Medicare Skilled Benefits

It can be tough for older adults to rely on others for help, just as its difficult for family members to watch them decline. At a certain point, assisted living might be the best option for you or your loved one.You may have considered assisted living communities, but when is the right time to move forward? Here are 11 signs it might be time for assisted living. Plus, we added a bonus sign at the end!Signs It Might be Time for Assisted Living1. Memory ChangesMemory loss is normal as we age. For example, your loved one might forget why they entered a room or where they put the keys. But certain signs can raise forgetfulness to a new level.Examples include:Confusion about where they areGetting lostAsking the same question over and overIn these cases, assisted living communities can provide support and care to meet their needs. You can also consider an assisted living community with a memory care facility if needed.2. Cleaning and Household Chores Have Gone DownhillEven younger people have trouble keeping up with household maintenance sometimes, and age can make it harder to bend down, carry a laundry basket, or get on a stepstool to change a lightbulb.Rather than normal chore neglect, look for a clear sign of a lack of household upkeep.Examples include:Consistent dust and dirt around the floorsSmelly or stained clothingDishes repeatedly piled up in the sinkThis sign is even more important if messiness is a change from your loved ones previous habits. An assisted living community can help, as they provide cleaning services and remove the stress of maintaining an entire household.3. Assisted Living Facility Transportation Would HelpAt a certain point, driving might become dangerous if your loved one has cognitive impairments, slow reflexes, or other issues. You may notice signs of driving troubles from the passenger seat, or it might take your loved one getting a ticket or damaging their vehicle (we hope not).Assisted living communities provide transportation that can take your loved one from their home to shopping centers and doctors. Using the facilitys transportation service enables your loved one to still have some alone time, a sense of independence, and even a sense of dignity because they can run their own errandsand they can do it without using their own vehicle. 4. Eating ChangesPay attention to significant weight loss or changes to eating habits.Check for signs like:A reduced appetiteForgetting mealsLacking an adequate amount of fluidsWhile its good to ask a doctor about changes to eating habits to see if theres an underlying physical health problem in your loved one, its also possible that these signs would improve through the nutritious meals and check-ins that an assisted living facility provides.5. Personal Hygiene ConcernsSimilar to your loved one failing to keep up with home cleaning and maintenance, they may also neglect their personal hygiene.Notice signs like:Body odorDirty hairUnclean clothingSome other signs, such as an unclean home and weight loss, can also indicate that older adults neglect self-care. An assisted living community can support your loved one who self-neglects through regular meals, check-ups, and more.6. Spending Too Much Time AloneIts not bad to spend or enjoy time alone. However, it can become problematic if your loved one isolates too much. Many older adults make time for family and friends, join social groups, and head to daily activities at the senior center. However, others may live alone and be cut off from social ties for the most part.Its hard for some people to maintain a social life when they no longer have connections in the workplace and may have lost their spouse, who kept up social connections. Some people are better at being social than others, and some have decreased abilities that keep them from participating.Whatever the reason, isolation can contribute to poor health outcomes. Also, its often connected to other signs like poor hygiene and living conditions. If you notice isolation in your loved one, consider that assisted living communities bring people together for daily activities like meals and offer scheduled social interaction.7. Declining Medical ConditionsIts common for aging adults to have chronic health conditions like high blood pressure. While it is possible to manage health conditions from home, look for signs that your senior loved ones physical health is declining and chronic conditions are worsening. For instance, your loved one may have had multiple hospitalizations.These signs could indicate that your loved one is having difficulty managing the condition. Assisted living professionals could properly care for them and provide services like medication management and disease control. This can help with improved health and overall, well-being.8. Trouble Keeping Up with Daily TasksPart of an older adults failure to manage a health condition could be forgetting or neglecting to take medication. This sign can be included with failing to manage daily tasks.In addition to skipping important medication, your loved one might neglect other responsibilities.Examples include:Not paying billsNeglecting petsSkipping doctors appointmentsThese are signs of a need for extra support. Assisted living facilities can help individuals with these tasks by providing assistance with check-ins, transportation, medication management, and some medical care, including memory care if needed.9. Family Members Dont Give Enough HelpFamily members can be a great support for aging parents, but its not always enough. After all, family members have other responsibilities like work and children to take care of. Many families may not have the time, ability, or energy to care for an aging adult.Even if they can help, there may be gaps when no one is available, and a family member is generally not the same as a trained professional in senior care. Keep this in mind for yourself as an adult child, as you may not be able to fully care for your loved one, or you may have caregiver stress.While assisted living does not provide around-the-clock care like a nursing home, the staff is available to provide assistance when needed, and many of the residents consistent needs, such as meals, are taken care of. Assisted living falls on the spectrum of senior living options between independent living and a nursing home.10. Safety ConcernsSafety is an important concern regarding your senior loved one, especially if your aging parent is living alone. Keep an eye out for signs that your loved one may not be safe in their own home.Examples include:FallsDifficulty using stairs at homeWanderingDriving incidentsAssisted living can provide a secure environment that includes check-ins and various forms of support. It can take away numerous dangerous situations and provide safety features.For instance, assisted living communities offer transportation to replace your loved one driving independently and provide meals, which removes potential cooking hazards.11. Poor Mental HealthIn addition to physical health, its important to consider mental health. You might notice that your loved one has signs of depression or another concern. Or they seem sad or anxious a lot.It is possible that specialized care of assisted living could help; it provides benefits that can support mental wellness.Examples include:Proper nutritionStimulating activitiesA supportive environmentSocial connectionsIn addition, the trained professionals working at an assisted living facility can check on your parents mental health regularly and ensure your loved one is taking their medication if any is needed.11 1/2. Your Loved One Likes the Sound of Assisted Living CommunitiesOur bonus sign is that your loved one may actually want to live in an assisted living community or are at least ready to check some out. This is great news, as it can often be challenging to convince someone to give up their familiar surroundings and move to a senior care facility sometimes, its the hardest battle of all.How CarePatrol Helps You Find Assisted Living Your loved one might recognize that they could use some extra help and may like the idea of being more connected to others. Once you have them on board, it will be much easier to check out assisted living facilities and find the right one.CarePatrol has locations across the nation with local senior care advisors ready to help you with your senior care needs. Finding the right assisted living facility is often time consuming. Our local senior care advisors know the communities inside and out and can direct you to the one that best suits your needs. The best part? Its no cost to aging adults or their families. To get started, find a CarePatrol Local Senior Care Advisor near you and give us call, or request more information online. 

In addition to regular health insurance, long-term care insurance, or LTC insurance, is worth considering as part of senior care, whether for yourself or your parents.When you need this type of insurance, it can be too late to get it, so it is critical to consider it in advance when planning for the future. This guide answers the question, What is long-term care insurance? and provides more information for your planning process. Table of Contents: What is Long-term Care (LTC) Insurance?How Does Long-Term Care Insurance Work?Who May Need LTC Insurance?Who May Not Need LTC Insurance?How Do You Qualify for Long-Term Care Insurance?Benefits of Long-Term Care InsuranceWhere to Find LTC Insurance?LTC AlternativesWhat Is Long-Term Care (LTC) Insurance?Generally, regular health insurance plans do not cover long-term care services. This is where long-term care or LTC insurance comes in. It can cover services that help you with activities of daily living (ADLs), like assistance with showering and eating.This insurance helps cover personal and custodial services whether you or your loved one still lives at home or has moved to a community, such as a nursing home or assisted living community. It could also cover some services provided by a human services community organization.There are newer types of LTC insurance, including combination, hybrid, asset-based, and linked benefit options. It may be worth looking into your options and seeing whether a certain type could suit your needs and situation.How Does Long-Term Care Insurance Work?When you use care services that support activities of daily living, long-term care insurance coverage can pay you back a daily amount to cover some or all the costs of the services. The reimbursement amount depends on the pre-selected limit of your policy, like how you have certain limits and guidelines associated with a regular health insurance plan.Like other types of insurance, your coverage will vary by the insurance company you choose, the policy, and the terms of that policy. When you use the coverage, it will have maximum amounts for how many days/years it will cover and how much it will cover each day. There is also a lifetime maximum amount that reflects the two numbers together.Generally, your policy will have a waiting period. You must pay for the care up front, often for a waiting period of 30 to 90 days, and then the policy will reimburse you.Long-term care insurance often does not cover the costs of care indefinitely. Policies tend to have limits, including coverage for a limited number of years or the amount covered. Nonetheless, some policies cover long-term care costs for the rest of your life. It is essential to consider the type of plan and coverage when comparing providers. Be aware that policy premiums can increase over time.Who May Need LTC Insurance?Long-term insurance is beneficial for individuals who need to hire a professional to help with activities of daily living, such as bathing, going to the bathroom, getting dressed, and eating. When applying for LTC insurance, it is not enough to want this kind of support; you must show that you actually need it. This might be due to a chronic condition or an impairment that prevents you from being able to care for yourself.Some avoid long-term care policies because they think they are for living in a nursing home, and many people do not plan to live in one or hope to avoid it. However, you or your loved one can use LTC insurance to stay in your own home and receive extra assistance. LTC insurance can also help with other options if your family needs them, including assisted living, community services, or a nursing home if that indeed is something you end up needing even though you did not plan for it.Who May Not Need LTC Insurance?You may not benefit from this kind of insurance if you do not need professional assistance with activities of daily living. Maybe your parents can still do these activities independently, or they may have a spouses support to help them daily. Alternatively, there may be family members or friends who can help. In this case, your family may not need to hire anyone and, therefore, will not need long-term insurance to help cover costs.If your loved one does not have the conditions or diseases covered, they might not need or qualify for this insurance.How Do You Qualify for Long-Term Care Insurance?You cannot just get or use long-term care insurance. You must qualify to buy the initial plan and use its coverage.Qualifying for Long-Term Care InsuranceYou must get LTC insurance coverage when you are still healthy, so you must sign up before you need it. Ideally, you need to sign up when you are still healthy, active, and independent. If you need extra support in the home or need to move to a facility, it is often too late to get coverage. You may not qualify for long-term care insurance if you wait until you need it.You need medical underwriting to get one of these policies, so the state of health impacts whether you qualify. Policies even look at health history.The chance of being declined for LTC coverage is about 12.4 percent from ages 40 to 45 and 47.2 percent from ages 70 to 74. Further, most people wont get approved past age 75. Most people with long-term care insurance buy it in their mid-50s or mid-60s. If you can find a policy that covers you despite poor health or older age, it may be limited or cost more as the price is determined by your age when you sign up; the older you are when you first sign up for the policy, the more it will cost. Benefits of Long-Term Care InsuranceWhile long-term care insurance does not make sense for everyone, it provides numerous benefits to many people. Here are a few benefits to consider:Support for the FamilyThis insurance can help your family feel better about having your needs met as you age and have more difficulty caring for yourself. It can even take some of the burden of care away from your family members. Caring for an aging loved one can be difficult financially, physically, mentally, and in other ways. Hiring professional in-home care can reduce the burden on your family and ensure you have the right level of care you need, which may even help you have a better relationship.Increased OptionsThis kind of insurance generally gives you more options for the care you can receive. Without this insurance, you could be limited by your private finances or the restrictions of what Medicaid will cover. Having this coverage could open your options and even help you stay in your home, which many people want as they age.Tax BenefitsIn addition, having long-term care insurance can come with tax benefits. On your federal taxes and even some state taxes, you can include long-term care insurance premiums on your itemized deductions as medical expenses. Of course, this requires filing your taxes with itemized deductions and following other limitations. A tax professional can help you determine whether you could file these expenses as deductions, how much you can file, and whether it is beneficial to do so.Where to Find LTC InsuranceTalking with an estate planning or elder law attorney can help you and your family learn more about LTC insurance and how it fits into your planning.When you are ready to sign up for a plan, apply through an insurance company offering long-term care coverage. Like regular health insurance, you can look for policies through an employer, the insurance company, or an insurance broker or agent.As with other insurance, compare quotes and policies from different companies.  If applicable, you may be able to get a better group rate and easier qualification process through an employer, but it is worth comparing it to independent plans.After you apply, you go through an interview that covers your needs and personal information, such as health history and personal finance information. An insurance professional or company provides a custom policy to fit your unique situation.At this point, there is a medical underwriting process that includes contacting your physicians offices and reviewing their medical records. This part of the process can take weeks.LTC AlternativesHow else can you pay for support if you do not have long-term care insurance? If you are of age to qualify for Medicare, it can cover a portion of long-term care. Nonetheless, its coverage is extremely limited. Beyond that, you can pay for care out of pocket. Further, Medicaid is an option if you meet the qualifications, which can happen after people spend their savings on care.Medicaid vs LTC InsuranceYou may have heard that the government program Medicaid can help with the cost of long-term care, and that is true. Nonetheless, it has limits, as does long-term care insurance. What are the pros and cons of each type?To use Medicaid, you must meet financial requirements. These vary by state, but you must use your personal financial assets until they are spent down to a certain level. Medicaid will check how you used your assets over the previous 60 months, so you cannot give them away to others. Learn more about these limitations in your state and the amount a healthy spouse can keep in that state.You should also investigate whether your state has a partnership program. A partnership policy helps people use up their long-term care benefits and then switch to Medicaid coverage while keeping more of their assets. This kind of policy enables you to keep a higher amount of personal assets while using Medicaid to cover long-term care, as well as qualify for Medicaid sooner than you normally would have.Medicaid only provides coverage for certain skilled nursing care facilities and some community-based care options, such as an adult day care center. Long-term care insurance, on the other hand, tends to cover care in your own home or an assisted living facility. If you need a skilled nursing care facility, you will find more options available to you with long-term care insurance than with Medicaid.Find Support from CarePatrols Local Senior Care AdvisorsLong-term care insurance can help cover the cost of senior care, which is a critical component, but selecting the right senior care solution is equally important. CarePatrols Local Senior Care Advisor can help you determine the best senior care option for you when that time comes. Whether that means receiving home health care or transitioning to the support of assisted living, memory care, or a nursing home, our advisors will help you find the best option. Contact a CarePatrol Local Senior Care Advisor today to get started.

Congress recently made significant changes to Medicare's Part D prescription drug benefit as part of the Inflation Reduction Act. While some changes aim to help seniors afford their medications, others may have unintended consequences.On the positive side, insulin costs are now capped at $35 per month for Medicare beneficiaries. This has already provided relief for many seniors with diabetes.Starting in 2025, out-of-pocket Part D drug costs will be capped at $2,000 annually. Seniors will also have the option to spread these costs throughout the year through the new Medicare Prescription Payment Plan. These changes can benefit seniors who rely on multiple brand-name medicines or have fixed incomes.However, awareness of the new payment plan is low. Medicare could do more to inform seniors about this option, which requires opting in. Seniors should consider contacting their Part D insurers during open enrollment if they would benefit from spreading out pharmacy costs.The law's drug price negotiation provision has led to some unintended effects on drug development. At least 36 research programs and 22 experimental drugs have been discontinued as a result.Part D premiums have also increased. This year, standalone Part D plans were set to cost 21% more on average compared to last year. Many seniors switched to lower-cost options as a result. The number of available plans has decreased by about 25% since 2020.Some insurers have moved certain medications to tiers requiring higher out-of-pocket costs, restricting access to previously covered drugs. New rules like step therapy requirements have also been implemented, potentially making it harder for patients to access drugs their doctors recommend.It's important for seniors to understand these changes and their potential impacts on drug access before Medicare's open enrollment period begins in October.  Contact Carleen Lachman, Independent Insurance Specialist at 724-571-4688 to learn more.