attendance which may help with some of the costs.  Check with your local VA office to see if your loved one qualifies.  In addition to this is another government program open to any resident called Medicaid.  It is also a needs based program and assets must be “spent-down” to very low levels to qualify.  A single person can retain only $2000 of assets including the house, car, IRA, investments, etc.  They can keep $45 a month from any income source(s) for income, and must cash in any life insurance they own if the face amount is over $1500.  If any money was given away in the past 60 months, a penalty period will be imposed before Medicaid is available.

In many areas, Medicaid means you will be in a nursing home, even if that level of care is not required (this is just one of the reasons to consider LTC insurance while still healthy).  At death, the $2000 may go back to the Medicaid program leaving literally nothing available to pay for the funeral.  Often adult children pool their available savings to pay for funeral expenses.  This can be avoided if the person requiring care has set aside money for funeral expenses in an irrevocable burial trust (IBT).

The IBT can hold up to $15,000, even if that person is already in care and spending down.  In addition to their own IBT, the same type of fund can be established for each of the children and the spouses of those children.  The IBT (for self or children) does not count as a gift and there is no 5 year look-back or penalty period.  If there are 4 married children, an additional $120,000 can be protected for burial expenses in addition to the $15,000 for the person needing care.

There are even more ways to protect funds, or make the money last to pay the bills for LTC.  It is best to consult with an expert in this area to learn what you can do.  Call Romeo Raabe at (920) 884-3030 or (800) 219-9203 to arrange a meeting and investigate what your options are.