Long Term Care: A Factor in Retirement

Our family is working on a Long Term Care (LTC) plan for our mother. We are struggling with the issues. First problem is everyone wants control but with control comes responsibility. Our parents tried to establish who would be the decision makers. In their plans they gave power of attorney to one of my sisters and me. I never challenged this request but maybe I didn’t really understand everything.

My Dad died in 2001. My roll as one of many primary care provider to my mom didn’t really hit home till this year, 2010. In late fall of 2009 she started to need more and more assistance. I didn’t see this coming. I early 2008 she lived with us for 6 weeks or so. Then she went back to being on her own. I wish I had started then to plan for all these decision. She could have played a bigger role. My sister and I are now faced with some choices that we don’t always agree on.

I do not believe in making life style choices focusing on the financial answers. This should be one of many factors. This is good for a car but not for a life style. We need to identify what are the requirements. The list I have developed looks a little like this:

  • 24 x 7 Care
  • Ability to administer medication
  • Ability to adjust patient care and medication
  • Religious needs
  • Religious affiliation of LTC
  • Food Service
  • Care focus
    • Patient Centric
    • Medical Concerns
  • Atmosphere
  • Location
  • Amenities
  • LTC licensed
  • Hospice
  • Per day cost
  • Medicare / Medicaid eligible & accepted
  • Patient availability to family
    • Does the facility have limited visiting hours?
    • Does the patient have their own phone?
    • Is there a room for family to stay overnight?
    • Is there a larger room or area for family to gather and visit?
    • Can the patient go outdoors?
    • What is available for younger relatives
  • How many Nurses to Patients Ratio
  • Staff Turnover
  • RN’s:LPN’s:Trained Caregivers:Volunteers
  • Availabilty and Call Backs from Management Staff
  • Family Counseling services availability

This is not a finalized list but is a good start. This list is not prioritized. That task is dependent on each patient and family.

Other concerns that need to be addressed:

  • Is there a legal will in effect?
  • Is there a trust involved?
  • Is there a prearranged funeral contract?
  • Who is preparing the tax returns?
  • VA Benefits available

If there is no will, you need to see a lawyer for help. The funeral contract is a good thought especially if your parent/patient has funds. Medicaid availability is affected but those funds. It is better to put that money aside while it is available then to have to have a negative inheritance factor.