Does Long Term Care Insurance Really Work?
by Thomas Day
courtesy of the National Care Planning Council
Insurance agents who sell long term care insurance and the people who buy this insurance are confident that this product will protect the purchasers from the financial ravages of needing long term care services in the future. Having sold long term care insurance myself for many years, both I and my clients generally experienced a piece of mind that all challenges associated with the future need for long term care had been solved. Over the years, I have discovered that peace of mind assurance is not always warranted. The insurance does not always provide the solution for issues associated with needing care later in life.
I would prefer to refer to “long term care” as “eldercare” or simply “care” for the remainder of this article. The reason for this is in most people’s minds, long term care means to them the insurance and not the services that are provided.
Please don’t misunderstand me. I am a believer in long term care insurance. My wife and I went through the need for eldercare with both of my parents and with both of her parents. One of the reasons that I started selling insurance was because of our experience with our parents. That experience opened my eyes to the need for having funds to pay for caregivers. My wife and I bought policies for each of us, 25 years ago, that started out with premiums at $79 a month each. Over the years we have had a number of premium increases with the last one taking those same policy premiums to just under $300 a month for each of us. We will still keep the insurance, but we had to adjust the benefits downward in order to even afford the new lower premiums of $197 a month each. Even with misgivings about how the insurance will not cover all of the issues that we will face, we still think it is valuable.
So what is it that makes the insurance an incomplete solution for the need for eldercare? It has to do with what the the long term care insurance policies define as conditions to trigger the benefit. Practically all policies require that benefits will not be paid unless the insured person requires significant supervision due to cognitive impairment or the insured person needs help with at least 2 or more activities of daily living from a list of either 5 activities of daily living or 6 activities of daily living, depending on the policy. Activities of daily living could include assistance with bathing, dressing, toileting, transferring, incontinence or needing to be fed.
Here is the problem though. Many older individuals, for various reasons, often need assistance from other people to function. For example they may need help with paying bills, requiring transportation, answering the phone, doing the laundry, cooking meals, cleaning the home, watering plants, tending to pets, managing medications, assisting with grooming or many other functions that they cannot do themselves. They may not need assistance with more than one activity of daily living – they usually have a need for assistance with bathing – or they don’t have a level of memory loss or dementia that would trigger benefits from an insurance policy.
In addition, many people want to remain in their homes, but the long term care insurance policies, even if triggered, will often only pay for services directly connected to activities of daily living or for supervision due to dementia and not cover the other activities listed in the paragraph above. Some policies do not even cover home care or cover home care at a lesser benefit than facility care. And to make matters worse, some policies have provisions that deliberately avoid paying benefits by extending out the period of time that the policyholder must pay out-of-pocket before the policy will take over. Many of these provisions are hidden in the language of the policy.
This need for helping hands is often more prevalent than the more direct hands-on care that is paid for by long term care insurance. But if the insurance won’t pay for it, where does the help come from? Usually the burden falls on a spouse – if there is a spouse. But many of these people needing care have already lost their spouse to death or were never married. Or as is often the case, the spouse is also disabled and incapable of providing the services that the policy will not cover.
If family or friends live close by, those loved ones needing the eldercare will generally get what they need from these caregivers. This care provided by family or friends often represents a sacrifice as these caregivers may have jobs, their own families or other pressing personal issues that they have to take time away from in order to provide the care. Sometimes children taking care of their parents – even before the level of assistance with activities of daily living – sacrifice promotions at work, get fired or have to quit their jobs.
But what about those needing eldercare who might have long term care insurance but don’t have the disabilities to trigger the policy and in turn don’t have spouses, family or friends to help them? These people are in a bind. Sometimes religious organizations will step forward and help. Oftentimes, those needing care sell their homes or move from their apartments into independent living facilities. These facilities at least provide some of the services that care recipients cannot do such as providing meals, doing laundry, providing transportation or helping with medication management.
If those needing care don’t have the funds to pay for independent living or other living arrangements where they can receive assistance, they often hunker down under deplorable conditions in their homes or apartments and do what they can to survive. They may even have long term care insurance, but their specific needs for assistance would not trigger the policy benefits. County aging services, church groups and other government agencies may step up to help if these groups know about the situation, but often they don’t know these people are in need of assistance.
It should be obvious to my readers at this point that long term care insurance does not completely solve the problem of needing eldercare in future years. It is important for those eventually needing the care and for family members to plan for the eventuality of eldercare. According to government estimates the need for eldercare will happen to at least 60% of the elderly population. Some planning can be done in advance to avoid some of the issues that I have addressed above.
In a future article I will discuss how this planning, when done in advance, can help plug the void that exists prior to a long term care policy paying out benefits. Or as is usually the case, there is no long term care insurance. It is estimated that only about 8% or 9% of the population has this insurance. And many of those may have inadequate coverage. This is all the more reason that prior planning should be done to cope with the future devastation caused by the need for eldercare.
Virginia’s Try Transit Week Set for September 16-20
Virginians can pledge to try public transportation for a chance to win one year of free transit and a pair of round-trip Amtrak tickets
RICHMOND – The Commonwealth of Virginia and the Virginia Department of Rail and Public Transportation (DRPT) are pleased to celebrate “Try Transit Week” Sept. 16‐20, 2019. During this weeklong educational event, Virginians are encouraged to try the bus, commuter rail, ferry, or vanpool.
Participants who pledge to try transit at trytransitweek.org are automatically entered for a chance to win a year of free transit service from a participating Virginia transit provider as well as a pair of round‐trip tickets aboard Virginia’s state sponsored Amtrak Northeast Regional train.* Other prizes include monthly or weekly passes for transit service in areas throughout Virginia. Pledges will be accepted through September 20, 2019.
“Public transportation is an effective way of mitigating traffic congestion, improving air quality and getting around Virginia,” says Jennifer Mitchell, Director of the Department of Rail and Public Transportation. “Virginia’s transit services connect the Commonwealth to employment opportunities and make experiences more accessible to the community.”
The American Public Transportation Association (APTA) reports people who switch their daily commute from car to public transportation save about $10,000 annually. Investment in public transportation also benefits local and statewide economic growth. Every $1 appropriated for public transportation generates $4 in economic returns.
DRPT and transit operators across the Commonwealth are spreading the word about public transportation, accessibility, and its numerous benefits. For more information about local transit options visit trytransitva.org.
*Please visit trytransitweek.org for contest rules and regulations.
At age 82, Mable began receiving service from LOA Meals on Wheels after her husband became very ill, while at the same time, she was suffering from the debilitating aftermath of a stroke, a triple bypass surgery, and glaucoma. Unable to drive, Mable needed the support of volunteers in her community to deliver fresh, hot meals. Four years have since passed and Mable is now a widow, living alone. Recently, Mable learned she had been diagnosed with ovarian cancer. Now unable to leave the house even with assistance, Mable is more dependent on LOA’s Meals on Wheels program than ever before.
Mable tells us she enjoys the hot meals for lunch and dinner. She rarely uses the stove for fear of leaving it turned on. And when she doesn’t feel like eating, Mable drinks an Ensure®, provided by Meals on Wheels, to satisfy her hunger and
supplement nutrition. For Mable and many like her, it’s about more than the food. Mable relies on the enthusiastic volunteers that deliver her meals for a few minutes of socialization, conversation, and laughter to help keep her spirits high during this difficult time. She describes her volunteer friends as godsends and thanks them for providing their company and support.
Although she has a very supportive family, Mable’s closest relatives are coping with their own serious health problems and they appreciate the support Mable receives from LOA Meals on Wheels very much.
Last year, LOA helped 844 seniors just like Mable live healthier and safer in their own homes because volunteers provided friendly visits, well-being checks, and more than 124,000 meals.
You can help. Volunteer, donate, or simply share Mable’s story.
If you or a loved one are in need of healthy meal deliveries and well-being checks, please call (540) 345-0451. For more information about volunteering or donating to support the LOA Meals on Wheels program, visit loaa.org.
Senior Food Box Program Expands
In August, the Local Office on Aging began a partnership with Feeding America Southwest Virginia to provide a box of food items to low income seniors in need in Roanoke County, Roanoke City, Salem and Craig County. Just under 100 food boxes were delivered to the seniors’ homes on that third Tuesday in August. Fast forward to October and close to 450 boxes were delivered!
The boxes consist of shelf stables items such as cereal, soups, fruits and vegetables. Each recipient also receives a large block of cheese. The boxes weigh about 20lbs. And, they are always well received by the seniors who get them.
Just over 100 of those that receive the boxes are recipients of other LOA services. The others are either not eligible for any LOA services, not in need of the services offered or are currently on a waiting list. “It’s great to be able to reach low income seniors with this program that we have not previously been able to serve,” said Michele Daley, Director of Nutrition Programs for LOA.
Daley delivered several of the boxes to homes in October. LOA provides this service in partnership with Feeding America on a budget of zero. Because of the sharp increase in those the program is able to serve, LOA staff have had to pitch in once a month to ensure the boxes are getting to their destinations. “We really need more volunteers for this program to truly make it successful,” said Daley.
It’s a once a month volunteer opportunity that should take 2-4 hours, depending on your availability. On the third Tuesday of every month, the boxes need to be hauled from Feeding America to low-income independent living facilities in addition to the LOA office. In the afternoon, volunteers are needed to pick up the boxes from the LOA office and deliver them to the homes. A vehicle large enough to carry the boxes is needed and volunteers must be able to lift 20lbs (in some cases, up steps). A few volunteers are needed on the following Wednesday to deliver the undeliverable boxes.
“Many of the people I delivered to expressed their sincere appreciation for the food,” said Daley. “Many told me the food was a way for them to get through the rest of month.”
Headlines alert us to the impact of the aging of America. The “silver tsunami” or “age wave” is already here as over 10,000 Baby Boomers reach the age of 65 every single day. One quarter of today’s 65-year-olds will live past the age of 90 and will experience many of their daily chores turning into insurmountable everyday challenges. These seniors already represent the fastest growing population segment in the U.S. The LOA strives to carry out its mission of helping older persons remain independent for as long as possible. Eliminating hunger is a viable step in carrying out this mission.
If you would like to get involved in this program, call the LOA office at 540-345-0451.
Growing Forward Together
On Thursday, August 23, 2018 Local Office on Aging, Inc. (LOA) celebrated a new chapter with a purpose-built space retrofitted to further its mission to help older persons remain independent for as long as possible.
At the ribbon cutting the LOA officially opened its doors and launched its Capital Campaign for the facility located at 4932 Frontage Road NW Roanoke. During the summer of 2017 the opportunity to custom retrofit a central office that specifically addressed the needs of LOA staff, programs and clients could not be ignored. The purchase and renovation of LOA’s new central office was the first opportunity in the history of the organization to construct a purpose-built space.
With mission at the forefront, LOA leadership focused on building upgrades and technology improvements to meet our growing needs and better serve the seniors in our community through programming enhancement that would have previously been impossible.
For over 45 years, LOA has served seniors age 60 and older in the Roanoke Valley and Alleghany Highlands with one singular mission—helping older persons remain independent for as long as possible.
Since 1972, LOA has carried out the mission by coordinating more than 25 senior-centric community service programs providing nutrition, education, advocacy and socialization to a growing population of aging adults. Currently in our region one out of four citizens are 60 and older. Over the next ten years 85% of projected population growth will be in the 65+ age bracket.
Despite being challenged with an office that was outdated and had long been outgrown, LOA, its dedicated staff and loyal volunteers have managed to help thousands enhance their quality of life in the home and avoid early institutionalization, while providing support to caregivers and advocating for quality medical and housing services.
Replacing the Campbell Avenue office, best known for its exterior charm and interior challenges, LOA’s new central office is more centrally located to our footprint service area while italso unifies all central staff under one roof allowing for onsite community engagement events.
The newly renovated central office space is:
Roanoke and its surrounding region faces a steep slope of shifting demographics with the ratios of older adults far exceeding the current state and national average. As we approach 2030, the population of adults 65 and over will outnumber children under 18 for the first time in our nation’s history. LOA is challenged by these projections for our region which is ahead of both the commonwealth and national curve.
At LOA we believe that what we do matters and we’re making major advances to more efficiently serve our increasing maturing population. LOA is committed to Growing Forward Together to help older persons remain independent for as long as possible.
When Alisha first stepped into her caregiver role 15 years ago, she didn’t know what to expect nor what services were out there to assist her. She happened into this role rather gradually as her widowed mother grew older and lost her independence bit by bit. “But, she never truly lost her independence and I was able to keep her home where she belonged,” commented Alisha.
Alisha was 55 when her 88-year-old widowed mother suffered a stroke and lost much of her mobility. “By that time she had already downsized significantly and had asked my younger brother, who had recently divorced to move in with her.” Patrick, however, needed to work during the day and sometimes on weekends. Alisha worked part time, but had three young daughters who also needed her. The family still needed help.
The call to LOA began with a legal question. An appointment was made for Alisha and her mom to meet with an attorney at the LOA office who was able to get a simple will drawn up and establish power of attorney. The family later had a case manager come to the home to determine eligibility for Meals on Wheels.
“It was easy and simple and the smartest thing we have ever done,” said Alisha. The family had peace of mind during the day know their legal affairs were in order and that a hot meal was being delivered to the home since no one else was available during the day to provide one.
Alisha’s mother passed away six years ago and never had to spend one day outside of the home. “This was a priority for me and I knew I could not have done it without the assistance of LOA.”
Last year, Patrick, who had just turned 60, suffered a major heart attack. Alisha found herself in the caregiver role again. “This time I was prepared and immediately called LOA,” she said.
Patrick receives Meals on Wheels and was referred for home health services. “This had been a different path because we expect to care for our parents, but never our younger siblings. I’m thankful for having already had some experience with it,” said Alisha.
Cooling Assistance Helps Senior Remain at Home
Allow us to introduce you to Jack. Jack is an 81-year-old Salem resident who is fiercely independent. He lives at home and relies on his sister, who lives nearby, to provide him with transportation to and from doctors’ appointments and church on Sundays.
Jack is homebound and loves sitting on his front porch and enjoying the day. He has managed to live on his own for several years with the help of his sister, a few thoughtful neighbors and the Local Office on Aging. For the past two years he has received Meals on Wheels, which allows him to enjoy a nutritional lunch delivered every weekday by area volunteers. And of course, this time of year, he is almost always sitting on his front porch when the meals arrive.
But in the afternoons when the temperature starts to climb, Jack needs something more refreshing than what his front porch can provide. “When I first turned my air conditioner on this year it wasn’t working right. I tried to fiddle with it and fix it, but it tripped a breaker and I lost power,” said Jack. “It was in the house when I moved here so I don’t know how old it was.”
He admits that he looked into getting a used window unit AC, but was worried about its reliability. He didn’t want to risk the safety of his home to a faulty unit. And like many seniors, he is on a fixed income and couldn’t afford to put money into a used unit that might not work and could certainly not afford a new unit.
“My sister called LOA for me,” he recalls with a smile. When Jack and his sister visited the Local Office on Aging they met with Elaine Engleman, LOA Senior Services Coordinator, who approved him for a new AC window unit through the Cooling Assistance Program. LOA’s annual Fan Care and Cooling Assistance Programs provide fans and air conditioners free of charge to seniors 60 and older who are on a limited income and without any other source of cooling in their home.
Many seniors have medical conditions for which overheating can be deadly. LOA’s Cooling Assistance Program helps combat heat stress brought on by high temperatures. As the thermometer starts to climb, the risk of heat stress increases. Hot weather can strain older persons’ bodies, especially the heart. Some prescription drugs may also reduce the ability to cope with hot weather.
Jack says he refuses to think of what he would have done had the LOA been unable to help him. “I can’t afford to buy much, so risking it on a used air conditioner is too much,” he said. Jack received his new air conditioner on a warm, sunny day in June. His neighbor helped him install it that same day and he slept peacefully that night.
Donations toward the purchase of fans and air conditioners are being accepted at LOA’s new central office location at 4932 Frontage Road NW, Roanoke, Va., 24019. LOA also accepts donations of NEW fans and air conditioners for distribution. For more information or to make a donation, visit us online at: http://www.loaa.org/services/critical-assistance/fan-care/
The annual Fan Care and Cooling Assistance Programs are sponsored locally by Virginia Power, American Electric Power and the Local Office on Aging.
LOA Meals on Wheels Helped Me Remain in My Home
Jerry suffered a major stroke at the young age of 61. The stroke left him wheelchair bound and with limited use of his right hand and arm. His speech and his vision were also affected. At first, his wife was able to care for him until she was diagnosed with Stage 4 lung cancer just two years after Jerry’s stroke. At this point, both Jerry and his wife needed assistance and were at a crossroads they never imagined. Who was going to care for them and how were they going to stay in their own home?
When they were first referred to Meals-on-Wheels, their only daughter, Cindy, was trying to manage their care but felt overburdened, as many caregivers do. She is part of the “sandwich generation,” which means she is caring for her parents as well as her teenage children that are still in the home, all while trying to work a full-time job. It was at this point that Cindy reached out to LOA for help.
Jerry has been on the Meals-on-Wheels program for a little over two years now and his wife was on the program for a month before she passed away. Jerry is always sitting at his kitchen table, in his motorized wheelchair, waiting on the volunteers to come. With tears in his eyes, he said the volunteers are usually the only people that he sees besides his daughter and her family. He says he waves to the neighbors but it has not been the same since the stroke because he cannot get out to visit them. He also looks forward to the hot meals and eats them right away. Due to the stroke it is very difficult for him to use a stove or even a microwave.
His daughter says Meals-on-Wheels has helped her maintain her full-time job and gives her peace of mind knowing that someone is checking on him at lunch. She feels that Meals-on-Wheels has allowed him to safely stay in his own home after his wife passed away and does not know what she would do without the program.
Last year, in LOA’s service area which includes the rural county of Botetourt where Jerry resides, 847 seniors lived healthier and safer in their own homes because volunteers provided friendly visits and well-being checks while delivering 129,797 meals.
Local Office on Aging Celebrates Older Americans Month This May
Across the country, a rapidly growing population of older Americans are taking part this month in activities that promote wellness and social connection in observance of Older Americans Month. They are sharing their wisdom and experience with future generations, and are giving back to enrich their communities. They’re working and volunteering, mentoring and learning, leading and engaging. The Local Office on Aging invites you to participate!
For 55 years, Older Americans Month has recognized older Americans and their contributions to our communities. Led by the Administration for Community Living’s Administration on Aging, every May offers opportunities to hear from, support, and celebrate our nation’s elders. This year’s theme, “Engage at Every Age,” emphasizes the importance of being active and involved, no matter where or when you are in life. You are never too old (or too young) to participate in activities that can enrich your physical, mental, and emotional well-being.
It is becoming more apparent that remaining socially engaged can improve the quality of life for older adults. When the Local Office on Aging thinks “Engage at Every Age,” our many wonderful and dedicated older volunteers immediately come to mind. LOA’s Meals on Wheels volunteers not only add to the social and nutritional welfare of this community’s homebound elderly, they are enriching their own lives and remaining young by contributing to the lives of others. The same holds true for LOA’s Chronic Disease Self-Management Volunteer Master Trainers, LOA’s very knowledgeable Insurance Counselors, LOA’s varied Soup for Seniors volunteers, and the many others who come to us to aid in different endeavors.
Ellie has been a dedicated Soup for Seniors volunteer for the past six years. She started out picking up at a few of the drop-off sites and moved on to delivering door to door. Now, she knows many of those she delivers to by name and looks forward to the time she gets to spend with them each February. “Giving means getting something in return,” she says. “What I put into being a volunteer always comes back to me. The time spent with these seniors can change your life and theirs.”
Harold has been a LOA Meals on Wheels volunteer for 13 years. He gets up every morning, but says he particularly enjoys getting up on the mornings he is scheduled to deliver his route. “I feel closer to those that I deliver to than I do to some members of my family,” he said. “I guess that makes them family.”
Harold started delivering meals with his wife. After she become ill, he continued to volunteer with the LOA, while caring for his wife at home. “Volunteering provided that sense of normalcy that was much needed at a very stressful time in my life,” he shared. “I became more vested in my volunteer role, realizing how much the service I was providing was needed.”
“The LOA was recognized this year as having delivered more Meals on Wheels than any other agency in Virginia. We were able to attain that recognition because of the many volunteers who help us make the meal delivery possible,” said Ron Boyd, LOA CEO. “We value the contributions made by all of our volunteers and the seniors we serve every day. It was an easy decision to celebrate Older Americans Month, with the theme Engage at Every Age in honor of them.”