A. Long-term care is a variety of care services that includes medical and non-medical care to people who have a chronic illness or disability. It is assistance with those activities of daily living that an individual cannot accomplish alone, or services typically provided following an injury or illness, or when advanced age and frailty render individuals unable to care for themselves.

A. The activities of daily living (ADL’s) are: Bathing, dressing, continence, and toileting, transferring, eating and ambulating.

A. Yes, the various levels of care are:
• Personal care (also called custodial care): help with bathing, grooming, transferring from a chair to a bed, taking medications, and other activities of daily living. Services at this level are provided either at home or in a residential facility.
• Home health care: medically oriented services provided to a person at home by a nurse or other medical personnel, usually on a part-time basis.
• Intermediate care: care provided by skilled personnel, such as a speech, physical or occupational therapist-on an intermittent basis rather that daily. Services at this level are provided at home or in a residential facility.
• Adult day care: a program of therapeutic, social and health activities with services offered on a per-day basis. These services are provided at specialized centers that are either free standing or part of a larger medical facility.
• Assisted-living (also called residential care): provides personal care and some medical care for people who live in the assisted-living facility (usually called “residents”).
• Skilled nursing: care provided by licensed personnel, such as nurses, for people who are under a physician’s order 24 hours a day. This care is provided in a hospital, nursing home, assisted-living facility, or at home. A Skilled Nursing Facility (SNF) is an independent facility or specialized unit of a larger medical facility that provides this level of care.
• Respite care: part-time, occasional care for a person while his or her at-home caregiver, such as a spouse or adult child, takes time away from 24-hour-a-day care.
• Hospice care: care for individuals and their families in the last days and weeks of the individual’s life.

A. You may never need long-term care, although this year about nine million men and women over the age of 65 will need long-term care. By 2020, 12 million older Americans will need long-term care. Most will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly.

A. Consider long-term care when someone can no longer perform basic functions by themselves. Perhaps they need a medical professional to assist them with various tasks, which can be as simple as getting out of a chair or as complex as cooking a meal or bathing. Both mental and physical ailments can bring about a need for long-term care, including strokes and car accidents. Alzheimer’s disease is just one of the many conditions that requires extensive long-term care.

A. It is important to realize that long-term care is not just for the aging. Forty percent of people in nursing facilities today are under age 65. The average hospital stay is now two days. People recovering from a serious accident or illness will find themselves quickly released from a hospital to a separate facility for continued rehabilitation or skilled nursing care.

A. Most medical policies require a three-day hospital stay and immediate transfer to a rehabilitation or skilled nursing facility for this benefit to be paid by the insurance company. Therefore, most individuals will not be covered by that insurance if forced to leave the hospital in less than three days.

A. With continued decreases in government support, the best, and sometimes the only way to ensure that you get the type of care you want when you most need it is by planning ahead. The benefits of planning ahead include:

A. You may want to speak to an attorney, an accountant, a financial/investment advisor, and an insurance broker or agent.

A. These activities include the preparation of individual meals, shopping by oneself, using the telephone, paying one’s bills, managing one’s money, doing light housework and the ability to take medications.

A. Yes, a qualified financial advisor and/or financial planner.

A. What you can do at this point is:

A. An unplanned long-term care event can be financially and emotionally devastating at any age.

A. Planned activities to keep a senior’s mind active; such as, memory games, art projects, gyms, painting, gardening, exercise classes, field trips, concerts and lectures.

A.An injury or an illness can incapacitate an individual at any age.

According to a report by the Alzheimer’s Association there are 500,000 Americans who get the disease when they are younger than 65 years of age, the early-onset category.

A. Experts say a person diagnosed with Alzheimer’s disease at or before the age of 40 is likely to live another 20 years. The estimated costs for caregivers are an average of $19,000 per year in out-of-pocket expenses.

A. The new Medicaid restrictions further encourage long-term care insurance while young and healthy before becoming too old or sick to qualify. The older you are the higher the premiums.

A. Because the need for care increases with age, it is important to plan for your long-term care needs while you are healthy.

A. To preserve an estate, provide good tax planning, to maximize estate transfer at the lowest level tax and to be provided with a full range of choices.

A. Yes. The average middle-class American has enough assets to cover long-term care costs for approximately one year, after medical expenses and other incidental costs are factored into the equation.

A. It is estimated that 25% of all households have one adult providing care for an elderly person. This number is expected to increase substantially over the next ten years. For working caregivers, the strain of balancing work plus care giving can hurt job performance and productivity. Working adults caring for elders in their home have more unscheduled absences and unexpected emergencies that interrupt their work during the day or require them to adjust their schedule. In addition, many individuals caring for an elder in the home are forced to reduce their hours or turn down addition responsibilities.

A. For employers:

A. The reason people don’t buy long-term care insurance is denial and high premiums.

A. The primary reason people don’t buy long-term care insurance is denial and high premiums.
A. A 1991 study by Kemper and Murtaugh in the New England Journal of Medicine estimated that 65-year-old males have a 33% probability of needing a nursing home sometime during their remaining lives. The corresponding probability for females is 52%.

A. According to the National Nursing Home Survey (1999) data indicate that buying long-term care insurance appears to be preferred over self-insurance for all but the most aggressive female investor. It is also desirable for cautious male investors, but may not be for more aggressive investors. According to the New England Journal of Medicine long-term care insurance is desirable for almost all males studied, and continues to be more desirable for females. Market quotes in 2006 did not produce any major changes for women, but the purchase of long-term care insurance was even less desirable for some males.

A. A financial professional can help with decisions such as: