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I generally get involved in long-term care (LTC) when the client
(usually single) comes in to ask me about long-term care insurance
(LTCI) -- "What to look for" in a policy or "Which is
better" after handing me information about two policies. I then
have the difficult job of asking the client to "step back" from LTCI to look at other
important factors. It is a difficult job because
the client comes in with the preconceived idea that LTCI is the
"magic bullet" for good long-term care. An extreme
illustration is the time about a dozen years ago when a client visited
me about LTC (long-term care counseling was rare in those years) and
asked me immediately "What is the best long-term care insurance
policy? Where is the best nursing home?" And when I told her that
I didn't have the answers, she asked if I could refer her to an
"expert" on the subject. Needless to say, a very disappointed
lady left my office (and she had traveled from one of the outer
boroughs to Manhattan). However, I have always believed, based on my
experience (outside my counseling) with several cases of custodial
care, that long-term care insurance is just one of a number of facets
of a very complex subject, "Long-Term Care". So in my
counseling I address LTCI only after discussing the other components of
LTC such as the following:
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1. Family support available during periods of long term
care.
2. Factors -- medical and personality -- involved in deciding on type
of care -- home care or nursing home care.
3. Choice of home attendant.
4. Choice of nursing home.
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After discussing the above I turn to long-term care
insurance and close with Medicaid, which is generally the last resort
for financing of most long-term care. The above factors can be delicate
and very personal -- with a person I am meeting for the first time,
without family input. Additionally, I am covering these points
currently, with the future (ten to twenty years forecasting) in mind.
Therefore, I consider long term care the most difficult and complicated
counseling challenge. I have always believed the presence of a family
member (son, daughter, nephew, and niece) would be helpful, but it
happened in my counseling experience only a few times.
Updated:
January 3, 2007
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