Articles Posted in Long Term Care Planning

The stigma associated with life in nursing homes remain strong. Many seniors do everything in their power to avoid moving into a skilled nursing facility over fears of the quality of life that residents experience. These are common worries, and a key reason that New York resident conduct early estate planning and elder care planning to ensure they are doing everything they can so they have quality living options if necessary down the road.

Unfortunately, progress in addressing quality of life issues at these facilities is often slow-going. For example, one of the most well-known issues affecting nursing homes throughout the country, including New York, is the overuse of antipsychotic drugs to “control” residents. These “chemical restraints” make it easier for employees to watch a larger number residents. But the drug use drastically lower the quality of life of many residents, often placing them in a stupor without the ability to meaningfully interact with the world.

The problem of chemical restraints have been known for years, and recently federal agencies pushed to tackle the issue. But, so far, the progress has been limited. As a New York World story noted, the overall decrease in antipsychotic use is modest and some facilities throughout New York continue to increase use of the dangerous drugs.

The reverberations of Hurricane Sandy’s impact on the city are far from finished. We will be cleaning up and adapting for many months–likely years–into the future. Considering the predictions of some, we may even have to deal with large storms of this magnitude on a far more consistent basis. It affects all areas of life–including things like senior care and nursing home operations.

Many New Yorkers were shocked to learn of the goings-on at some long-term care facilities hit hardest by Sandy. Stories have been told of seniors stuck in upper levels of flooded facilities for days without power. Many questions have been raised about the management of the long-term care facilities and confusion over why the senior residents were not evacuated. In fact, in large part because of the struggle with NYC nursing home evacuations during Sandy, the Center for Medicare and Medicaid Services (CMS) will release new disaster planning for all nursing homes in the coming year.

Looking to the future, local residents are advised to understand evacuation plans for long-term care facilities where loved ones reside–or to ask about such plans when making nursing home choices. An AARP story recently profiled nursing home evacuation plans, pointing out the critical issues that facility caregivers need to consider. It is worth browsing the list to get an idea of the questions that owners and operators in New York need to be asked to ensure that seniors are protected in case any manner of natural or man-made disaster strikes requiring quick action.

From suspicious claims in an email to unsolicited letters, most of us assume we are not naive enough to fall victim to a financial scammer. This is a mistake. It takes only a moment of confusion or a lapse in judgement to provide a fraudster with the the tools they need to steal.

Financial scammers thrive in confusion and unfamiliarity. There is a reason that seniors are targeting more often than others–the elderly may be less familiar with certain aspects of modern technology or culture. As such, scammers are able to poke at their uncertainty in order to gain trust and ultimately take advantage.

These frauds are often connected to current events. Disgustingly, it was only hours after the Boston bombings that some fake charities were set up in an attempt to dupe well-intentioned community members into donating money that would end up in the pockets of criminals. Along the same lines, fraudsters are trying to exploit unfamiliarity and confusion about the high-profile national health care law. Many aspects of the law are set to take effect this year, and most community members are unfamiliar with the details of those changes. Scam artists are stepping into the void, working to use the complexity of the law to solicit funds from unsuspecting community members. Senior citizens are the most likely to be hurt.

All medical care is expensive. Many people are shocked when they get a medical bill covering costs for even minor incidents, emergency room visits, or very short hospital stays. Consider then what the costs must be for care that occurs every day for month or years–it is staggering. That is the prism through which nursing home costs should be examined. While the traditional skilled nursing home does not necessarily provide the same comprehensive care as an actual hospital, the costs of ensuring around-the-clock access to certain medical treatments is incredibly expensive.

NY Nursing Home Study

The shocking nature of those expenses were recently verified in a new study. The NY Daily News reported this week on the findings. The results of Genworth’s annual “Cost of Care” survey were revealed, confirming that there is almost nowhere more expensive to receive long-term care than New York. For example, according to the study, on average, a single room in an elder care facility in Manhattan costs a mind-boggling $180,000 per year. And this cost is not some anomaly for that borough. The average yearly cost for a senior in Queens is about $140,000, and a Long Island resident should expect to pay $160,000 each year.

If stereotypes are to be believed, all living arrangements outside of the home are mired in neglect, confusion, and unhappiness. Virtually no one claims that they want to move into a nursing home or assisted living facility, and many assume that leaving one’s house is only done at the last possible minute and often under duress.

This sort of generalizing about the “horrors” of senior care facilities is often misplaced. There are certainly many low-quality homes and individual residents who despise their living situation. But that is not at all to say that every facility–or even a majority–are like that. The truth is that there are many homes that allow residents to thrive, providing support so that their daily lives are more fulfilled than before, when they lived in their own home (often alone) and without necessary assistance with day to day tasks.

On that topic, a recent New York Times “New Old Age” blog post provides some interesting first-person discussion with one of the nation’s “foremost advocate for people living in assisted living,” Martin Bayne.

This week the New York Times published a story that will likely ring true to all those who have gone through the process of helping a loved one figure out how to secure the ideal long-term care. It is one of those issues that is easy to talk about in the abstract but that comes packed with intense emotion when one is actually thrust into it and forced to help those closest to them.

One of the scariest aspects to this situation is that it can arise virtually overnight. The NYT story shares the example of one man whose 81-year old parents seemed to go from swimming and playing sports to both becoming frail the next day. Their ailments struck at the same time. His mother developed dementia and passed away within a year of first falling ill. This left the family in a very tough spot. In the midst of grief, they had to make tough choices about how to ensure their father had proper care. Fortunately, the family was in a much better position than many, because the patriarch had purchased a long-term care insurance policy nearly three decades before. That insurance has been able to provide at-home caregivers for the last two years.

That is a key reason why the NY elder law attorneys at our firm encourage families to use long-term care insurance when possible while crafting long-term care plans.

Sunshine is often the best medicine–particularly when it comes to worries about quality of care and value of public services. When community members are able to easily find out information which explains how much services cost, error rates, and similar details, then efficiency and overall quality will likely improve. That is the idea behind a new “Sunshine Week” project that is being unrolled this week by state officials. As discussed in Business Journal story, the initiative is spearheaded by Governor Cuomo’s office in order to raise awareness of the value of open government.

The project is actually a series of unveilings, all focused on providing data in easily understood formats for residents. Conveniently, the data is all available of a new website: The New York Open Data Portal.

The goal is comprehensive, intending to provide a single location for community members to obtain information about virtually every area of government services, from county-based crime statistics to recommended fishing and river locations. Some aspects of the project may be valuable to area senior citizens and their families. For example, you can view a spreadsheet that lists the specific expenditures from the Office of Aging based on fiscal year and county.

Many of the changes and new rules associated with health insurance as part of the “Affordable Care Act” (Obamacare) will only take effect over the next year or two. One of those new rules prohibits most health insurance providers from making premium pricing decisions based on one’s gender. However, those rules do not apply to companies that provide long-term care insurance.

Therefore it does not come as a huge surprise that the nation’s largest provider of such insurance–Genworth Financial–announced that they will soon being change rate plans to account for the fact that women are more likely to need paid long-term care. According to a Washington Post story, women seeking such insurance on their own will likely see anywhere from a twenty to forty percent increases in yearly long-term care insurance payments. Importantly, the change will only affect new policyholders, as current members should not be affected. Observers note that other long-term care insurance providers will likely follow suit.

The policy change was made, say the company, because of the fact that over ⅔ of all claims on the insurance are made by women. In order to stabilize prices, the company claims that the premium rates needed to better reflect the risk and ultimate need for long-term care. The increased claims by women are likely a product of the fact that they generally live longer and provide care to their own spouses. Men are far likelier to avoid having to make claims on the insurance because their health declines sooner and their spouse often provides care. Elderly women, however, often come to need support after their spouse has passed, and they do not have the luxury of receiving free care from a relative.

Last year federal legislation was passed affecting elder care issues. In particular, the new law eliminated a floundering attempt to create a national long-term care insurance program. At the same time, the law also called for the creation of a commission to study issues of senior care financing, delivery, and workforce needs. Known as the “Long-Term Care Commission,” the general idea was that the diverse Commission would investigate the issues, create policy proposals, and submit the ideas to Congress to spur possible legislation.

The Status Update

Unfortunately, as a recent Forbes story shares, the Commission is still in dock and there are serious doubts as to whether it will be able to achieve its mission at all. The first issue is that the slate of 15 people to sit on the panel have yet to be decided upon. Apparently the White House has yet to make its three choices, and nothing can be done until the roster is actually complete.

Like the every other demographic, many older Americans are struggling with financial challenges. High costs of medication, healthcare, and concerns about the need for possible long-term skilled care often weigh on the minds of those in their fifties, sixties, seventies, and beyond. Retirees often struggle more with comparable financial issues than their younger counterparts, because their ability to increase their income to account for problems is limited.

In fact, a new report issued by the AARP (view here) actually found that one money hurdle–credit card debt–affects seniors more than anyone else.

Consumer Survey & Seniors

Contact Information