Making Life Better For Seniors In Phoenix With Home Care

Phoenix is the capital of the U.S. state of Arizona and the fifth most populous city of the United States. It was founded near the Salt River in 1868. It has become a major financial, industrial, transportation and cultural center of Southwestern United States.

While Phoenix has big public library, Chase Tower, the tallest building in the state and long native American heritage, it does lack better non-medical senior care and personal care services for its large population. There are hundreds and thousands of elderly people in Phoenix who need assistance to live a better life.

As the members in family grow older their grown up children find it taxing to take care of them. It leads to friction at home at a time when aging parents need most support and understanding in this phase of their lives. A better option to help aging members in the family is to provide them with senior care. Home care Phoenixcity’s seniors need, can come from companies who provide services for senior care as well as personal care.

Ailing or physically weak elderly persons require highest level of compassionate personal care. Skilled, loving, caregiver Phoenix individuals can be of great help to make a difference in lives of these senior people. Providing personal care and living assistance to elderly people is a noble service and many companies are coming forward to render it to the masses in Phoenix.

Seniors who like to stay at home instead of spending days in retirement homes can be provided in-home personal care service. They can be renedred assistance in doing their grocery and shopping, cleaning home, cooking meals and driving them to community activities. In case of illness some caregiver Phoenixor senior care service provider can take them to doctor or hospital for treatment.

Senior people love to be at home where they have spend years and like to be near their family members and friends. At home senior people need companionship, particularly when their adult children are working, or out of city. Personal care providers take care of mechanical routine of cooking food and cleaning house. They provide companionship and keep them fit by taking them to daily walk. Senior care service providers also keep elderly people alert by reading to them about daily news and TV sitcoms.

Senior homecare Phoenix is not an easy task. It requires tons of patience, skill and physical strength which can be rightly provided by caregiver Phoenix alone. Although in-home senior care costs money, its benefits cannot be matched with cash value.

Senior care provider or personal care provider take care of following chores daily.

Preparing special meals on time, feeding them, giving bath, dressing, taking them to doctor, giving medicine, cleaning and dusting, laundry, shopping for their needs playing and reading for them and taking care of pets.

In-home care enables you to go to your work without worries while making lives of your seniors better and more comfortable.

Senior Care North Carolina – Improving the Quality of Life for Family Caregivers

When the entire baby boomer generation has reached retirement age in 2030, an astonishing number of U.S. families will have faced the challenge of providing care to an aging loved one. Today, caregivers are present in one out of every five U.S. households. With over 80% of these being family members, and with demand for caregiving only expected to increase as members of the boomer generation reaching retirement age grows steadily, there is becoming increasing need for outside help.

For millions of Americans who offer informal care to ill or disabled family members, caregiving is a Catch-22. On one hand, the commitment to provide care is a very rewarding personal experience. At the same time, numerous studies have quantified how exhaustion, worry and ongoing caregiver demands can cause chronic stress, depression, anxiety, premature aging, high blood pressure, headaches and back pain.

Given that most family members begin providing care to their loved ones without training or counseling, they often are not aware of the overwhelming stress associated with it. For many, caregiving is not the only role they are filling as adults. Most are married or living with a partner, have a full time job and children at home. Thus, friends, family, spouses and even family caregivers themselves should be aware of the stress associated with caring for a loved one.

Fortunately for family members, there are steps that can be taken to help alleviate some of the pressures associated with caring for others. Most of these steps are centered around self-care and personal well-being, as staying healthy while caring for a loved one is of supreme importance. Some things that family member caregivers can focus on include: eating nutritious meals, exercising, engaging in social activities, finding time for personal relaxation as well as joining a support group.

It is important for caregivers to take the necessary steps to ensure that they get the proper nutrition, exercise and respite they need. On top of this, in-home care can also be a viable option for many families. Professional home care agencies have well trained staff available to provide support for a wide range of situations.

Senior Home Care Services Can Provide an Alternative to Long-term Care

It can be wrenching to see the independence of a loved one or family member decline. Simple tasks that used to be effortless, such as cooking a meal or keeping a house tidy, can become impossible for someone who is recovering from a hospital stay or whose strength is declining with age.

As the population ages, more and more people will face the reality of an older adult who may need assistance to live independently. For many in this group, a nursing home or retirement center is more than they need; and yet complete independence isn’t realistic, either.

One option that is becoming increasingly available across the nation is senior home care services. These services allow many people to remain in their homes and enjoy the independence of their daily routines and familiar surroundings. Senior Home care services typically provide non-medical help with daily living tasks including meal preparation, light housekeeping, errands or even simple companionship.

When considering a senior home care service, it’s important to know about the agency providing the service and its process for screening and matching its employees with care recipients.

It’s never easy to make the decision to invite a stranger into your home to provide senior care home. But there are steps to take and questions you should ask of an agency that can help minimize the emotional trauma of leaving a loved one at home alone.

Of course, the first requirement is a criminal background check for any caregiver. However, we also believe it’s important to screen for intangible traits such as a caring personality and a desire to help people.

The most important step in screening is to verify the quality of the caregiver’s employment history while choosing a caregiver from any senior home care agency. Many senior home care agencies focus on building relationships with each client.

After a caregiver has been placed with a client, the agency should continues to monitor service through telephone calls and in-home visits to make sure the client is satisfied with the caregiver and the services provided.

Senior home care agencies now provide a range of non-medical services including assistance with hygiene (subject to restrictions in some states), meal preparation, light housekeeping, errands and shopping, weekend or holiday care, live-in or live-out care, temporary or long-term, and respite for family care givers. A senior home care agency also provides personalized care for seniors as an alternative to assisted living facilities or nursing homes. The longer a senior can remain in their own home, the more active both mentally and physically they will stay. Companions provided from home care agencies can help an individual with their routine and assist in their activities. It is a priority for a patient to continue to live a healthy lifestyle, which maintains a sharp mind, and using elder care services contributes to this goal.

Managing Long-Term Elder Care

When senior citizens find that they have a harder time doing daily activities and functioning in everyday life, they may consider the option of utilizing some kind of long-term care. There are many different ways that senior citizens and those coordinating their elder care can seek assistance without creating a financial burden. Though some options will be discussed in this article, it is always best to discuss your needs with your physician and family in order to make the decision that best fits your needs and abilities.

There are many people who volunteer or work with non-profit organizations that provide caregiving services to senior citizens. These groups tend to help with basic daily life activities like shopping, traveling, or providing prepared meals to those who have difficulty accomplishing these tasks on their own. The following is a list of services that are typical in many communities:

Adult day care
Meal programs
Senior citizen centers
Friendly visitor programs
Help with shopping and transportation
Help with legal questions, paying bills, or other financial matters

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In home health care is a more personal option that provides more focused and individual attention to senior citizens who require aid for longer periods of time throughout the day. There are in-home health care agencies that provide elder care for senior citizens who need the extra support apart from what friends and family already provide. Apart from agencies, you may consider hiring independent in-home health aides. You can locate independent aides through www.TheCaringSpace.com and other resources. Using an independent caregiver may be more cost-effective than using an agency. In-home health aides can offer help with daily activities such as preparing meals or household chores as well as general health management.

Senior citizens who require extra assistance may be able to live with family or friends in something called an Accessory Dwelling Unit (ADU). Smaller unused sections of the house like a basement or attic can be used as ADU, which typically serves the purpose of maintaining privacy while providing safe and accessible living space for loved ones who require aid. ADUs can also be added onto an existing house.

 

 

Another option that can provide more focused care than subsidized housing is a board home, care home, or group home. There is usually a team of individuals at these facilities that can offer more basic help, but they do not often provide private caregiving services. Again, the cost of living is often dependent upon the income of the individual living there.

Organizations that provide medical services to senior citizens in addition to living arrangements are commonly called assisted living facilities. These organizations usually provide more care to those who need medical assistance or more intensive care throughout the day.

Continuing Care Retirement Communities (CCRCs) are communities that offer a wider variety of living conditions and services according to the senior citizen’s need. This allows for movement within the facility as the senior’s abilities and health change. These may require large fees for admissions.

in home health care professionals, doctors, and counselors who try to make these patients and their family members and friends as comfortable as possible.

 

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For people who need rest after caring for others, respite care provides relief services. People receiving hospice are covered for up to five days to check into a hospital or some other care facility that provides services while the usual caregiver is on leave from the position.

For more information on long-term health care and other topics relating to seniors, visit www.TheCaringSpace.com.

Many Americans Need Long-Term Care

Most Americans fear they’ll need long-term care at some point after retirement, but only a small percentage are are doing anything about it, according to a survey conducted for the John Hancock Life Insurance Co.* It states that 85 percent of respondents worry about needing long-term care at some time in their future, an increase from 80 percent a decade ago.

Long term care addresses a wide range of long term care and supportive services for people who may have cognitive impairment or who are unable to accomplish certain activities of daily living over an extended period of time. These can include activities such as bathing, continence, dressing, eating, toileting, and transferring. Long term care services can be provided in a variety of settings, including your home, assisted care facilities or nursing homes; and it can be very expensive.

Many Americans incorrectly believe Medicare and/or Medicaid will help fund their long-term care expenses. This is simply not true. Some feel they will be able to “trick” the system, but this has become much more difficult to do. The Deficit Reduction Act that was signed on February 8, 2006, has caused most states to radically alter Medicaid parameters and long term care programs. The loopholes are being closed.

The study also found that almost 60 percent of the respondents worry about paying for long-term care, but nearly 70 percent of these people said they have done little planning, if any, for long-term care needs. Furthermore, Americans are living longer, care costs are rising, and company pension programs are being cut back. Because the average cost of nursing home care has risen to more than $71,000 a year, the costs for in-home care are also rising and it is apparent the rate of future increases will continue to be high; there is a looming crisis in America. Americans are not facing the realities of what lies ahead, especially the potential need for long-term care.

Right now, Americans seem to be avoiding the issue. According to the survey, more than 60 percent of adults haven’t tried to calculate the amount of money they need for retirement. Of those who did the calculation, nearly half didn’t factor in long-term care. Of those who did, nearly four in 10 did nothing about it.

One important financial tool possibly being overlooked is Long-Term Care Insurance. Many people do not realize this type of insurance can be tailored to fit a persons budget as well as help with some of the potential costs of long term care. In other words, there are many variables that can be tailored to meet an individual’s financial budget as well as help with the cost of future long term care needs. A qualified Long-Term Care Insurance representative should be consulted to help develop an appropriate plan.

* The survey was conducted by Greenwald & Associates.

A Buyer’s Guide To Long-Term Care Insurance

Long-term care insurance can help defray the costs of a nursing facility, home care, or other paid long-term care for your parents — or for you. Because the older you get, the more expensive the premiums, people usually buy long-term care insurance in their 50s or 60s, which means it may be more relevant to look into it for yourself than for your elder parents. But it may still be affordable and available for your parents if they’re in their 70s, depending on their health history.

A policy with poor terms and coverage is a waste of money. So, if your parents are going to buy this insurance, be certain they get a policy from a reputable company, and make sure it has good provisions regarding premium raises, types of coverage, inflation protection, and coverage eligibility and exclusions.

Once you and your parents have narrowed your choice to a few policies, you can use the long-term care insurance buyer’s worksheet to compare policy terms and conditions side by side.

Long-term care insurance basics

Here’s a quick summary of the basics, pro and con, regarding long-term care insurance:

Best For

· People with liquid assets between $200,000 and $1,500,000
· Those who don’t have extended family who are willing and able to provide unpaid long-term care
· People who will have enough retirement income to cover premium payments

Not So Good For

· People with less than $200,000 liquid assets
· People whose retirement income may not be able to keep up with premium payments

Look For

· Controlled premium hikes
· Inflation protection
· Highly-rated insurance company

Watch Out For

· Policy conditions that make it difficult to qualify for benefits
· Coverage exclusions
· Unwritten promises by insurance broker

Tip

Unless your parents are first buying long-term care insurance in their late 70s or early 80s, they’re not likely to qualify for the benefits for at least 10 and perhaps 20 or more years. So, in every aspect of choosing a policy, you need to consider what their financial capabilities will be over the course of that time. That is, they shouldn’t buy a policy whose premium will become too high for them to pay down the road.

You also need to consider what the cost of care is likely to be later, not now. That means buying a policy with good inflation protection.

How to begin searching for a long-term care insurance policy

Like any insurance, a long-term care policy is a financial gamble: A buyer bets years of premiums against the likelihood of a long stretch of expensive long-term care. If your parents decide to take the gamble, you need to make sure they get a policy with premiums they’ll be able to afford for many years to come — and one that will pay substantial benefits if and when they need care. Here’s what to consider when shopping for a policy.

You have three basic options:

Insurance agents or brokers
Large private or government employers (if either of your parents has worked for such an employer — and, in some cases, if you do)

Professional, labor, fraternal, or other nonprofit organizations

Insurance brokers or agents tend to be familiar with a limited number of long-term care insurance policies (ones they sell and perhaps some from direct competitors). So, while you may want to consult an insurance agent (who usually represents only one company) or a broker (not restricted to one company) about policies, don’t limit your search to only one.

Also, don’t rely on what an agent or broker tells you about how the policy works or what it covers. They usually don’t know the policies in much detail. Make sure you get an actual copy of any policy your parents are seriously considering. Look it over with your parents, and put in writing any questions you have. Get those questions answered in writing by a representative of the insurance company itself, not just in conversation with the agent or broker.

Large employers may offer long-term care insurance policies. Check with your parents’ previous and current employers to see if this is the case. If so, the prices may be a bit better than what you can find on the open market. But remember that the policy itself is from an insurance company, not the employer. So it’s equally important to thoroughly check out any employer-sponsored policy. Also, if either of your parents is a veteran, check with the Department of Veterans Affairs about its long-term care insurance program.

Professional, labor, fraternal, or other nonprofit organizations may also offer long-term care insurance policies. If either parent belongs to any such organization, find out if it sponsors group policies. If so, the organization’s buying power may result in a better price than your parents could get for a similar policy they purchased as individuals.

Group policies offer slightly lower initial premiums, the result of the group’s buying power. But they also harbor potential disadvantages. Over the years, the group will negotiate with the insurance company regarding premiums. The group might favor younger workers over retirees, negotiating lower premiums for new policyholders and steep premium hikes for existing policyholders. Or the group might one day cancel the arrangement altogether, transforming the group policy to an individual one with much higher premiums.

How to check on an insurance company’s reliability

Your parents aren’t likely to collect on their policy for 10, 20, or 30 years, and if the company that issued the policy goes belly-up in the meantime, your parents will be left holding a very expensive but worthless piece of paper. There’s no way to guarantee that an insurance company will still be in business when your parents are ready to collect policy benefits years from now. But you can at least make sure that a company is in good financial shape for the foreseeable future by checking its financial ratings with Moody’s Investors Service or Standard & Poor’s insurance rating services.

You also want the policy to come from a company that has a track record of honoring long-term care benefit claims. Check on the company’s record of complaints with your state government’s department of insurance. You can find contact information for your state’s insurance department by going to the home page of your state government and searching on Department of Insurance or Insurance Commission. If a company has a steady pattern of complaints, you should look for a different company.

Special advantages to look for in a long-term care insurance policy

Some broad categories of policies offer certain advantages beyond their coverage and benefits.

Qualified Long Term Care Insurance (QLTCI): One type of long-term care insurance offers the advantage of a double tax break. Premiums paid for these QLTCI policies can, under certain conditions, be deducted from federal income as an itemized medical expense. The deductible amount depends on the insured’s age. The other part of the tax break is that benefits paid under a QLTCI policy are not taxed as income. Since a policy might pay upwards of $30,000 per year in benefits, this could be a big savings.

State partnership policies: State partnership long term care insurance policies are available in eight states: California, Connecticut, Florida, Idaho, Indiana, Kansas, Nebraska, and New York. They are connected to Medicaid, which can pay the full cost of a long-term nursing facility or home care. Medicaid allows a beneficiary only very limited income and assets, however. With a state partnership policy, your parents could keep considerably more assets and still qualify for Medicaid coverage of long-term care costs that insurance doesn’t pay.

How initial premium amounts are set
In general, a long-term care insurance policy’s premium amount depends on several factors, which are determined by the insurance company’s own formula. But your parents can control some of these factors by the choices they make. Factors include:

Age. The older your parents are, the higher the premium.

Health. Prior or existing health conditions can raise premiums; these conditions are revealed during underwriting, which may include both an examination of your parents’ medical records and a physical exam by an insurance company doctor.

Coverage. The more types of care the policy covers, the higher the premium.

Benefit amount and duration. The higher or longer the benefit, the higher the premium.
Inflation protection. Benefits that increase with inflation are a crucial part of a good policy but may add to its cost.

Waiting period before benefits begin. The shorter the waiting period, the higher the premiums.

Miscellaneous provisions. Provisions that allow premium reduction or cashing-out of the policy may affect initial premiums.

Shop around. Remember that for virtually the exact same policy, different companies might charge your parents widely different premiums.

Locking in long-term care insurance premiums over time

Except for “attained age” policies (see below), an individual’s premiums won’t go up just because he gets older. But while individuals aren’t singled out for premium increases, an insurance company can and will raise premiums across the board for everyone who holds a similar policy.

How much premiums go up over time may determine whether the policy will still be affordable for your parents 15 to 30 years from now. That’s why it’s important to understand how companies set up premium raises and, if possible, to pick a policy with favorable terms.

Level premiums are the best type of premium increase provision. The insurance company will only increase premiums by the same percentage for everyone holding the same policy. For this type of premium raise, an insurance company needs approval from the state insurance commission. This provides some protection against frequent or dramatic premium increases.

Attained-age premiums increase every time the insured reaches a certain age benchmark: 70, 75, 80 years, and so on. If an attained-age policy spells out how much the premiums will rise at each attained age, it offers some predictability. You can do the math and figure out whether those amounts seem like they’ll still be affordable 10 to 30 years out. Avoid a policy that says premiums will increase at various age benchmarks but fails to spell out by how much.

Issue-age premiums, which are less common than the other types, use the age at which your parents first buy the policy as the basis for premium increases. Let’s say one parent buys a policy at age 65. From then on, your parent pays the same amount as anyone who first buys the same policy at age 65 — no matter what age your parent reaches. The premium steadily increases as the cost of insurance does, but market forces provide some limit on how much it will go up, since the company will always want its rate to look attractive to new 65-year-old buyers. This is a risky kind of policy term.

Be prepared for premium hikes. During the first two decades, when long-term care insurance was first being offered, policyholders forfeited about half of all policies because they were unable to keep up with rising premiums. So, unless you’re certain what a policy says about the circumstances under which its premiums can be raised, your parents shouldn’t buy it.

Premium payments once your parents start collecting benefits

A policy term called a “premium waiver” allows your parents to stop paying premiums after collecting benefits for a certain period — usually 30 to 90 days. A few policies allow an immediate premium waiver. Be aware, though, that some premium waiver provisions apply to collecting nursing facility benefits but not to home care. Usually, a more generous premium waiver provision means slightly higher initial premiums.

Types of care coverage available

Some policies routinely include coverage for several types of care. Others charge extra for different types of coverage. Here are the types of care covered, and the situations under which your parents might consider them:

Nursing homes. As part of standard terms, all policies offer nursing home coverage. This is the most expensive care — other than 24-hour home care — and the type that concerns most people. Still, it’s possible that your parents might never need nursing home coverage and, if so, could save a lot of money by limiting coverage to other types of care. This could be the case if one of your parents has a younger, healthy spouse who can serve as a primary home caregiver and many nearby family members are willing and able to commit themselves to help care for your parent at home. If so, your parents might choose to buy coverage for home care but not for a nursing home for one of them, and broader coverage for the other.

Assisted living communities. Assisted living, in which elders maintain their own private living space in a group setting, is for those who need some assistance and monitoring but not at the level of care a nursing home provides. Many policies now include assisted living coverage as standard, but many others charge higher premiums for it.

Home and community care. Including home care in a policy can make the difference between your parents staying at home — theirs, yours, or another family member’s — or having to move into a nursing home. As their needs grow, paid home care can allow them to live with family but not place the entire burden of care on family members.

Some policies also include coverage for community care, which usually means adult daycare. This is nonresidential care during “office hours” at a senior center-type facility. It can help allow your parents to live in a family member’s home by relieving the family from care duties during the daytime.

Independent, nonagency home care. Home care from a state-certified agency is covered by any long-term care insurance policy that includes home care. But many people find that independent, nonagency home care aides provide more flexible, more consistent, and far less expensive home care than aides provided through a home care agency. To take advantage of independent — even unlicensed — home care, a policy’s home care coverage should not be limited to state-certified home care agencies.

How much benefits coverage your parents need

Most long-term care insurance policies pay a set daily benefit amount, usually twice as much for nursing home care as for home care, while benefits for assisted living are usually somewhere in between. What’s the right amount for your parent?
There’s little point buying a policy if the benefits would only make a small dent in long-term care costs. The minimum should be:

· $100 per day for nursing facility care
· $50 per day for home care

Amounts nearer to $200 per day for nursing home care and $100 per day for home care are more comfortable figures, but this benefit level means higher premiums. Those who can afford the higher premiums choose $300 per day for nursing home care and $150 a day for home care. At that level, benefits would cover $110,00 a year for nursing home costs and $55,000 for home care, which is close to the full cost of care currently available in many areas of the country (and significantly higher than average costs in others).
Inflation protection. Whatever level of benefits your parents wind up buying, make certain that the policy contains inflation protection. Without it, the policy your parents buy today may be next to worthless when they’re ready to collect on it.

The benefits of inflation protection

Inflation protection is a highly recommended feature. Why? Let’s say that at age 65, your parents buy a long-term care insurance policy with a flat benefit of $200 per day for nursing facility care and $100 per day for home care (and we’ll assume that these numbers reflect the cost of care in the area where they live). The problem is that the cost of care won’t be anywhere near those amounts 15 or 20 years later, when your parents are likely to collect on the policy. Every year, the cost of healthcare goes up faster than the general cost of living. So, while a $200 daily benefit might cover nearly the full cost of a nursing facility now, in 20 years it might pay only 10 percent.

That’s where inflation protection comes in. This important provision increases the amount of your parents’ benefit over the years they keep the policy. In fact, many policies now include inflation protection as a standard policy term. With other policies, you have to pay a higher premium for it. Either way, make sure the policy includes it.

Most policies place a time limit on inflation protection, usually 10 to 25 years from the date the policy was first purchased. Other policies stop the benefit increases when your parents reach a certain age, usually 80 or 85. Look for the longest period of inflation protection, especially if your parents are relatively young when first buying a policy.

Best types of inflation protection

Inflation protection comes in several forms:

Compounding automatic increase. This is the best kind of inflation protection. It automatically increases benefits each year, by a percentage set in the policy. Also, it has a compounding effect, using each year’s increased benefit amount as the base for calculating the next year’s increase.

Simple automatic increase. This type of inflation protection automatically increases the benefit amount each year by a set percentage but it uses the policy’s original benefit amount to calculate this increase. Over the life of the policy, this increases benefits far less than a compounding increase would.

Added coverage purchase. This is a very poor cousin to automatic increases. It allows you to increase the benefits every few years — by paying more. Unless there’s a guarantee about what this added coverage would cost, it might not be affordable. This is a gamble to avoid, if possible.

How long a benefit period your parents should buy

Once you’ve decided how much in daily benefits your parents will need and can afford, the question becomes how long the benefit period should last: One year? Three years? Five? The longer the period of coverage, of course, the higher the premium.
Limiting benefits to a year probably isn’t worth the cost of the policy. Buying coverage for more than six years of nursing home care is generally unnecessary and usually unaffordable. Three to five years of nursing home care is what most people choose and, statistically, what’s most appropriate. Whether you choose three, four, or five years depends on what you think is affordable now and in the future.

Flexible payout versus payout only for specific types of care

Because you can’t be sure whether your parents will need care at home or in a nursing home — or some combination of the two — it’s best to find a policy with a flexible payout. This combines the policy’s maximum total benefits for home and nursing facility care into a single coverage pool of money. Your parents can then use this benefits pool in whatever combination of home care and nursing home care is needed.

Buying a joint long-term care insurance policy for both parents

Most long-term care insurance companies offer “share-care” policies for couples. With these policies, the total amount of coverage is pooled between the two. If one parent dies without having used up all his policy benefits, the survivor gets those unused benefits added to the remaining policy.

This type of shared policy makes a lot of sense because women tend to live longer than men, and so they usually need longer periods of paid care. Share-care policies cost more than two individual policies, but they’re a particularly good idea if either of your parents living alone would likely depend mostly on paid care, or if one of your parents is quite a bit younger than the other.

Hidden coverage exclusions you should know about that might prevent benefits from being paid

During the first decades in which these policies were sold, many long-term care insurance policy holders never saw a dime in benefits. A major reason was that many policies had coverage exclusions — buried in the policy’s text, obscured by insurance lingo — that blocked people from getting their benefits. Policies have fewer of these exclusions now. But they still exist, so it’s important to keep an eye out for the following:

Prior hospital or skilled nursing facility stay requirement. This can be a disastrous policy provision. Many early long-term care insurance policies would not pay benefits unless the long-term care followed — usually within 7 to 30 days — a stay of at least three days in a hospital or a skilled nursing facility. But many people need long-term care because of increasing frailty, chronic illness, dementia, or Alzheimer’s, which do not necessarily lead first to hospitalization or skilled nursing facility care. With a prior hospitalization requirement, these people would be completely out of luck. Most states have outlawed these exclusions, but they’re still legal in about a quarter of states, so keep a sharp eye out for such a policy provision and avoid it at all costs.

Permanent exclusion for certain conditions. Most long-term care insurance policies permanently exclude coverage — meaning no benefits will ever be paid — for care that’s necessitated by certain conditions, the most common being drug or alcohol abuse and HIV-related illness. But some policies also permanently exclude coverage for mental illness, Alzheimer’s, certain forms of heart disease, and certain forms of cancer or diabetes. Be very careful not to buy a policy that excludes coverage that results from any of these common conditions.

Preexisting conditions. Many long-term care insurance policies have an exclusion period for care related to an illness or condition that a parent had before buying the policy. This means that for a certain period after long-term care has begun, the policy pays no benefits for that condition. A relatively short exclusion period — one to three months — is acceptable, but avoid any exclusion period of more than six months.
Elimination or waiting period. Elimination or waiting periods refer to a timeframe — from ten days up to a year — immediately after your parents qualify for benefits during which the policy doesn’t pay anything. The longer the waiting period, the lower the premiums — for example, a waiting period of six months could reduce your parents’ premiums by a third. The younger your parents are when buying a policy, the more sense it makes to trade a longer elimination period for a reduction in premiums.

When benefits payments will kick in

To begin collecting benefits, an insured individual has to meet certain conditions, called the benefit trigger. The conditions usually have to be certified by a doctor. A good policy allows this certification to be made by your affected parent’s doctor, though the insurance company may have its own doctor check this determination. There are two different ways a policy might define the benefit trigger:

Activities of daily living (ADLs). Most policies use ADLs to determine when someone qualifies for benefits. Each policy includes its own list of five to seven ADLs, and your parents must need assistance with a certain number of them to trigger benefits:

· Bathing
· Eating
· Dressing
· Using the toilet (“toileting”)
· Walking
· Getting in/out of bed/chair (“transferring”)
· Taking medications
· Remaining continent

Some policies require that a parent need help with two ADLs; others require three. Some have different qualifying numbers for home care than for nursing facility care.
In choosing a policy that uses ADLs as its benefit trigger, make sure of a few key points:
Bathing and dressing must be included in a policy’s list of ADLs — these are almost always the first tasks that someone needs help with.

Be sure that benefits are paid if acognitive impairment (such as Alzheimer’s or dementia) prevents the covered parent from performing the required number of ADLs, even if he is physically able to perform them.

Be sure that the policy doesn’t consider your parent able to perform an ADL just because sometimes he can manage it.

Medically necessary due to illness or injury. A few policies require a doctor to certify that the affected parent’s need for care is due to an illness or injury, and that care is “medically necessary” — meaning it’s needed to prevent the illness or injury from worsening. This trigger excludes frailty or weakness and can be a very difficult standard to meet. Avoid any policy with this benefit trigger.

If premium payments become unaffordable

Some policies have extra provisions that provide some refund protection if, years down the road, your parents can’t keep paying the higher policy premiums. A good refund provision can make one policy more attractive than a similar alternative. There are several types of refund provisions:

“Step-down” provision. This allows your parents to lower their premiums in exchange for a lower benefit amount or a shorter benefit period.

Nonforfeiture provision. The term nonforfeiture is a bit misleading. It doesn’t prevent forfeiture of the policy’s benefits, but it does provide a small refund if your parents drop their coverage before collecting benefits. If your parents have paid premiums for a minimum number of years (usually 15 or 20) and then can no longer afford the premiums, this provision will refund a small percentage of the total payments.
Reduced paid-up provision. This allows your parents to drop the policy — that is, stop paying premiums — after a set amount of time (20 or 25 years) but still collect a reduced benefit amount if and when they qualify for benefits.

Death refund. This provides a small refund to your parents’ estate if they die before a certain age (usually 65, 70, or 75).

Survivorship provision. If both your parents buy a single long-term care insurance policy, this provision allows your surviving parent to stop paying premiums a certain number of years after your other parent’s death, with the policy remaining in force.

Build Your Retirement Savings with Your Health Care Savings Account

Health Savings Accounts are an excellent way to build a second retirement account.  These tax-favored accounts, which have only been available since January of 2004, can be opened by anyone with a qualifying high-deductible health insurance plan.  Once you open an HSA account, you can place tax-deductible contributions into it, which grow tax-deferred like an IRA.  You may withdraw money tax-free to pay for medical expenses at any time.
The biggest reason more people don’t retire before age 65 is lack of health insurance, and many Americans reach age 65 woefully unprepared for the medical expenses they’ll face once they do retire.  One of the most important long-term reasons for establishing an HSA is to build up some money for medical expenses incurred during retirement.

Fidelity Investments reports that the average couple retiring in 2006 will need $190,000 to cover medical expenses during retirement.  This assumes life expectancies of 15 years for the husband and 20 years for the wife.

HSAs are, without exception, the best way to build up money to pay for medical expenses during retirement.  You should not contribute any money to your traditional IRA, 401 (k), or any other savings account until you have maximized your contribution to your HSA.  This is because only health savings accounts allow you to make withdrawals tax-free to pay for medical expenses.  You can take these distributions anytime before or after age 65.

Your HSA contributions won’t affect your IRA limits — $3,000 per year or $3,600 for those over 55.  It’s just another tax-deferred way to save for retirement, with the added advantage being that you can withdraw funds tax-free if they are used to pay for medical expenses.

For early retirees who are healthy, a health savings account can also be a smart option to help lower their health insurance costs while they wait for their Medicare coverage.  The older someone is, the more they can save with an HSA plan.  For many people in their 50’s and 60’s who are not yet eligible for Medicare, HSAs are by far the most affordable option.

Any money you deposit in your health savings account is 100% tax-deductible, and the money in the account grows tax-deferred like an IRA.  For 2006, the maximum contribution for a single person is the lesser amount of your deductible or $2,700.  In other words, if your deductible is $3,000, you can contribute a maximum of $2,700; if your deductible is $2,000, then that is the maximum.  For families, maximum is the lesser of $5,450 or the deductible.

If you’re 55 and older, you can put in an extra $700 catch-up contribution in 2006, $800 in 2007, $900 in 2008, and an additional $1,000 from 2009 onward.  The contribution limit is indexed to the Consumer Price Index (CPI), so it will increase at the rate of inflation each year.

How much you accumulate in your HSA will depend on how much you contribute each year, the number of years you contribute, the investment return you get, and how long you go before withdrawing money from the account.  If you regularly fund your HSA, and are fortunate enough to be healthy and not use a lot of medical care, a substantial amount of wealth can build up in your account.

Health savings accounts are self-directed, meaning that you have almost total control over where you invest your funds.  There are numerous banks that can act as your HSA administrator.  Some offer only savings accounts, while others offer mutual funds or access to a full-service brokerage where you may place your money in stocks, bonds, mutual funds, or any number of investment vehicles.  

One of the biggest advantages of retirement accounts like HSAs are that the funds are allowed to grow without being taxed each year.  This can dramatically increase your return.  For example, if you are in the 33% tax bracket, you would need a 15% return on a taxable investment to match a tax-deferred yield of only 10%.

As another example, if you are in a 33% tax bracket and were to invest $5,450 each year in a taxable investment that yielded a 15% return, you would have $312,149 after 20 years.  If you put that same money in a tax-deferred investment vehicle like an HSA, you would have $558,317 – over $240,000 more.

Because catch-up contributions are allowed only for people age 55 and older, if one or both of you are under age 55 you should establish your HSA in the older spouse’s name.  This will allow you to capitalize on the expanded HSA contribution limits for people in this age range and maximize your HSA contributions.  Once that person turns 65 and is no longer eligible to contribute to their HSA, you can open another health savings account in the younger spouse’s name.

Strategies to Maximize your HSA Account Growth

If your objective is to maximize the growth of your HSA in order to build up additional funds for your retirement, there are three important strategies you should implement.

Strategy #1: place your money in mutual funds or other investments that have growth potential.  Though this is riskier than placing your money in an FDIC-insured savings account, it is the only way to really take advantage of the tax-deferred growth opportunity that an HSA provides.

Strategy #2: delay withdrawals from your account as long as possible.  Though you may withdraw money from your HSA tax-free at any time to pay for qualified medical expenses, you do have the option of leaving the money in the HSA so that it continues to grow tax-free.  As long as you save your receipts, you can make medical withdrawals from your account tax-free at any future date to reimburse yourself for medical expenses incurred today.

As an example, let’s say a 45 year old couple places $5,450 per year in their HSA over a period of 20 years, they have $2,000 per year in qualified medical expenses, and they get a 12% return on their investments.  If they withdraw the $2,000 from their HSA each year, they’ll have a net contribution of $3,450 per year into their account, and they’ll have $248,581 in their account when they begin their retirement years.

If on the other hand they delay withdrawing that money, they will have $392,686 in their account at age 65.  If they choose they can withdraw the $40,000 to reimburse themselves tax-free for the medical expenses incurred during that 20 year period, and still have $352,686 in their account – over $100,000 more than if they had withdrawn the money each year.

Strategy #3: make the maximum allowable deposit to your HSA at the beginning of each year.  Even though you are allowed until April 15 of the following year to make deposits to your HSA, you should take advantage of the tax-free growth in your account by funding it as soon as possible.  The extra interest you can earn by contributing to your account on January 1 of each year rather than the next April 15 can amount to over $40,000 in a 20 year period, and over $100,000 in 30 years.

Using Your HSA to Pay for Medical Expenses during Retirement

When you enroll in Medicare, you can use your account to pay Medicare premiums, deductibles, copays, and coinsurance under any part of Medicare.  If you have retiree health benefits through your former employer, you can also use your account to pay for your share of retiree medical insurance premiums.  The one expense you cannot use your account for is to purchase a Medicare supplemental insurance or “Medigap” policy.

Though Medicare will pay for the majority of health expenses during retirement, there many be expenses that Medicare will not cover.  Nursing home expenses, un-conventional treatments for terminal illnesses, and proactive health screenings are all examples of medical expenses that will not be paid for by Medicare, but that you can pay for from your HSA.

Long-term care is assistance with the activities of daily living, such as dressing, bathing, or feeding yourself.  It can be provided in your home, a retirement community, or a nursing home.  Long-term care expenses can be paid for using funds from your HSA, and long-term care insurance can even be paid for from the HSA up to the following maximum annual amounts:

- Age 40 or under: $260
- Age 41 to 50: $490
- Age 51 to 60: $980
- Age 61 to 70: $2,600
- Age 71 or over: $3,250

To establish a health savings account, you must first own an HSA-qualified high deductible health insurance plan.  Compare HSA plans side by side to determine the best value to meet your needs.  Once you have your high deductible health insurance plan in place, you can open your Health Savings Account with the financial institution of your choice.

Understanding Long Term Care Insurance

“Old age may seem a long way off. But on the day it doesn’t, it will be too late to do anything about it.”

Sooner or later, we all need help. While we age, our wisdom increases but our body decays. All over America, tens of thousands of people need regular professional care. Though it is not an eventuality for everyone, the right thing to do is to be prepared. This is where Long term care insurance comes into play. Truth is not every family can afford the kind of care that sick people might need to get through daily activities. The result is taking a sabbatical from work or worse even, dipping into retirement fund due to lack of options. We all want a cheerful and comfortable life for our families. The tax of long term care could do just the opposite.

Long term care is needed by people who are unable to perform at least two activities of daily living or need supervision while performing these activities. Though the majority of people need it due to old age, debilitating accidents, chronic diseases or a health conditions that require constant monitoring are other reasons why even young or hitherto healthy people might require long term care. Taking out a Long term care insurance policy should cover the expenses like home care, assisted living, adult day care and even nursing home in the untoward event that you need the assistance due to a physical condition or due to the complications developed in old age.

There are several options in long term care insurance through which you can choose the type of care and the maximum expenses that could occur. You can also choose the benefit period, i.e., the amount of time you will be expecting long term care. It could be anywhere between three years and ten years while there is also the option of unlimited term care. You can pay for the insurance using limited pay plans or life plans. Through limited pay plans you can choose to pay the premiums for a certain period like ten years or till you reach a certain age. Generally, people pay the cost of insurance in premiums till they retire.

Like every other insurance policy, term care insurances come with several stipulations too and one needs to be wary of these while buying one. The most important factor, however is to start on a policy as soon as possible. With age, one might develop health conditions that can increase the cost of premium or can make one ineligible for long term care insurance. Also, the cost of the premium is lesser when one is younger.

Senior Care Homes-Care and Housing Options in NJ

Many times, adult children of seniors find themselves playing the role of advocate to obtain care of parent. This may begin when a parent becomes ill or injured and has to be hospitalized or you may see that your parent is declining and can no longer be alone and will require ongoing care. What do you do then? So many people, it’s like a “trial by fire”, trying to learn the language of senior care homes options in order to make the best decision for their loved one. Understanding the different senior care terms can make this an easier task.  

Rehabilitation/Sub acute Care Center-this type of facility provides short term therapeutic care for patients once discharged from the acute care of a hospital. The therapy provided includes physical therapy, occupational therapy, and speech therapy. A typical stay in a rehab center is usually about two to three weeks. The goal is to restore the patient to normal capacity.

Home Care-also known as senior in home care or home health care. This type of service provides a range of services that include assistance with bathing, toileting, dressing, and ambulation. Home care can also include meal preparation, light housekeeping and laundry services. In-home care can be provided for a few hours per day or on a 24 hour per day basis depending on need.

Adult Day Care/Medical Day Care-a protective environment for seniors needing a structured program. Services for adult day care vary from custodial care, offering stimulating activities for independent seniors along with meals, to an adult medical day care which provides activities to seniors with medical needs.  Seniors are usually brought to an adult day care program in the morning and leave in the evening. Transportation to and from the center is often available.

Assisted Living-is a combination of housing and personal health support services for seniors. Services in an assisted living usually include:
-private or semi-private apartment
-emergency call systems
-daily meals served in a common dining room
-social and recreational activities
-transportation
-assistance with personal care
-medication management
-24 hour staff
-laundry and housekeeping services
In addition, many assisted living facilities have a secure unit for memory impaired seniors.

Nursing-Convalescent Home/Skilled Nursing Facility-For those with a need for more acute care, a nursing home provides patients with 24 hour care. This type of facility is generally for patients requiring ongoing skilled care such as bathing, toileting, dressing, as well as assistance with ambulation. Medical supervision and rehabilitation services are also provided.  

Continuing Care Retirement Community (CCRC)-a community that offers multiple levels of assistance to seniors. Levels of care range from independent living, assisted living and nursing home care. A CCRC provides a continuum of housing and health care options on one central campus.  Seniors who opt to live at a CCRC usually sign a long term contract (often the length of a resident’s life). This offers the senior the peace of mind that they can receive housing and assistance at one site, as their needs increase.

Senior Citizens Should be Aware of Private Long Term Care Insurance

Long term care is a major concern of American senior citizens and their families. Studies have shown that Americans rank long term care second, behind saving for retirement, when prioritizing financial needs. Unfortunately, many Americans do not want to think about needing long term care and, therefore, fail to plan for it. Others wrongly assume that Medicare or standard health insurance policies will cover the costs of long term care services. As a result of this failure to plan, tens of thousands of Americans are impoverished each year by the costs of long term care.

The best time to plan for long term care is before it is needed. Start thinking about long term care when you plan for retirement. If you are already retired, it is not too late to begin planning for potential long term care needs.

Private long term care insurance is an excellent way to finance long term care. This brochure will guide you through the important process of selecting the right long term care insurance policy. This booklet provides information on long term care services, what to look for in a long term care insurance policy, and a glossary of terms.

Finding a good policy will take some effort, but the effort will be worthwhile. Here are some steps to take when considering the decision to purchase a long term care insurance policy:

1. Talk to your financial planner or insurance agent about whether long term care insurance makes sense for you.
2. Ask your financial advisor to recommend a company and a policy.
3. Check with insurance rating services to make sure the insurance company you are considering is financially secure.
4. Call your state insurance department and ask about the company and its record in your state.
5. Make sure your insurance agent is licensed to sell long term care insurance in your state.
6. Review all the details and options of the policy. Do not rely just on the marketing materials or outline of coverage.
7. Make sure you understand all the provisions before you purchase any policy.
8. Ask your insurance agent questions. Seek guidance from the state insurance commission office, the Area Agency on Aging, or local senior centers. Discuss policies with friends, family, and others whose opinions you respect. Take time when choosing a policy, and don’t allow yourself to be pressured into making quick decisions. And remember: Never pay cash.

The decision to purchase long term care insurance is not a simple one, but thorough investigation and thoughtful planning now can offer you and your family financial protection for the future, and, most importantly, peace of mind.

Defining Long Term Care

Long term care includes a range of nursing, social, and rehabilitative services for people who need ongoing assistance. Most people in long term care facilities are older, but many young people need long term care during an extended illness or after an accident.

Assistance with routine personal needs such as bathing, dressing, eating, toileting, and taking medicine is the most common long term care service. Long term care facilities also provide skilled nursing and rehabilitative care, which is ordered by a physician and supervised by skilled medical personnel such as a nurse or licensed therapist.

Long Term Care Is Offered In A Variety Of Settings

Nursing facilities are the primary settings for people who require medical care daily or intermittently. You must have a physician specify needed services in a written treatment plan for admission to a nursing facility. Many nursing facility stays are short periods of recuperation from an acute medical episode such as a hip fracture or surgery.

Assisted living facilities or residential care facilities provide general supervision, housekeeping services, medical monitoring, and planned social, recreational, and spiritual activities for people who are still independent and ambulatory. Assisted living facilities do not provide medical care.

Facility care services include skilled nursing care, speech, physical, or occupational therapy, facility health aides, or help from facilitymakers. Sometimes, family members, or caregivers, provide most of the care with the help of facility aides and skilled professionals.

Adult day care services are available in many communities, providing personal care, skilled care, and recreational services.

Financial Issues And Long Term Care

The cost of long term care varies by the level of care needed, the setting where the care is provided, and geographic location. Nursing facilities, assisted living facilities, and facility care services provide different levels of care to different resident populations; therefore, costs are not comparable.

On average, round-the-clock long term care services in a nursing facility cost $40,000 per year, or $112 per day.

Assisted living costs vary dramatically-anywhere from $900 to $3000 per month depending on room size, amenities provided, and services required.

Facility care, if needed daily, also can be quite expensive. In 1996, an average facility care visit from a registered nurse (RN) cost $99. RN visits for facility care typically do not exceed 2-4 hours per day, so care is not round-the-clock.

Eight hours of adult day care can cost an average of $45 per day.

Nursing Facility Care: About one third of the costs of nursing facility care are paid directly by individuals and their families. Two government programs may pay for some of your care.

Medicare, a health insurance program for people age 65 or older, only covers skilled facility care and up to 100 days of skilled care in a nursing facility if you are admitted after a three-day hospitalization (not required if you are an HMO member) and your physician prescribes skilled care in your treatment plan. Many people think that Medicare is the primary payor of nursing facility stays, but Medicare accounts for only 9 percent of nursing facility expenditures.

Medicaid, a program for the poor, pays for approximately 52 percent of the nation’s nursing facility care, but only for people who have spent almost all their assets and become impoverished. Due to lack of planning for long term care, Medicaid is the source of payment for nearly 70 percent of people in nursing facilities!

Unless you have long term care insurance, qualify under limited conditions for Medicare coverage, or become poor, you will pay out of your savings for nursing facility services.

Assisted Living: About 90 percent of the nation’s assisted living services are paid for with private funds. The Supplemental Security Income, Older Americans Act, and Social Services Block Grant programs pay for some assisted living services, while about one-fifth of the states allow the federal Medicaid program to pay for some service components.

Facility Care: Private funds pay for about 46 percent of facility care costs; Medicare covers 32 percent; Medicaid, 22 percent.

Adult Day Care: There are some out-of-pocket expenses for adult day care; however, the majority of funding comes from public sources either the state exclusively, or, in some states, Medicare and Medicaid. Private donations from corporations and charitable groups such as the United Way also supplement the costs of adult day care.

When To Buy Long Term Care Insurance

Because long term care insurance premiums are based on age at the time of purchase, the younger you are when you purchase a policy, the less expensive the annual premium. These premiums for most policies stay level each year as you age. If you buy at age 55 a policy that cost $800 per year, you will continue to pay the same premium. However, if you wait until you are 65, the same policy will cost you $1,700 per year.

What To Look For In A Policy

The best policy for you depends on several factors, including your family arrangement, your financial situation, your preferences regarding long term care choices, and the level of risk you are willing to accept. There is no one best company or one best policy for everyone. You should select a policy that meets your needs.

Before you buy a policy, make sure you know the product you are buying and from whom you are buying it. Be sure your agent is licensed to sell insurance in your state and has received specific training on long term care insurance. Consult friends, consumer guides, and information from your state’s insurance counseling program or local agency on aging.

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