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"Aging in place" is an oft-quoted ideal for seniors of all ages and stages. But it takes a lot of personal, professional, and community resources to do so. The Villages movement seeks to expand the idea by helping people "age in community".
NPR looked at the "village" movement for seniors last month in a four part series. Villages are groups of seniors living in the community who come together to offer support and companionship to each other as they "age in place". For an annual fee, Villages provide volunteers and vetted professional services like handymen, as well as sponsoring events, arranging assistance for members, and other services suited to each unique "village". CLICK HERE to read - or listen to the stories!
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"I know people who refuse to visit a family member in the nursing home. They say it’s too difficult to see Grandpa that way. They’d prefer to remember him the way he was, not the way he is now. They mention the sights and smells and it disturbs them. I understand those sentiments. But I believe it’s a mistake not to go." Here is a beautiful, personal essay on living with and loving someone with dementia. The "new thinking" on caring for people with dementia is a shift from exclusively a "tragedy" narrative to one that honors, respects, and continues to celebrate the life that the person is still living. Life's different with dementia, but it's still a life and it can still be a good life. This essay not only illustrates that this is possible, but it also shows us with personal examples how to do it. Greg Lhamon is a friend and a client and one of the best radio and media executives I know ... He's also a wonderful writer and a die-hard Cardinals baseball fan. CLICK HERE or on the link or photo below to read Greg's story...  If an insurance agent tells you to replace your long-term care (LTC) insurance, be careful! Take your time. Get a second opinion. It's probably a mistake, and the agent pushing a replacement may be breaking the law. It is almost NEVER a good idea to replace an in-force LTC insurance policy. We are hearing stories almost daily of unscrupulous agents urgently telling their clients to immediately replace their in-force long-term care (LTC) insurance for a variety of reasons, all bad:
A huge mistake that many people make when considering LTC insurance is "over-quoting".
Most people do not need to buy coverage for 100% of the cost of the highest-possible cost of care (skilled nursing home), and even shorter benefit periods (3-4 years) will cover the vast majority of care needs. It's kind of like thinking, "If I can't afford a Mercedes, then I'll just wait for the bus." It shouldn't be a zero-sum, all-or-nothing decision - that's a HUGE mistake. A Malibu with cloth seats and a 4-cylinder is great transportation ... $3000 a month of LTC insurance benefits will pay for five hours of home care seven days a week, or 10 hours every-other day. It will cover more than 1/2 of a good Assisted Living Facility in most of the country, and provides a 33% "discount" to a $9000/month bill in a nursing home. LTC insurance claims data show that 60%+ of claims start at home. Guess what, about 60% of claims also END at home. Only about 20% of LTC insurance claims end in a nursing home. The average LTC insurance claim is less than four years, even less than three years for men. Cover that first before you worry about Alzheimer's care for 6+ years. If you only buy a 3-year policy (couples can "share" up to a total of 6 years for the price of 3 each), and if you do get Alzheimer's, you will still have much more private-pay flexibility than having nothing. We need to stop worrying about the cost of care in a facility where most of us are NOT likely to end up (especially with reasonable - and affordable - planning). We do need to worry about where we will get an extra $3000-$4000 a month to pay for part-time home care so our spouse can have a life, get a good night's sleep, stay healthy, etc., and so our adult kids can be care managers not caregivers. Home care comes first. Always. And this is also where families are personally and financially most at risk when someone they love needs care. Solve the part-time home care problem first. What does this have to do with LTC? Nothing ... but it's sports history and so much fun for true baseballs fans (excluding Indians'). A fantastic 7-game World Series, and an epic game 7. I'm a St. Louis boy, born and raised, and therefore a dyed-in-the-red Cardinals fan ... BUT I couldn't be happier for Chicago Cubs fans everywhere!!!  As an insurance broker who has sold LTC insurance since 1992, and who has focused exclusively on LTC insurance since 2000, I have been following the FLTCIP rate increase news since it is such a large player in the marketplace. The "average" increase for current policyholders is over 80%, with some as high as 125%!
Here's my take: Welcome to LTC insurance. The FLTCIP is basically having to realize the same increases, for the same reasons as the rest of the private LTC insurance marketplace. 125% is NOT an outlier. Several other companies including some of John Hancock's individual policies, and Genworth’s have had 80%-100%+ increases. Others have had those amounts as well cumulatively over 2 or 3 increases in the past 10 years .......... Another story that confuses "independent living" with long-term careThis was an interesting article about alternative retirement living up until the author started comparing it to assisted living and nursing homes. (Link to full CNBC article at the end of this post.) The only reasonable land-based analogy here is "independent living". Even mentioning assisted living, or worse nursing homes, is completely ridiculous. While a cruise ship is staffed for "medical care" that means, acute, temporary medical conditions, not long-term, custodial care. NO cruise ship will provide help for you to physically get out bed, bathe, dress, etc., the types of basic care services provided in assisted living. And NO cruise ship wants a long-term passenger with safety issues related to Alzheimer's or dementia. And if you're so poor off to be in a skilled nursing home, you probably can't even get on the ship. Here is a quote from today's CNBC article: A study published in the Journal of the American Geriatrics Society found that when considered over a 20-year span, "cruises were comparably priced to assisted living centers and offered a better quality of life, "though land-based assisted living can vary greatly by facility, location and needs." And here's a quote from the source article linked in the quote above (published in 2004!), that itself is quoting an article (from 2004!) in a medical journal: "Elderly people often choose assisted living facilities, nursing homes, 24 hours a day home caregivers, or family support. Living on a cruise ship might be a better choice, says Lee Lindquist, instructor of medicine at Northwestern University's Feinberg School of Medicine in Chicago, and a geriatrician at Northwestern Memorial Hospital." Dr. Lindquist should lose her (his?) license, hospital privileges, and teaching post. While there are indeed people with canes, walkers, and wheelchairs on cruise ships, NONE of them are living there. And who is it helping them bathe and dress and use the toilet on board? Right, spouses or other family. If someone needs the degree of care provided in assisted living, they cannot "live" on a cruise ship. MAYBE they could take a vacation, but the ship's staff sure as heck is not going to provide any direct care services. BTW, getting "long-term care" in a Holiday Inn is just as ridiculous. Follow this link to the full article on-line:
http://www.cnbc.com/2016/07/26/ahoy-matey-more-folks-retiring-on-a-cruise-ship.html
This idea (or the "Cruise ship vs. nursing home" variation) has been around on the internet and e-mail chains for years. But when my mom recently forwarded it to me from a group of her friends, it just set me off. Here's the e-mail ... my commentary follows: No nursing home for us. We'll be checking into a Holiday Inn! Please pardon my over-sensitivity to this old trope. I do realize it's really just a joke (as a "real" LTC planning idea it's truly a JOKE), but I meet far too many people on a daily basis who continue to turn a blind eye toward real, thoughtful, grown-up long-term care planning who take ideas like this as Conventional Wisdom, and they flippantly use it (or the "Cruise Ship vs. Nursing Home" variation) as a convenient way to allow themselves to shrug their shoulders at engaging in a personal, adult conversation about the topic. The real problem with this is two-fold:
Click "Read More" below for more details:
Genworth is selling one of its life subsidiaries (not LTC company) and the CEO got a big pay cut.
CEO pay tied to performance is a good thing for shareholders & policyholders. It's a sign of honest struggles as he brings a new, deeper understanding of and financial discipline to the LTC business. As I said last fall, part of the financial "loss" - a good 1/2 or more - was attributable to the company putting over a half-billion into policy reserves. Shareholders lost value, but policyholders gained value. The CEO's lower comp now is a result of the decisions made last year, not a sign of more, new problems. This article notes, and others are highlighting GW's attempt to sell one of its life/annuity companies. That is NOT the LTC business. At this point it appears the company is working to focus on and shore up its biggest business, LTC. The sale of a different life & annuity subsidiary will give the company more money to use to stabilize and improve its core businesses: LTC insurance and private mortgage insurance. Again, policyholders are secure with very strong reserves. Shareholders are suffering. Importantly-different perspectives. Many wonder if Genworth will, or should, stop selling LTCI. That won't solve any of their problems. New biz rates are higher, right-er priced for actual historical experience and equal to its peer competitors, if not on the high end of new rates. New sales are not the problem, it's the 35 years of old, under-priced business that continues to challenge as they work to bring those rates up closer to the new, more-experienced, "correct" rates in order to sustainably pay claims. Another reality: no one is buying LTC blocks of biz, so GW must own what it has and manage it to the best on-going value and protection for policyholders and shareholders. Again, currently, this is an investor/shareholder problem, not a policyholder problem. LTC policies are guaranteed renewable, the reserves are mandated to meet regulatory minimums to pay claims now and in the future, and the money now in reserve (including the new $500-million+) cannot be taken back out or used for anything other than policyholder claims. One size does not fit all.That bit of common sense seems to fly out the window when anyone starts commenting on how to "fix" anything, especially, complicated, dynamic problems like financial planning, retirement planning, investing and insurance. A new opinion about how to make LTC insurance cheaper and more effective is getting widespread attention thanks to an editor at the Wall Street Journal. Quoting from a column in Financial Planning magazine, Glenn Ruffenach (who I know, respect, and who has quoted me several times) writes: "...a policy with a two- or three-year elimination period — and benefits that subsequently cover as much as five or 10 years of care, if needed — would be more effective, [the author] says. "'With an elimination period that high, even the average stay in a nursing home will fall within the deductible period; the actual probability of ever having a material claim against the long-term care insurance would fall dramatically,' [the author] says. 'That’s good, as it means the cost of coverage could fall significantly, while policies could simultaneously have richer benefits (after the elimination period) and do a better job of insuring against extreme events when they occur.'" There are two significant errors in this concept:
While it is true that LTC insurance is less expensive with a longer Elimination Period - essentially creating a "higher deductible". And the advice that the EP should be two to three years is also reasonable IF the client can financially - and wants to - self-insure that much care out of pocket to have even longer benefits after that time. While not common, there are LTC plans available with extra-long EPs. But many clients remain well-served by the typical 30 to 90-day EP with total benefits lasting only three to four years. These shorter-benefit plans can be designed to provide guaranteed Medicaid asset protection in most states if there is a worst-case, very long care event. And many people rightly realize that long-term care planning with well-designed LTC insurance coverage is not about leaving money to heirs, but preserving income - and lifestyle - for others at the very beginning of a long-term care event. Bottom line, what does a particular person or family need? Long deductible plans are available, but "normal" 90-day plans remain financially viable for many. Read the WSJ article by clicking here: http://blogs.wsj.com/totalreturn/2015/01/26/a-way-to-fix-long-term-care-insurance/ You can also find it by clicking here to read it on MarketWatch.com: http://www.marketwatch.com/story/how-to-make-long-term-care-insurance-more-affordable-2015-01-26?siteid=yhoof2 The original article in Financial Planning magazine requires a subscription to view.
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