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IN YEARS past, long-term care (LTC) usually meant going to a nursing home for a few months or years, and then passing away. This is no longer true.

Long-term care now covers a variety of custodial (unskilled or semi-skilled) types of care.  Although nursing homes are still part of the long-term care equation, there are many other options to consider:

  • Home health care
  • Community-based care
  • Assisted living facilities
  • Adult day care
  • Respite care
  • Hospice care

In many instances, the care that used to necessitate confinement in a nursing home can now be provided in the home or an assisted living facility.  

One of the most requested benefits of long-term care insurance is the option to stay at home, and/or to keep one's spouse or other family members out of a nursing home, for as long as possible.  

In today's world, many care facilities are integrated. That is, you can live in a retirement community and receive home health care services; move to the assisted living facility and receive increasing levels of care; and finally enter the nursing home or cognitive impairment facility.  

Another interesting aspect of long-term care is this: many people transit through the various care options and eventually are able to return home or to a less demanding level of care. But, this presents a problem if Medicaid is your payment source.

In order for Medicaid to pay your long-term care bills, you generally need to be in a nursing home or cognitive impairment facility. 

Most states do not pay for other forms of care. You also have to be nearly destitute. So, if you give away assets or spend them to qualify for Medicaid "aid," and you get well enough to leave a Medicaid-covered facility, what will your plan be?  Definitely something to keep in mind.

It's important to have discussions - with your spouse, your aging parents, your adult children - about what long-term care really means. A couple of important items for discussion would be: how you (or they) will pay for this care, and who will make the decisions if you (or they) are not able to do so.

You should also take time to visit the various facilities you might want to live in. If you are considering selling your home and retiring to an integrated retirement/long-term care campus, make sure you like all the aspects of the facilities. 

Many of these facilities require you to pre-pay large sums to ensure you can transition smoothly from one living arrangement to another, so it is important to make an informed decision.

As you can see, LTC now covers a very different set of circumstances than when your great-great uncle or great grandfather went into the nursing home.  With a bit of planning and a strong long-term care insurance policy, you can continue to live almost a normal lifestyle well past the time you might otherwise have ended up in a nursing home. Give us a call if you would like to discuss your options.

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