Costs and Conversations of Long-term Care

He was such a kind man, and tired. He came to my window at the bank a couple times a month where we exchanged casual conversation. This time, he opened up about his financial frustrations. He and his wife had done everything right! They dreamed together and lived frugally as they stashed away cash for their big retirement travel dreams. He had been so proud of their nest egg and hopeful for a few years of adventure. Unfortunately, his adventure balloon had burst now that his sweet wife had Alzheimer’s and was in a care facility at $7,000 per month. Good-bye entire nest egg and dream of travel. I hate that look on people’s faces when they feel their dreams have slipped through their fingers. Damn it! If only they had known about long-term care insurance! It would not have solved everything, but it would have preserved hope and made this time in his life much easier.

Other conversations I have had on this subject stand out in my mind. I recall the emotional and physical exhaustion of Susan who worked as a 24-hour live-in care taker for a older woman with dementia. The adult children were spread across the country in very busy stages of their lives with growing careers and growing children. The lack of plan or preparation had left most of the responsibility on one daughter, draining her emotional and fiscal resources. She resorted to hiring Susan, a kind woman desperate for a job, at a below market rate with little to no relief. The poor communication among siblings and strain for money and energy had created an all around toxic situation.

I also recall Mark and Diane. They joked they had unofficially entered the nursing home business. Diane had been the primary care taker for her mother a few years earlier until her mother passed. Mark’s mother’s health had seriously deteriorated as she acted as primary caretaker for her husband until he passed, and so they moved her in with them. Mark and Diane also flew back and forth between their home and the homes of two aging aunts. Neither of these spunky women had children and Mark, an only child, found himself playing honorary son to both of them. Diane spent each visit cleaning the houses, bathing the aunts, fighting with them about medications, consulting with physicians, and doing any other task that had been neglected since her last visit. As sincere as Mark and Diane were and as much as they loved these women, this responsibility significantly affected their lives, their budget, their energy, and their relationships with these women.

52% of 65-year-olds today will eventually develop a disability and require some long-term care services, according to a study by the Urban Institute and the U.S. Department of Health & Human Services. See this link for lots of great statistics.

What is your long-term care plan?

A large percent of people answer, “Well, I guess I’ll stay in my home as long as possible and my kids will check in on me,” like a fairy-tale ends with “and they all lived happily ever after.” Wouldn’t it be wonderful if we could be the lucky one who dies quickly from a heart-attack or in our sleep?

MANY cultures assume the children will simply take care of the aging parents. This is a difficult assumption in America where the average person is living paycheck to paycheck and struggling to keep up with financial and emotional obligations. Also, only 22% of American households are a traditional nuclear family structure which adds to the complications of long-term care needs.

Discussions about caring for an elderly loved one is a sensitive subject. The broad spectrum of deep emotions involved on both sides can make it feel difficult to maneuver conversations gracefully. We idealistically think that we can avoid openly speaking and planning and assume love will be strong enough to move through the demands and changes. Unfortunately, the story commonly ends with VERY expensive years of failing health, exhaustion, and resentment from a slew of unspoken and, therefore, unmet expectations from both the aged and the care-giving family members. Conversations NOT had are self-fulfilling and, ironically, do more damage to finances and relationships than the conversations that are had even if they are clumsy at first.

Regular health insurance does not cover long-term care. If you don’t have insurance to cover long-term care, you’ll have to pay for it yourself. And Medicare won’t come to the rescue either; it covers only short nursing home stays or limited amounts of home health care when you require skilled nursing or rehab. It does not pay for assisted living or custodial care, which includes supervision and help with day-to-day tasks. Medicare is also no help with home alterations such as ramps, widening doors, etc.

Having a plan provides options and options are powerful for you and your relationships.

Long-term care insurance is a great first step to starting these needed conversations and an essential part of a solid financial plan as you or your loved one approaches 60-years-old. The cost is surprisingly affordable, around $180 per month depending on policy details, if started between the recommended ages of 58-60. This is the recommended age because it is the sweet spot between giving you the cheapest cost (prices start to go up after 60) and having coverage when the need springs up in surprise. Waiting until your 70’s or 80’s to address this issue adds to the cost and reduces your options. However, now is always the best time to take action and there are still many options. Even if your policy were crazy high at $500 per month or $6000 per year, that is still less than ONE month’s costs in a care facility! See National Average Costs of Care in America.

Listen to this brief explanation of one very important and overlooked reason to have long-term care insurance.

Many employers offer a group rate or you can contact Zanders Insurance for more information on coverage and a highly competitive prices for your area. Start the process to get your finances and insurance in place TODAY!

If finances are a deterrent, it could be a good discussion for siblings to share in the long-term care insurance cost so long as the elderly family member is willing to do the qualifying medical exam process. It will be a FRACTION of the price of what will be paid without the insurance. Did you know that long-term care expenses are a major contributor to foreclosures and bankruptcy?!

Long-term care insurance is not a cure-all, and it does not mean that family won’t need to support the aging loved one at all. It simply offers the funding that removes obligation and desperation while allowing relationships and life to be front and center. It gives family members and close friends permission to hire out many aspects of care and spend time and energy enjoying each other. It allows the best medical decisions to be made as the aging parent’s physical health and independence wanes. It removes the financial liability that would be placed on the shoulders of those who most likely already feel overwhelmed by their own obligations. Taking the responsibility to cover the costs of long-term care and engage in open conversation is such a gift of love.

For more information about the costs and coverage of long-term care insurance, see this excellent resource.

See this list of Top 10 Reasons to Get Long-term Care Insurance

We can use our relationships, time, and health to preserve our money or we can use our money to preserve our time, health, and relationships.

According to “Our Family, Our Future: The Heart of Long Term Care Planning,” a national examination by Age Wave, three key topics are core to conversations with family about long term care:

  • (1) What long term options are most preferred
  • (2) Potential roles and responsibilities of different family members for managing care
  • (3) how long term care needs would be paid for if they are needed.
    • The vast majority of families have not had a comprehensive discussion regarding long term care.
    • Seventy-eight percent (78%) of men and women say they would find it helpful to talk to a financial professional about long term care planning. However, only 16% have had this conversation with a financial professional.

Minus the details of which ailment you suffer from and the time it takes for your body to say “peace out,” what do you want the final years of life to look like? to create? Yes, CREATE. You have spent your whole life learning and living, and your senior years are your chance to harvest AND sow a legacy. You will leave a legacy no matter what you do. What do you want that legacy to be?

Ruth had a plan. She talked regularly and openly with her adult children and grandchildren and was proactive with her long-term care as she aged. She spent several years in an assisted living community and enjoyed frequent visits with her family. As her health declined, the pattern of communication continued and each child did what they could to support their mother and each other. When her needs became more than her assisted living community provided, she moved in with her oldest daughter. Her finances and planning were in order so there was always adequate support. Each exchange with her children and grandchildren was clearly out of love rather than obligation. Ruth died in her daughter’s home, and her daughter’s greatest resentment was that she didn’t get to enjoy her mother longer.

There are so many moving parts to create a plan for the last decade of life, and everyone’s financial situation and support system is very unique. Start the conversation today! Share this post with those you love so they can begin, too.

If you want help getting your finances in order, outlining your legacy, or figuring out how to have a conversation with your loved one(s), Contact Ruth Liebel Financial Coaching today or schedule a free consultation. I am on a mission to help people live abundantly. How can I help you with that?

There are simple, inexpensive things you can do TODAY to help plan for aging with dignity, choice, and independence. Enjoy these fascinating Ted Talks on the greatest way to improve your quality and longevity of life.


Published by Ruth Liebel

I am a mother of 4, wife of a surgeon and soldier, girl of the Southwest but I love The South. I am a formally educated financial counselor and a Ramsey Preferred Coach. I love my work and want to empower others to live abundantly through budget, boundaries, and beliefs. What can I help you accomplish today?

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