“What are they going to do with Dad? Kick him out?”

When do most people start planning for their long-term care arrangements and financing? Unfortunately, it most often doesn’t start until there’s a crisis according to Lynn Peel of Beach Glass Transitions. Only when a care giver runs out of energy or the individual in need of care runs out of money do many people confront the inevitable decisions of what to do, where to go and how to pay for it. It’s not just about the money, says Peel. There are three primary areas for evaluation and understanding.

Getting a handle on a person’s situation includes an evaluation of their medical, financial and social status – each having a profound impact on a person’s quality of life. Understanding each of those aspects also will help determine where the patient will best adapt.

Peel stressed that families, spouses and partners need to have regular discussions about their wishes, mutual responsibilities and expectations. Often, those conversations begin in an emergency room when the health care provider says,. “She can’t go home without a personal care giver or a bed in a care giving facility.”

When that conversation begins, there may be only a few days or hours to begin the discharge process as well as begin searching for available space or in-home care services. With the aging population in New England, support services and facilities are becoming more and more difficult to find, particularly on short notice. There also are procedural stumbling blocks. For example, to qualify for Medicaid assistance in a facility in Maine, a patient is supposed to have an official evaluation recognized by the State of Maine. However, you can’t get an evaluation unless you have a Medicaid-funded bed reserved. Catch-22.

Peel’s business is to assist clients with every aspect of moving from independent living through the continuum of care we all will experience. Though much of the work is evaluation and counseling, much of the value is in their advocacy and negotiating. Determining the scope of services a patient needs (e.g. a sitter vs. assistance bathing or eating) has different costs. In addition, Beach Glass Transitions (www.beachglasstransitions.com) will appeal if insurance coverage is denied. By having the foundation of the case well mapped and documented, they have been successful in savings tens of thousands of dollars for their clients.

Another surprise for aging couples is that insurers and the government may see them as individuals rather than as couples. The outcome is that many facilities can accept only the patient and not the couple – even though the quality of life may depend on couples remaining together. Peel’s approach is to do a matrix of services and circumstances that allows the family and patient to make informed decisions under the criteria of the facilities in consideration.

Perhaps the greatest jolt to a family comes when the money runs out. The question, “What are they going to do with dad? Kick him out?”The answer is “yes.” Nursing and long term care facilities are businesses with very real costs. They have salaries, benefits, maintenance, food, utilities and insurance to pay just like any other business. Though the average stay at a facility has dropped from four to two years, they are years of intensive costs.

These nearly inevitable circumstances can be avoided by early conversations.

Finally, and just as important, is avoiding the toll it takes on the caregivers. With folks living longer than ever expected, adult children and spouses are finding themselves migrating into the caregiver role while still trying to conduct their own lives. Some give up their employment while others are beaten down by the 24/7/365 responsibilities of being the child or spouse on-deck.

For employers, there is a measurable reduction in employee productivity as well as an increase cost of health services for care givers. When you lack sleep, exercise and proper nourishment, the care giver can find themselves in worse physical condition, as well.

Part of the early conversation is to explore the cost of long term care insurance. Having money available creates greater possibilities and options. These policies are becoming harder to find and more expensive as many insurance companies didn’t fully realize the costs associated with a growing number of claims. That’s why talking to an agent like Kerry Peabody at Clark Insurance makes sense. The last thing you want to do is deplete all resources leaving little for your spouse or children after your life-time of hard work and saving. So, start the conversation now.