• Mary Sizemore

The Reality of Not Pre-Planning for Long-Term Care

Charlene, a widow is 92 years young. She lives a simple life. She never worked or drove a car. She raised 3 children and was happy to be a grandmother and great grandmother. She was active and loved having her hair and nails done at the salon.

Six weeks ago, Charlene broke her hip. The hip was replaced, and Charlene went to rehabilitative center covered under her Medicare Part C plan. Her family thought, Charlene would be there for a few weeks and then would be released home. Unfortunately, a few weeks into her stay, Charlene complained of pain in her heel. After x-rays it was determined that she had a fractured heel. Charlene was now bed bound, unable to put weight on her leg, perform her activities of daily living and to continue rehab.

She was transferred to the hospital to treat an infection that developed from her being bed bound. She was in the hospital for 10 days. The doctor gave orders that Charlene needed skilled nursing care, since she was unable to perform her activities of daily living. Skilled nursing care for personal care is not covered under Medicare. Her family would have to apply for Medicaid.

Charlene’s family started working with the social worker at the hospital to find a bed for her in a skilled nursing facility. January in Florida is also called “snow-bird” season. Just as our restaurants and roads are overflowing with visitors so are our skilled nursing facilities. There were no Medicaid-approved beds for Charlene in the county she lived in. There was a bed about 90 minutes away in a neighboring county.

Charlene’s family is devastated and overwhelmed. This entire situation has become so stressful and caused friction between her children. No one wants Charlene to go to a skilled nursing facility, yet no one has the financial means to pay for home care on a 24/7 basis which is what Charlene requires. Now, her family has the extra burden of having to drive 90 minutes each way to see her.

By not having a long-term care plan in place, Charlene and her family were left with little choice. They had no options on where she would receive care and by whom.

Encourage your clients to have a plan. Oftentimes, that plan includes long-term care insurance – however even for those clients that are not good candidates for insurance – they still need a plan of action should they become disabled. Pre-planning with long-term care insurance is one of the most affordable solutions. However, If your client is beyond the pre-planning stage and is crisis-planning, it’s important to work with an Elder Attorney familiar with your state’s Medicaid rules. For more information, please speak with one of our marketing specialists at 1-800-945-1953.

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