Today, Paula is joined by Laura Eliason of Acsia Partners, an expert in the long term care space. She shares some personal stories, from having to take care of her aging parents to a sudden health scare with her husband.
Long term care can be the most costly need for people. It's statistically likely to happen, and it's the least protected. Typically, parents and even grandparents assume that their children or grandchildren will care for them. But this really is an undue burden to place on a loved one, particularly if they weren't aware of this possibility.
Most people think of LTC as relating to a nursing home situation, but often, it can relate to in-home care for a patient, or even respite care for a primary caregiver. If a family member is the primary caregiver, it becomes paramount for them to take care of their own health and well-being.
Long term care is defined as needing assistance for 90 days or more for a patient who needs help with two or more of the six activities of daily living - bathing, dressing, eating, transferring, toileting, and continence.
Laura deals the myth that long term care is expensive, and shares how thinking about this when you are younger is so important. Your age will help dictate your cost, but your health will be what affects your eligibility. This is why it's so important to explore this when you are younger and healthier.
For more, you can reach Laura at 248-921-4957 or via email at Laura.Eliason@acsiapartners.com
To reach Paula Christine and to check out the Making Money Matter course, you can visit her website at PaulaChristine.com
Or email Paula: Paula@PaulaChristine.com
Paula: So welcome to Beyond the Paycheck. I'm Paula Christine. Living paycheck to paycheck and struggling to get ahead really sucks, but you can take control of your money and live the life that you dream about, with knowledge and commitment. I'll provide you with the knowledge, it's up to you to make the commitment.
So I often see that families struggle when someone becomes ill and needs to be taken care of. And usually that happens when you get older in life, like maybe your parents or your grandparents. So I've asked, my friend Laura Eliason, who's a long term care specialist, to come in and explain about what long term care is and how you can protect yourself. Welcome, Laura.
Laura: Thank you.
Paula: So my first question to you is, I was reading your bio and I understand that you've experienced that long-term care situation with your parents. Do you wanna talk about that brief? If it's not too personal?
Laura: No. If that's fine. I share it with people all the time. Yes. Both my parents needed help at different points of time in their life, and there was a long time when they both did.
And when someone needs help, it can be a sudden health event, a brain injury or a stroke or just even frailties of aging. But theirs was gradual, My Dad's was more physical. My Mom' s was more dementia. And I found I was spending more time there longer and more often, and longer and more often, and trying to do the best I could with them, but also juggling my family, my children, and my job with that.
And it's very difficult. And they did have a plan. I was their long-term care plan. And that's not a bad thing, but it probably isn't what most people would want.
Paula: So they didn't have any insurance at all, they were...?
Laura: No long term care insurance, no.
Paula: Nothing?
Laura: Mm-hmm.
Paula: Yeah. I've seen that several times where in the worst case, you know, maybe there's three or four kids and one of them quit their job to go in and take care of mom and dad on a full time basis.
Which is unfair to that child because they lose out on their ability to earn income, contribute to social security, their 401ks. You know that mom and dad pass away, and then they've got to really kind of start their whole life over.
Laura: You're right. And if there are other siblings that can cause challenges and conflicts with the other siblings because it's usually the one who is closest that's called more into duty and rightfully so, I guess. But it can cause a lot of relationship challenges among siblings. Because often that burden isn't shared equally.
Paula: True. And that person needs a break. You can't do that as work and take care of parents 24-7. You know, you need to be able to walk away.
Laura: Yes. And it isn't always 24-7. It might be when they need some assistance in the morning, getting their day started, in the middle of the day, getting their medications and lunch and meals. Or it can be 24-7, but sometimes maybe in the earlier stages it isn't that much. So children or siblings might be able to help a little bit, but then that need usually increases quite a bit, that it becomes very difficult and often even before children are involved.
The spouses are or the partners are, but then you've got one person, elderly, taking care of someone who's similar age, and often the caregiver's health becomes compromised as much or more than the person they're helping. Then you've got two people.
Paula: Yeah, I heard that story one time. I was watching something about long-term care and they were interviewing a gentleman whose wife had Alzheimer's and he would not get help.
He was gonna take care of his wife and he did, but his health ended up deteriorating.
Laura: Very common.
Paula: He ended up, you know, deteriorating before she did.
Laura: That's very common, very sadly.
Paula: So let's back up a little bit and personally talk about what is long term care.
Laura: Okay. My definition of long term care, is when we need help or assistance by another person for an extended period of time, meaning 90 days or more.
And that help is usually provided in the home. The vast majority of long-term care is in the home. And I find most people don't wanna talk about it because they think of nursing homes, but the vast majority of it is in the home. And then assisted living. Last resort is nursing home, and that need for assistance can be because of some physical impairment.
When we need help with what we call, two out of the six activities of daily living or cognitive impairment and can be one or the other, sometimes both.
Paula: So what are the activities of daily living?
Laura: To help remember them, think of everything you do about the first 45 minutes to an hour of every day, transferring, getting out of bed or chair, bathing, dressing, toileting, continence, and eating.
So to qualify for needing long term care is when you need help with just two out of those six activities of daily living. Usually if you can't do one safely alone, you can't do two or three.
Paula: Yeah, that would make sense. I read a statistic that it will affect two out of every three people.
Is that correct?
Laura: Yes. The statistic has been for quite a while, 70% of people over the age of 65 will need some extended care for a period of time at some point in time.
Paula: Does it happen to people under 65? I mean, are there circumstances?
Laura: Absolutely. Yep. Very often. It can be from an injury, it can be someone working around the house, falling off the ladder, having a head injury.
People have strokes, younger. There's even early onset. Long term care isn't always old age, end of your life. It can be any age and at any stage. And I also had a personal experience with my healthy, tall, slim fit, active husband, um, had a ruptured brain aneurysm.
Paula: Oh, wow.
Laura: And he survived, which they told me he wasn't going to. It was about a 10 month process, but he did need to use his benefit. We used it for about six months, so I could, after he got home from facilities after six months, then he was getting at home therapy and then outpatient therapy, but when he wasn't receiving therapy, he couldn't be alone for a second, so I had to be in the house 24-7.
So I couldn't always do that. So I could use our policy for about five, six months and have someone come to the home about four or five hours a day so I could leave and do other things and help run his business and all kinds of things like. And then he got better. He rehabilitated, he got better and then he went off of claim and then the rest of his benefits will wait till he needs it again.
Paula: So you both have, well assuming of course you would have long-term care insurance cuz you're a long-term care specialist. That just makes sense. But isn't long-term care insurance expensive?
Laura: Um, No. And I guess everything is relative of course. So it's kinda like saying, Oh, cars are expensive.
Well, it depends what kind you get. Or houses are expensive. It depends. Or life insurance. Do you want a $50,000 policy or $500,000 policy? So it depends on what you put together as far as benefits and the different features and options in a plan. And your age is what determines premium. So the younger you do it, the better.
And even though you start younger and pay more years, you're actually paying thousands of dollars less over that period of time.
Paula: So what's the youngest you could get covered?
Laura: Depends on the carriers. Most are about 30.
Paula: That's pretty young.
Laura: Yeah. I'm doing more plans for people in their forties and fifties, which is good because like I said, the age determines your premium with what we design in your plan.
But your health is what allows you to be considered. So often I hear people, Oh, I hear you're supposed to wait until such and such an age. No, I can't tell you how many people I talked to in their forties and fifties that might not need long term care yet, but they either have a health situation, a chronic condition, a past event, or a recent diagnosis or treatment of some kind that makes them uninsurable.
And that just breaks my heart. And people that of course really need it. Really want it and can't get it.
Paula: Well, isn't that about everything? I mean, when you really want it and need it. Yeah, of course you can't get it cuz you've got that experience that's put you unqualified.
Laura: Right. Well, you can't get any insurance after you need it.
Paula: Yes, true. Your house goes up in flames, you go and try to buy homeowners insurance.
Laura: Yeah. Timing is really, really important. And again, the age is what helps determine your premium, but your health is what allows you to be covered. So that's the most important thing. So when I hear people say, Oh, wait till you're 60, or, Oh, wait till you're 62, I don't know where these people are getting these numbers.
But don't listen to it, please. And I always tell people, it won't hurt you to at least become informed, and then it's your decision. If you decide not to do anything, that's still a decision, but at least you've made that decision after you have proper information.
Paula: Let's say somebody decides not to do anything, so what are their options?
Laura: If they end up in a situation where they need long-term care and they chose to not get insurance, then your family. If you have partner or spouse, or children or family nearby, then they become your plan. And, they might not have been aware of that before until the need comes up. Or if you need to pay, then you're paying outta your pocket.
An average cost now, in the metro Detroit, area from home care to nursing home ranges from about $30,000, $40,000 to over a hundred thousand dollars a year. And so for most folks, you know, that's an invasion into your savings or your 401k or other accounts or assets you might have. It's really an invasion because you didn't plan for that.
And long term care is the largest risk that most of us will face with the highest probability, and it's the most expensive. But it's at least protected and it's because of denial and procrastination.
Paula: Yeah. Well that's the same thing about getting an estate plan. Everybody denies doing that too. I mean if you think about it, if someone says that half a million dollars and they're on care for two and a half, three years, which I think is somewhat the average. I mean, you're pretty much gonna wipe, if you're married, you're gonna wipe your spouse out.
Laura: Right. And then if one spouse uses all that money or most of it, what is the other one gonna do? What are they gonna live on?
Paula: Isn't the majority women that end up in a long-term care situation?
Laura: Well, generally because they live longer. Yeah. So most women become the caregivers. I mean, we've seen it both ways, of course, but most women are the caregivers for their husband, and it significantly affects their health usually. Or, adult children, usually adult daughters. Then when they are older, of course, as they're living longer and alone, then they're in a very tough spot.
Who's gonna take care of them? When? How? How are you gonna pay for it? And. So a long-term care plan isn't to replace family, it's to help your family maybe take care of you, but that whole burden won't be on them. That whole cost won't be out of your retirement or your savings or your annuities or whatever.
Paula: Yeah, I would think it would be very difficult. I mean, I have five children and I would not want one of them to be responsible to take care of me if something happens, It's just not fair.
Laura: Right, Right. And sometimes I meet with folks and they say, well, my kids will take care of me. I said, Okay, then that's your plan.
And if you're okay with that, that's fine. You have to make sure they're okay with that.
Paula: Yeah, that's a lot to ask is somebody, It's just not fair.
Laura: And if there is no other choice, you know, sometimes when people say, Oh, I only have one choice. Well, one choice is no choice. You don't have a choice.
That's the only time when one equals zero.
Paula: There is that option to do nothing and spend on your assets and then let the government take care of you.
Laura: Well, that's, there are again, a lot of requirements have to be met for that. And then there's look back periods, there's eligibility, then there's countable assets and the whole Medicaid, you know, filing for Medicaid or trying to get Medicaid to pay for your care.
There's a lot of requirement that must be met, a lot of criteria and it's not gonna happen overnight. And then your choice, so is to be in a Medicaid nursing home. Which is not what most people want. Another option, that's not really an option, of government care. Often people mistakenly think Medicare pays for long term care and it does not.
It's just a band-aid in the beginning because it has to follow a hospital event. If you're in a facility, it has to be skilled. You have to be there for rehabilitation. You have to be making progress. If they say they can't make any more progress, then Medicare says, Bye-bye. You gotta leave. We're not paying for you to just hang out.
And then again, you go back to who, what family are you gonna rely on? What money are you gonna pay outta your pocket?
Paula: So if I'm in my twenties and thirties and I'm looking at my parents and potentially my grandparents, how do I have that conversation with them? How do I sit 'em down and say, Hey, mom, dad, grandma, grandpa, whatcha got planned?
What's gonna happen? How do you start that?
Laura: Well, I think sometimes a good way to start some difficult conversations like that is with a story, Oh, I was talking to a friend of mine and their parent needed care, and you, it can either be a dementia, early onset Alzheimer's or like my husband rupture brain aneurism.
It can be so many different things. Again, not always old age or end of your life, so you just maybe start with a story. Gee, I was talking to a friend and her mother or dad needed help and they needed to go into a facility, had a stroke, or if it was in a nursing home or help at home. And you know, the mother can only do so much and the kids are working and it's a really difficult situation and I wanna make sure that I can do my best to help take care of you, what have you done for long-term care planning so I can best help you.
Paula: Yeah, that's a really nice way to handle it cuz you're not putting in them on the spot you're giving 'em, why you're concerned.
Laura: Yeah. It's a because I love you. I wanna make sure you're gonna get the absolute best care when you need it, because it's so much bigger than if it is a when.
Paula: Well, I'm not gonna get it.
Laura: I know. Not me!
And now there's plans now where traditional plans, but what I have a lot, and I represent many companies. Or there are many companies out there, but plans that are called hybrids, which have long-term care. And if you don't need long-term care and don't need that benefit, there's a death benefit. There's a life insurance and a death benefit that goes tax free to your beneficiaries.
Paula: Yeah, I'm familiar with those and I love those plans.
Laura: Or an annuity with long-term care, cuz most people besides their denial and procrastination say, Oh, what if I never used this? And it's interesting, we never say that about any other insurance, but we do about long term care, cuz it gives us a little excuse or deniability to not do anything.
But with these hybrids, you have long term care benefit if you need it, and if you don't, there's annuity benefit or life insurance benefit. So you really can't lose.
Paula: I mean, you've brought up some great points and so if someone wants to get ahold of you to talk about it further or put their parents in contact with you, how would they do?
Laura: Probably the best way. I'm happy to share my phone number. That's 248 921-4957. Again, 248-921-4957. And my email is Laura.Eliason@acsiapartners.com. So you can reach out to me any of those ways, even just to answer some questions or it doesn't hurt to have an informative session.
Let's talk about health. Let's talk about different types of plans and what may or may not be appropriate for you or your loved one.
Paula: So you can help people in different states, correct? Not just Michigan?
Laura: Yes. I'm licensed in 18 states.
Paula: Okay, great.
Laura: Or I can get licensed in most states in a couple days. Either that or I have partners in other states as well.
Paula: Okay, great. So I found this extremely informative. I seriously hope it's not me that ends up needing long term care, but I do know that it's something I haven't personally haven't looked at and I know I need to cuz I am getting up there in age and I have to, you know, make sure my children don't need to take care of me.
I really appreciate you spending time with us today.
Laura: Oh, my pleasure. Happy to do it.
Paula: Thank you. So if anybody would like to reach out to me, you can reach out to me at Paula@PaulaChristine.com. Or you can check out my website at PaulaChristine.com. So next week we have Jonathan Dwoskin, who is a business coach, but I've asked him to come on and talk about money mindset and setting goals, which is related to the Making Money Matter course that will be available later this week. And that's our first module, is about your money personality, money mindset, and setting goals. So look forward to hearing from Jon next week about those topics. Thanks for tuning in. We'll talk to you soon.