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    Beyond Long-term Care Insurance

    agingSeventy percent of people turning age 65 today can expect to require some form of long-term care during their lives, according to the U.S. Department of Health and Human Services. This stark fact makes long-term care planning critical. It can be uncomfortable to contemplate, as none of us wants to consider the times when we may necessitate assistance to meet our own physical needs, but failing to plan ahead can lead to even worse challenges not only for you, but also for your loved ones.

    Many people initially assume that obtaining a long-term care insurance policy fulfills the need to plan. While a policy can help to cover the cost of care, it does little to ensure that you would receive the type of care that you would want and under the conditions that you’d desire. A long-term care plan is a written document that describes your wishes and is shared with your community of family, friends, and caregivers. It therefore can be just as important as long-term care insurance.

    A long-term care plan is not a legal document so it can take any form, provided that it’s written and shared with others. Below is a list of what your plan should address:

    Who should provide assistance? Will it be a paid worker or a family member? If the person is to be a family member, will that individual be financially or otherwise compensated for their time? Have you had a direct conversation with the family member about your wishes and obtained their agreement?

    Where will you receive the care? Would it happen at your home or at another location? If it’s to be at your home, how long might that last and, if remaining in your home is a priority, should the care continue there at any cost? For example, are you willing to receive less assistance than you might get from an assisted living or skilled nursing facility? If care in such a facility might be required at some point, which would be your first and second choices, given your financial means and preferences?

    How will the details be coordinated?

    Long-term care needs are often challenging and confusing for family members who might have different opinions on how to help and uncertainty about how to ensure that care comes from reputable individuals or agencies. Some insurance policies offer a care coordination benefit, but the benefit could have conditions or restrictions. If you don’t have a policy, or your policy doesn’t offer a sufficient benefit, who will act as your care coordinator? Have you had a direct conversation with that individual to both obtain his or her agreement and to discuss your wishes?

    Do the answers to any of these questions change if your long-term care needs result from a memory condition, like Alzheimer’s or another dementia-related condition, rather than a physical limitation?

    Making long-term care decisions can be confusing and stressful when you or your loved one must make decisions quickly and under mental or physical stress. If initial decisions about care are made without the benefit of forethought, research, and the input of the person receiving the care, it’s likely that some of those decisions will need to be reconsidered. This would only extend the amount of time that you and your family members would spend in a stressful transition.

    By contrast, creating a long-term care plan in advance has some hidden benefits beyond making the transition to receiving care a smooth one. Conversations with friends and family members who will play a role in your care often relieves the stress those relationships may face as a result of unspoken expectations on both sides. Seeking answers to the questions outlined above can serve as an exploratory guide to discovering the various resources available to you. This gives you ample time to vet and consider each.

    Rachel J. Robasciotti is the founding partner of Robasciotti & Associates, Inc., a wealth management firm that, for over a decade, has been dedicated to serving the LGBT community.

    SFBT_AgingCommunity_1Dr. Marcy Adelman oversees the new Bay Times  Aging in Community column. For her summary of current LGBT senior challenges and opportunities, please go to:

    Founding Member of San Francisco’s LGBT Alzheimer’s/dementia Care Over Sight Committee and Co-founder and Board Member of Openhouse and Member of the Advisory Council to San Francisco Department of Aging and Adult Services.