Dan Nicholas, CLU, CLTC         Long Term Care Planner

Burden to loved ones: "Yes, I have adult children, a spouse, friends.  I don't what to put them at risk...if I can avoid this through planning.That's why I'm talking to you."

Asset Protection: "I don't want to lose everything I've built and saved because of one chronic health event...if I can avoid this through planning. Yes, let's meet."

Asset Protection:

Sometimes, the burden is financial.

+  Client: “So you're asking how much it cost for mom?  To keep her in assisted living and out of a nursing home?...(long pause) $600,000 about. Wife: "No, dear...  more like $800,000.  You're forgetting a few things." Santa Clara couple, still working the family business at age 74. 

+  Financial Planner: “As a couple in their mid 80’s they’ve set aside $350,000 in mutual funds and bonds and CD’s through the years; rainy day money.  Is that enough?”  Assisted living facility intake staffer: “Honestly?  It’s not enough for both of them.  Not if they both want quality care for as long as they both might have to stay here.  They also have some Long Term Care insurance or an annuity, right?”  Santa Cruz Co. private pay assisted living facility intake staff

+ Planner...on the high cost of staying out of a nursing home: “And I thought $7,000 was enough.  Now the kids are spending $15,000 a month for one parent…because they don’t want mom moved from assisted living to a nursing home…too depressing.  So it’s additional private pay staff for three shifts at $12 an hour just to have mom watched so she doesn’t fall out of bed.  Assisted Living rules don’t allow two bed rails.  Sad.” – Santa Cruz Long Term Care planner, trying to help a Bay Area family

+  “Yes, I’m working with a family now paying $10,000 a month for Long Term Care.  More and more I’m coming across this.  People would do well to transfer some of this financial risk.  It’s scary; the numbers are scary.  And when it comes down to it, sadly, it is fear that motivates us to look at this…” rather than planning. – Aptos Wills, Trusts & Probate Attorney, Santa Cruz County

+  “I’m well aware of the costs. My aunt is in a home now, paying $8,000 out of pocket each month.”

Single bay area mom in her early 50’s, applying for Long Term Care insurance

+  Financial Advisor: “Yes, people find it increasingly difficult.  Home care costs can run incredibly high.”  (This Washington state financial advisor has been trying to help a Bay Area widow whose husband inherited ten million dollars and was then diagnosed with Alzheimer’s.  “As a couple they went through all but $2,000,000 in ten years, remodeling the house, providing 24/7 quality home care using RN help.  She’s asked us to try to get for her a Long Term Care annuity plan to protect what remains of her estate.” -- Sacramento LTCi  agent on” hybrid” Long Term Care annuity plans

+  A CPA comments on the local $4,700 Bay Area average cost for residential care: “Oh believe me, I’m hearing how expensive good home care can be.  I have a client who is paying out of pocket over $10,000 a month now…because he wants to receive care at home.” --Santa Cruz County CPA

+  “My dad used to talk about this special kind of insurance policy he bought ten years ago, when he was 60…five years before this whole thing (dementia) started.  I didn’t pay much attention. Now I understand.  He lived alone then in that mobile home before...now, because he thought ahead about himself, about us, his kids…he can live here, be safe, get help.  $150 a day the policy is paying.  I had no idea…I am so grateful.  I don’t know what to say.”  --Adult child to Santa Cruz Co. private pay assisted living staffer at intake

+  “If you don’t love and take care of you, how can you love and take care of anybody else? Maslow’s  pyramid taught us that, right? Every estate plan I do begins with Long Term Care insurance” --David A. Straus, Nevada tax & trust attorney to Las Vegas multi-millionaire casino owners

+  "Want people to plan ahead for quality care?  Just have them visit a local, foreign owned senior facility that gets only Medi-Cal dollars and zero private pay patient dollars."   –Capitola Skilled Nursing Facility Director

Burden to spouse and family:

Yes, sometimes health event can be short lived and not chronic.  But sometimes they last well over 90 days. 

A stroke, Parkinsons, MS, dementia can endure, can be very emotional for the whole family.  Sometimes the burden can push adult children and spouses to the point of what I call "caregiver madness,"  a unique disease all its own.  Newspapers love these stories, of course:

• Westside Santa Cruz man, Ruben Ramirez Leon, a 41-year-old caregiver of his 82-year old father. The son pleads guilty, agrees to serve four years, is implicated in his father's death due to negligence in a home fire he is accused of setting.

• "A San Jose 32 year old caregiver son, Steven Tu, was booked into county jail today for elder abuse.  His father, 80, died at home last week of bed sores." (Legal note: Even if your father asks you to let him die at home, it is against the law to die at home of bed sores.)

• A Kansas City man, Stanley Reimer, 51, was arrested and now awaits trial for dropping his (chronically) ill wife, 47, over the balcony to her death as she lay mortally (and chronically) ill with cancer. He kissed her before he let her go, overwhelmed with the $75,000 yearly cost for her care.

While president of his local chapter of financial advisors, Dan hosted a speakers panel "Ethical Issues Facing Adult Children with Aging Parents" for his peers with Santa Cruz PD investigator and Sargent, Bernie Escalante, a local elder law attorney, Kathleen Brewington, and local nursing home administrator, Charles Bruffey.  A few of the family stories told that morning brought a certain chill to the room.

More often families make due as best they can...and even still:

• The Alzheimer's Association says that to care for a spouse with dementia cuts the mortality of the well, caregiver spouse by 60%. "Caring for mom killed dad."  How many times have we heard this?
• The Federal Gov't maintains that the work of a caregiver is even more dangerous than that of a coal miner.
• The average out of pocket cost of caring for a parent at home runs $500 a month for incidentals.
• Often one adult child, most often a woman, bears the weight.  Siblings can begin to resent each other.  Attorneys suggest drafted Care Contracts for adult child caregiver compensation; yet sibling friction can run deep, survive beyond the grave.
• Often there's no plan of funding for even "respite care", where the adult child can take a weekend off.