Alz.Org needs to concentrate on formulating and developing programs of care offering a greater economy than those as now exist.
When a family is faced with its diagnosis of Alzheimer’s disease it faces a variety of issues that need immediate resolution. One of these is the handling of their estate which may be irretrievably altered by reason of the current prognosis for care of the Alzheimer’s afflicted.
Financial Issues of First Facing This Disease.
Of the many things that need to be dealt with will be:
1. What will happen if the care needed has cost for which the family is not presently prepared to pay.
2. Is there long term health coverage to pay this?
4. Is the Alzheimer afflicted able to continue working, earning the same salary? Is the spouse working earning income, is that enough to currently support the family?
5. If income of one subsides or of all of them reduce will the family be able to make it?
6. Where does the family go to fill the gap?
The Answers To These Questions Are Not Pretty!
1. The family’s private funds are normally the first source for payment of any cost of care not immediately covered by the insurance of the family.
2. Long Term Health Care coverage, if sufficient, if it specifically makes provisions, and is designed to run a sufficiently long, will pay cost of care in the home and out of home care provided by agencies qualifying for reimbursement. This applies to most institutional Nursing Home and Assisted Living Facilities. It may apply to some day care and group home settings.
3. Health Care coverage and Medicare do not pay anything but immediate Hospital and Medically related expenses provided as part of treatment. This most often does not include Nursing Home, Assisted Living facilities or equivalent styles of In House or Away from Home kinds of help.
4. In the event of diminution in earnings in the household by reason of the disease the private funds of the families are the first if not only source to make up the difference. Charitable or public assistance is predicated on the inability to pay and in many cases is difficult to get unless there is no other way.
5. If the family cannot make it, Public Assistance is available as well as assistance from many giving groups.
6. The problem is for those in-between.
Long term health care seems worth every penny paid for it, if you have it. If you do not, with an Alzheimer’s diagnosis it is unlikely you can get it. But, remember, you get what you pay for, no more, no less. If you were smart enough and have it be sure it pays enough. Be sure it runs long enough. Be sure it covers Nursing Home and Assisted Living Care.
Some financial planning with an expert is recommended. This is most important when it comes to evaluating the availability of Public Assistance. A need for care does not automatically produce Public Assistance. The law is very specific in determining where and how you qualify for it before you can get it.
In most cases the funds of the husband and wife seeking assistance (their entire estate) cannot exceed a few thousand more than 100,000 between them. This may seem to be enough. It is not when you stop to consider this:
When the need for Assistance kicks in the current need of the family doesn’t kick out, it continues. As an example: The husband, no longer earning income, needs daily attendant care. If the wife is home, able to give it that is not a new cost. In this situation the couples living conditions do not change however, they continue as they were.
The cost incident to the disease only goes up and too often is yours alone. What this means is: Current cost of living does not go down, if anything it goes up. These costs continue during the lifetime of both the husband and the wife. Circumstances change what those costs might be. They can go up, they can go down. We of course know their usual direction.
They will go down if the husband needs to go into assisted living or nursing home or some other out of home care facility. Without regard to who pays the cost of this the expenses do go down for the wife to the extent she no longer has to pay the eating and living expenses of the husband. She need no longer pay those costs incidental to his living at home. These are the only costs that stop. Housing, clothing, medical care, health insurance for both, electricity, heat, rental or mortgage expense, insurance, car care, these all remain.
When the husband dies the wife’s financial needs do not change appreciably with respect to herself. They continue. They continue her life time.
Now we come to totaling all of this to see how long that $100,000 lasts. Pull out your budget. What do you pay a month, a year? What of it will change if at all when one of you enters out of home care? Of the fixed amounts multiply them by the number of years of life expectancy the survivor is likely to live. Will it last?