There’s a reason why most purchasers of long term care insurance are individuals who’ve gone through a caregiving experience. They understand what it means to be a caregiver, or, though not a caregiver themselves, they may have witnessed enough of the travails of caregiving to recognize the value of a policy.
Merriam-Webster’s dictionary defines the term “rabbit hole” as, “a complexly bizarre or difficult state or situation conceived of as a hole into which one falls or descends.” The definition continues, “especially: one in which the pursuit of something (such as an answer or solution) leads to other questions, problems, or pursuits.”
Coordinating a need for long term care is the best example of a rabbit hole I can think of.
Depending on the nature of the condition which predicates long term care, someone is thrust into the following systems and predicaments, often with little or no notice:
- Medical care/skilled care— is usually covered by Medicare and a Medicare supplement, either of which will determine the expected duration of follow-up care before the patient is discharged.
- Discharge to a safe environment— involves making the environment safe for the patient needing long term care; equipment, and modifications may or may not be covered by Medicare and Medicare supplements.
- If non-medical custodial care is required, it is almost never covered by Medicare; in such a case, care options range from home care (primarily private pay) to assisted living (primarily private pay). Nursing home care, the kind of care most people want to avoid, can be covered by Medicaid (for those whose finances are below the means-tested thresholds).
Once Medicare stops paying, it’s typical to find yourself in a “hot potato” type game where unless you can flash a long term care insurance policy or a large bank balance around, you won’t receive many choices for professional care. The Covid-19 pandemic has accelerated the pre-pandemic shortage of professional caregivers, so you may find limited choices. However, private payers (which includes long term care insurance policyholders) traditionally fare much better than those without money earmarked for care.
Beyond finances, unfortunately other problems still await. The rabbit hole of long term care is a topsy-turvy world where a family member is presumed to always be available for phone calls to schedule appointments for a variety of services. Some providers don’t even support email communications; if they can’t reach you or the patient, you may suffer a delay in scheduled services. Oh, and there may be different calls for medication management, OT, PR, speech therapy certified nurses aides, and specialist appointments. Not to mention house cleaning and laundry.
Once someone leaves a skilled nursing facility (AKA a nursing home, where rehab care might have occurred), there’s little standardization in anything. So, for example, when you endeavor to arrange home care, you may not realize that the hourly rate they charge is but one consideration. It’s common for one agency to have a two hour minimum visit charge, while another agency has a four hour minimum visit. Say you want two visits a day: one around breakfast/shower time and then another visit at the end of the day. The second agency would bill you for eight hours of care, while the other would bill for four hours only!
You may find that a home health aide, or even the caregiver in an assisted living facility, can prepare the 7-day cassette for morning and evening medications, and can remind the patient to take their pills. However, in many settings, did you know they are not allowed to physically put the pills in your loved one’s hands?
In view of the complexity of the long term care rabbit hole, one of the best ways to help prepare for an eventual care need is to investigate— now. So, how does care including home care work in your area? Talk with friends and relatives who’ve gone through a care need in their family. Ask them specifically what they learned, and what they wish they’d known then that they do know now.
A long term care policy won’t reduce the rabbit hole of long term care, but it will provide you with a funding source (and, sometimes, a care coordinator). Long term care is difficult. Long term care insurance makes it easier.
Please don’t hesitate to reach out to discuss any aspect of long term care planning or long term care insurance you might need more information about. Baygroup Insurance can be contacted at http://www.baygroupinsurance.com/forms/contact-us or call us at 410-557-7907 for more information.