The Rising Cost of Long-Term Care in Wisconsin
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Sarah recently appeared on WHBY's Fresh Take with Josh Dukelow to discuss the rising cost of Long-Term Care in Wisconsin and the impact of care on family caregivers.
Josh: November is National Long-Term Care Awareness Month and Family Caregivers Month. We've been talking recently about long-term care and this need to be thinking about this. Why is this such an important topic in the realm of estate planning? Long-term care might not be something a lot of people have on their radar. Why should it be on their radar?
Sarah: Long-term care is something that impacts almost everybody, whether it's an individual who needs the care themselves or a family member that needs care or they are providing care to a family member. There are very few people that aren't impacted by this usually in a variety of ways over the course of their life. The earlier that you start thinking about it, the better off you are.
Josh: So sort of the big question is, "OK, maybe I put a will together when I had my kids. Now I don't need to think about long-term care maybe until I retire. Right? Like, I shouldn't have to really worry about it until then, and then I can shop around and get what I need."
Sarah: Well [...] maybe for the fortunate few. Really, you want to start thinking about this in the context of your life and your choices. You want to understand what it is that you would like to see if you need care. Are you trying to stay home? Is there a family member that wants to provide care if they can? Can they afford to do so? Have they reached a point in their lives where they can retire or take the time off of work? Are you going to be providing some sort of payment to them and how are you going to do that?
You should consider insurance. Long-term care insurance is a wonderful option, and it can pay for at-home care, assisted living, skilled nursing level care. But it's something that you want to seek out information about before it gets cost-prohibitive. And the older you get, the more expensive it gets, because the shorter period of time the company will have to get the premiums. So the younger you start looking at it, the less expensive the premiums will really be.
And then through estate planning for people that aren't insurable or for people that insurance is just not the right option, there are options available within estate planning as well where you can have assets set aside to make sure that especially both spouses are able to afford equal care. We can equalize out situations where spouses have maybe unequal assets allocated between the two of them and making sure for everybody that you have the ability to continue to control your care and decide where and how care will be provided. That's really what long-term care planning is supposed to be about.
Josh: Making sure again, like, the larger question of estate planning that your needs and your desires are honored in the moment that the decisions have to be made.
Sarah: Right. And a big part of that is having conversations with the people that you want to have playing any sort of role within this. If the person that you're selecting to make decisions for you or to become your caregiver has no idea that they're supposed to be doing this, they can't do a good job for you. They don't have the necessary information. They don't know where to go for things. Having them have relationships with the professionals that you use so if you have a financial advisor, they know who that is and they can call and ask questions and try to make sure that you're taken care of. They start going with you to doctor's appointments, things like that. You want to put them in good position to succeed because that means you will get better care and it'll be the care that you're expecting.
Josh: Yeah. The idea of thinking about this, of planning ahead, I think really does for many, if not for most of us, require us talking to someone who knows a little more about this than we do. And that's again, where working with an estate attorney like the folks at Hooper Law Office can really help us even just understand what our options are, like what's available to us. Because I think a lot of people don't really understand what their options are.
Sarah: Oh, absolutely. The concept of long-term care in general, what exactly is long-term care? Is it care at home? Is it care in a facility? What is your definition of that, and what does it cost? In the Appleton area, it's about $119,000 per year on average right now for skilled nursing level care. And those costs are expected to double in 25 years.
Josh: So like everything else with healthcare, the price is going up. The other thing that I think is a tempting thought is, "Oh, I don't need long-term care until the end of my life." But there are things that can happen along the way that can necessitate something like skilled nursing care much earlier in your life [...] an accident where you're injured and severely disabled potentially could necessitate that kind of care and service much earlier than you may have expected.
Sarah: Absolutely. I have families that I've worked with, with spouses that have ALS, early-onset Alzheimer’s, head injuries that have resulted in early dementia, Parkinson's Disease, all of these things can impact people at a variety of ages. So it's not necessarily just about people at the end of their lives. It can happen much earlier, and then you have unique issues because, "Now we have minor children at home, and how do we make sure there are resources that are available to continue supporting them as well?"
Josh: Yeah. The other thing you mentioned earlier I want to loop back to is this idea of family caregivers, where one spouse ends up being the caregiver for the other. Again, that can happen much earlier in life than you might think it would, and that's something you want to plan for. Because like you said, there are a lot of different factors that come in, in a scenario like that.
Sarah: Absolutely. Spouses all the time, will try to provide care for each other. Or one spouse ends up declining and the other spouse becomes their caregiver, and then the stress on that causes the healthier spouse's health to decline more quickly than the one that has the problem. So it ends up being a really difficult situation for the family to be able to figure out what to do, because what's the plan? "Right now, we're just trying to get through the day." How do you figure out what the longer-term plan is? You really have to start thinking about that early.
Josh: Yeah. We have been talking in the take away this week about sacrifice inspired by Veterans Day on Monday and thinking about the sacrifices people make on our behalf, wondering whether the sacrifices we make are worth it or made in vain [...] some of the questions we've been asking.
This whole notion of planning for your estate, planning ahead is all about avoiding having to make some of those sacrifices, of having the thing you want for the people you love at the time you need it because you've planned ahead. I know Hooper Law is a big supporter of veterans across our area. Veterans and everyone else need to be thinking about these needs, because sometimes they come along in ways we're not expecting.
Sarah: Oh yeah. With veterans especially, there are resources available for people where they can use benefits to pay their family members to provide care at home. So if you do have a child that's taken a leave of absence or retired earlier, gone down to part-time hours, you can supplement their income so they can afford to provide the care that they want to for you.
I have families that come in all the time where the parent or the loved one that needs the care is sitting across from me saying, "My biggest worry is I don't want to become a burden. I don't want this to be some sort of negative issue in their lives. I want to make sure that I'm going to be OK, but I want to make sure my family's going to be OK if my health continues to decline." And it's harder to do that if you don't start looking at it early.
Josh: Yeah. And again, the planning, the conversations, the communication about all of this, that if you're number one concern is about not being a burden, then we need to make sure that the resources are in place to get the care you need without it being a burden. And there may be other considerations that have to be made as you said. You talked about family history and disease and things like that that can come into play later in life, and then there's the unexpected - the accidents and other things that can happen [...] even disease onsets there that can change those needs.
Sarah: There are always options. There's always something that can be done to help someone. It doesn't matter if they're already in care. We can always do something to put them in a better position. But the earlier you start looking at these options, the better off you'll be and the more options you will have. So you'll have more control over whatever it is you're doing.
Josh: Yeah. This is such an important topic. It's the kind of thing again, you need to talk to someone who knows more about what the options are to understand even what the questions are you are trying to answer.
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