Why You Should Consider Long Term Care Insurance in Your Retirement Planning

If you haven’t already done so, now is an excellent time to consider adding long term care insurance to your retirement portfolio. Because uninsured long term care expenses can pose a significant risk to the assets you’ve worked a lifetime to accumulate, long term care insurance should be considered as part of a complete financial plan.
 
As former Senator told the United States Senate Special Committee on Aging, “Although the need for health insurance to cover a patient’s medical expenses in case of catastrophic illness is widely recognized, few people are insured against the costs of providing long term support services for that same person. This lack of insurance coverage jeopardizes the financial security of families and diminishes the economic security of the country.”
 
The likelihood that you may need long term care is significant.  Some 70% of Americans who reach the age of 70 can expect to utilize some type of long-term care during the remainder of their lives.  And while long term care includes a broad range of services, from in-home care to nursing home care, each comes at a cost.  Those costs could be substantial, and could have a significant adverse effect on your retirement portfolio.
 
Why? Most forms of health insurance focus on medical expenses, not the custodial care and nonmedical expenses associated with long term care. Medicare only covers nursing home care after a related three-day inpatient hospital stay and even then for only 20 days before a daily co-payment is assessed and Medicare only covers a total of 100 days.

Medicaid doesn’t kick in until one has spent down a significant portion of their assets (spend-down to $2,000*).  Therefore, if either you or your spouse needs long term care, you may have to pay for that care out of your accumulated assets … unless you have long term care insurance.

genworth-nursing-cost-2016The average cost of a private room in a nursing home met or exceeded $80,000 annually.  If one partner needs such care, the cost could quickly and substantially erode the assets acquired over a lifetime.
 
Let’s use a hypothetical couple living off the interest of $500,000 of invested assets to illustrate how serious an impact long term care expenses could have.

For the sake of this discussion, assume the couples’ investments are earning approximately eight percent annually, generating about $40,000 per year in income.  Let’s also presume this couple needs all of this income to support them while they’re living together in their home.
 
Based on an $80,000 annual cost for nursing home care, it may appear that this couple has enough for a little more than six years of care. However, that basic calculation does not consider the living expenses of the spouse who remains in the community.  

If this couple is using all of their investment income to provide for their living expenses, they will soon need to start withdrawing from the principle for a portion of those living expenses as well as for the long term care expenses of the partner who needs care.
 
In circumstances like these, it’s easy to see how the assets accumulated over a lifetime could soon be completely exhausted.
 
Long term care insurance can help provide the funds to pay for the care you may need, while simultaneously protecting the assets you’ve worked a lifetime to accumulate. Long term care insurance may also help preserve financial independence, choice, and dignity, and those can be priceless.
 
It’s never too early to consider insurance because your health can change at any time, meaning you may be uninsurable and end up paying out-of-pocket.

The Partnership Asset Protection program is available in most states. This will protect your home and assets to the limit as was paid by a qualified policy.

Some people have too many assets to benefit from the Partnership. They may prefer an annuity or life insurance with a long term care rider. You can use an existing whole/universal life policy or existing annuity to fund a new policy with long term care coverage. The Pension Protection Act allows this transfer without having to pay capital gains.

Feel free to contact us for more information or for an updated quote.

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.* States can differ on spend-down.

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Don’t Fall.

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The reason for the majority of Emergency Room visits by older adults may surprise you. It’s not heart attacks, or illness, or accidents. It’s falls.

Falls lead to more nonfatal injuries in seniors than anything else, and falls are also the number one cause of injury-related deaths in older Americans.

Almost 15,000 people 65 and older died from falls and about 1.9 million were treated for injuries in emergency rooms.

1 in 3 over 65 have a fall each year, 70% of accidental deaths in people over 75 are caused by falls.

Falls are responsible for over 40% of nursing home admissions.

Injuries from falls in the elderly can include broken wrists, elbows, arms and hips.

Falling can be caused by many factors:
* Internal factors such as slowed reflexes, balance disorders, low blood pressure, visual deficits, etc.
* External factors such as poor lighting, poor room layout, the effects of medications.

What can be done?
* Make an assessment of the risk you have by answering the questions below:
* Add up your score on a separate paper or print this.
* Read information listed at bottom of this page on prevention.

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SCORE:
0-5 = Low Risk
6-8= Moderate Risk
8+ = High Risk


Prevention:
* Tell your doctor about any falls you have taken.
* Talk with your doctor and pharmacist about medications you take.
* Inspect your home for any safety problems such as lighting, flooring, and furniture.
* Make your home safer by installing night lights, bathroom grab bars and slip-resistant floors.
* In addition to strength exercising certain exercises — yoga, tai chi, and trying to balance on one leg with your eyes closed — can help improve balance.

OTHER INFORMATION:
American Academy of Orthopedic Surgeons
National Athletic Trainers’ Association
Centers for Disease Control and Prevention – Injury

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A Solution for Caregiver Shortage: Robots

The government of Japan expects a shortage of 370,000 caregivers for the elderly by 2025, and is will look to robots to help provide care in institutions and at home.

Robots can transfer patients who are unable to move themselves from bed to a wheelchair, or to a bath, for example.

A new robot named Named RIBA (Robot for Interactive Body Assistance) has been developed by RIKEN and Tokai Rubber Industries (TRI). Using the latest sensor, control, information processing, mechanical and materials technology, it is the first of its kind in the world. So far, RIBA can safely lift and move a human patient of up to 61 kg (around 135 lb.).

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RIBA’s arms have high-precision tactile sensors and its human-like body has a soft exterior of urethane foam, for patient safety and comfort. Having robots do the lifting will ease the burden on staff, reduce injuries to health care workers, and help patients who want to live at home.

Another use of robot tech is a walking aid that can give a boost when the person is walking uphill and a braking action going down hills. The robot prevents falls and helps the user carry loads safely.

There are monitor systems that collect information aimed at improving nursing care services, and robots that can detect when a patient falls down or needs help. For example, robots are being developed that can predict when a person needs to go to the toilet and guide them there at the right time, helping them with removing clothing and other necessary motions.

In addition to their uses in nursing homes, robots can contribute to self-reliance for people who have some disabilities but want to remain at home.

The Japanese government wants patients to get used to robot helpers, hoping that by 2020, 80% of patients will accept having some of their care provided by robots. Several Japanese government agencies want to encourage businesses to develop care robots, and popularize them.

The RIKEN-TRI Collaborative Center for Human-Interactive Robot Research (RTC), where RIBA was developed, expects to bring care robots to market in the near future.

Priority Areas to Which Robot Technology is to be Introduced in Nursing Care – get information at METI.

For more information on long term care issues, see the Guide To Long Term Care,

 

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Nursing home patients’ response to music opens new avenues for diagnosis and therapy

A nursing home in California began playing music for residents suffering from dementia, and got responses from patients once considered unreachable.

There are thousands of nursing homes participating in an international music and memory program.

At Villa Coronado, a nursing home in San Diego, 10 residents with traumatic brain injury were given an iPod to listen to music. Over 4,500 residents in 300 California nursing homes are taking part in a statewide experiment. One of the aims of the study is to find out whether music can replace antipsychotic drugs and restraints for agitated patients. With some patients, it seems to work.

This patient population receives little or no therapy, and are mostly bedridden, isolated from the world around them. Researchers are looking to see if the music program can reduce aggressive behavior.

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For some people, music brings back memories. It can help dementia patients become more aware of their surroundings. Music will bring a smile to some patients, and can calm those who are agitated. Some patients listening to the music will smile, move rhythmically, and be more responsive to their loved ones.

Music is said to activate more parts of the brain than any other stimulus. New research suggests music therapy could help people in a coma or in a vegetative state.

The patients’ response to music may even help physicians to diagnose consciousness. Studies show there is a high rate of misdiagnosis in vegetative patients, where it is important to determine a patient’s chance of recovery. Observing these patients leads some workers to conclude that rather than a steady state, there is a spectrum of consciousness, and patients drift in and out.

Caroline Schnakers is an associate clinical professor in the Department of Psychiatry at UCLA. Her research indicates there is a 40 to 50 percent error rate in diagnosing a patient’s consciousness. Some patients appear to be unconscious, and yet have some signs of consciousness and awareness of their surroundings.

A patient in a minimally conscious state (MCS) is considered to have more chance to recover than a patient in a vegetative state. If a patient is observed to be sometimes conscious, there is more hope of recovery. The diagnosis of a patient determines medical treatment and end-of-life decisions, so it’s important to diagnose correctly.

Some patients thought to be in a vegetative state are actually in a minimally conscious state, and they respond to the music. One nursing home activities director was excited to see how music affected the residents, saying they just come alive.

Researchers at UC Davis plan to have the initial results of their nursing home study by the end of this year. But regardless of whether music is able to replace medication, it’s worth giving patients music to improve their quality of life.

For more information on the care of dementia patients: Alzheimer’s on Guide To Long Term Care.

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After Disaster: New Emergency Requirements for Nursing Homes

During Hurricane Irma, 14 people died at The Rehabilitation Center at Hollywood Hills, Florida, due to a power outage that left residents in extreme heat. Lack of air conditioning made the building heat up like an oven. One of the victims died with a body temperature of 109.9 degrees. The nursing home’s owners now face criminal investigation and civil lawsuits.

In response to the tragedy, Florida Governor Rick Scott issued an emergency order requiring nursing homes to have generators that can run air conditioners.

The nursing home industry has brought court cases to challenge the emergency order. But in the meantime, state senators Lauren Book and Rene Garcia have filed bills to make the generator requirement a state law. Also, state senator Gary Farmer is preparing a more comprehensive Florida nursing home reform bill.

On the Federal level, U.S. Representative Debbie Wasserman Schultz is sponsoring a bill that will require nursing homes to have generators that can run air conditioning for at least 96 hours in the event of an emergency power outage. The bill will also put nursing homes on the top priority list, along with hospitals, for restoring power after a hurricane.

The Federal bill provides for loans to help small facilities comply with the new regulation. Homes that have fewer than 50 beds, or a private room monthly rate of $6,000 or less could qualify for a loan to get the generators and other required equipment. This bill also sets up higher fines for facilities that break the rules and adds nursing homes to the critical infrastructure list so power will be restored there first.

Nursing homes are among the most important resources for long term care. For more information about long term care insurance see the Guide To Long Term Care.

 

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Alzheimer’s drug: another take on Solanezumab

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The Alzheimer’s drug Solanezumab turned out to be a disappointment when clinical trials showed patients with long-established Alzheimer’s did not benefit from it. But a new study aims to find out if Solanezumab will help people who have high levels of amyloid in their brains but have not yet developed symptoms of Alzheimer’s.

Some people develop amyloid plaques in their brains years before Alzheimer’s disease symptoms appear. Amyloid plaques are a sticky buildup which accumulates outside nerve cells. These plaque formations can interfere with how the brain works, causing problems with memory and thinking. Research has shown that people with high levels of amyloid in their brains are more likely to develop Alzheimer’s disease, though some do not. The drug Solanezumab provides an antibody that binds to the amyloid proteins, and may slow the progression of the disease.

Dr. Brian Ott of Rhode Island Hospital is leading a study on the antibody drug. The vaccine is supposed to attach to the protein that makes neurofibrillary tangles in the brain, and block it from causing degeneration of other cells. This is the first study to find out whether Solanezumab can help prevent Alzheimer’s disease through early intervention.

The trial will examine healthy people ages 65 to 85, with normal memory. The subjects will undergo a Positron Emission Tomography (PET) scan to measure the amyloid in their brains. Participants must pass a general health screening and have normal brain function and memory, but an elevated amyloid level. The participants will be randomly assigned to get either the investigative antibody drug or a placebo by intravenous infusion every month. Three out of four participants will receive the drug, and the rest will get the placebo.

The study will last three years, and the results will show whether the drug can change the course of Alzheimer’s disease when given before symptoms start.

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Alzheimer’s is the sixth leading cause of death in America. It is the leading reason that people need long term care. For information on Alzheimer’s and long term care insurance, see the Guide To Long Term Care.

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Blood test coming to diagnose Alzheimer’s disease?

A research team has found a method to detect biomarkers of Alzheimer’s disease in blood platelets. The test uses a ratio between normal and abnormal brain tau proteins to identify those with Alzheimer’s disease and other neurodegenerative conditions.

The researchers found that the presence of abnormal tau proteins corresponds with decreased brain volume in parts of the brain where characteristics of Alzheimer’s appear.
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A non-invasive test for Alzheimer’s disease would help detect people at risk before symptoms develop, and make prevention and early treatment possible.

A study published in the Journal of Alzheimer’s Disease in 2016 described using levels of the protein clusterin to ascertain which dementia patients are at risk of Alzheimer’s. Also, a 2015 study focused on using metabolites in saliva to detect cognitive impairment.

In 2016, 5.4 million Americans were affected by Alzheimer’s disease. For more information, consult the Alzheimer’s @Guide To Long Term Care.


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