Mr. Long Term Care
Let Care be our Long Term Commitment
I can safely say that the purchase of my LTC insurance was the wisest and most forward-thinking, financial decision of my life. - Mr. LTC

Do your know someone who required or will soon require long term care?
"After age 65, Americans have more than a 70% chance of needing some form of long-term care."
-American Society on Aging

"An estimated 12.1 million Americans need assistance from others to carry out everyday activities."
- As noted on

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Interviews: A Letter to My Kids

About Mr. LTC

A letter to my kids

One of my clients said it most eloquently: "This [long-term care] policy is a letter to my kids. It says I've made plans. It says, 'Don't worry about putting Mom in a nursing home.'"

I like this idea. A letter to the kids. It should be more than just an insurance policy. It should be ... a letter. Dear Kids ...

I tell clients there are three elements to planning for long-term care: Physical, financial and emotional.

Physical planning can mean several things. First, it simply means doing everything we know we can to keep ourselves fit, healthy and independent for as long as possible. You know the drill: Eat right, exercise, get a good night's sleep, take your medications and supplements if you need to. This "preventive" care may even help prevent or postpone the need for long-term care.

You should also do a personal health assessment and learn your family's medical history. Is there a history of longevity? Alzheimer's or dementia? Strokes? Cancer? Sudden cardiac deaths? Your personal and family health history can have a large impact on the type and length of care you may need in the future. You have a professional advisor to help you: Your doctor.

You may need to consider physical changes to your home. If you plan to stay in your own home for as long as possible while receiving care, look at the layout and facilities. There may be modifications you can make now or at least plan ahead for in the event you may need long-term care.

Financial planning means taking stock of the potential cost and risk of needing care for a long period of time and assessing your ability to pay those costs. You may have many assets and decide to self-insure ­ that is pay any cost yourself, out of pocket. You may have little income and few assets and could quickly qualify for Medicaid ­ the medical care component of welfare. You may wisely choose to buy long-term care insurance. You have numerous advisors to help you here: Your accountant, insurance agent, financial planner and attorney. A caveat: Make sure your advisors understand or specialize in long-term care, elder care or elder law issues.

My client who said, "Don't worry about putting Mom in a nursing home," really meant, don't worry about the money if Mom needs a nursing home. Often the financial decisions are easiest.

Emotional planning. Well, that's not so simple. And where even the best intentions can fail.

Your financial advisors can make sure you have the money to pay for care ­ your own money or the insurance company's. Your attorney can make sure the legal strategies and documents are ready. But only you can tell your family what you really want, what plans you've already made.

This includes how you would like to receive care and where, as well as who you would like to provide your care. Some people might expect their family or friends to help, others are adamantly against it ­ they don't want to burden those closest to them with the often difficult tasks of custodial care giving.

Many people would like to plan to remain in their own home for as long as possible. Without round-the-clock professional help (which is typically three times the cost of an average nursing home), family members or friends usually must provide some care or at least supervise the care given by a spouse or outside care giving agency. Home health care is most often a partnership between the professional caregiver and family members or friends.

So, sit down and write a letter to your kids, from your heart, with an ink pen and a nice piece of paper. Send it to them as soon as you are done ­ actually put it in the mail, a copy for each child. And be ready for their phone call. Because the conversations that will follow are as important as the letter.

If you don't have children or family members to whom you can send your letter, send it to a close friend or a trusted advisor. Make sure your plans and desires are clearly understood. Because usually when care is needed, someone else will direct the show.

A social worker I know spent hours developing a plan of care for a woman who suddenly needed a substantial amount of custodial care. The entire family was consulted, plans were discussed, and a home care regimen was agreed to and was ready to be put in place. But the entire affair collapsed when the next-door neighbor intervened. It turns out she had been providing regular, informal care for years. The family didn't know. The ending to this story is a good one: Once the neighbor was brought onto the planning and care giving team, the plans were modified to include her and the appropriate care began.

Good long-term care is not a tragedy. The circumstances leading to a need for care may very well be a tragedy. But good care is not. Good care is a success for those who must depend on someone else to care for them at any level. And good long-term care is born of careful planning, attention to personal preferences, thinking ahead wisely and then communicating your desires to someone else.

Someone else may start the communication process. Your kids or other family members may bring up the subject of long-term care. Don't ignore them. It's your responsibility to let your wishes be known.

Your advisors may bring it up. Listen to them, and tell them what you want. Make sure they help you arrange your affairs so it really does accomplish what you want not the advisor's particular bias or sentimentality.

Again, my clients have been my best teachers.

After a lengthy description of all the wonderful long-term care insurance policy features that would allow for her to stay in her own home, a new client of mine looked at me and said, "If I ever need this kind of help, I don't want to stay in my own home."

I couldn't believe it. Doesn't everyone want to stay in their own home as long as possible? No. My client is a single woman with no family in town. She knew that if she needed on-going long-term care that it would be time to move ­ one of life's transitions. We found a policy with the best assisted living and nursing facility benefits she could get.

So seek out good information and advice. Decide what you need and want. It's not an easy process. But make sure you write that letter.