The NCPC publishes periodic articles under the title "Planning for Eldercare". Each article is written to help families recognize the need for long term care planning and to help implement that planning. All elderly people, regardless of current health, should have a long term care plan. Learn More...
From its inception, the goal of the National Care Planning Council has been to educate the public on the importance of planning for long term care. With that goal in mind, we have created the largest and most comprehensive source of long term care planning material available anywhere. This material -- "Guide to Long Term Care Planning" -- is free to the public for downloading and printing on all of our web sites. Learn More...
An aging senior is a person facing his or her remaining years of life. Perhaps because of frailty or poor health or simply advanced age, this person is anticipating the end-of-life. An aging senior is no longer climbing the hill of life but has reached the pinnacle and is looking down the other side.
Aging seniors are concerned about reducing debt and maintaining adequate income. Aging seniors and their families are concerned about the need for long term care and the interaction of family members in providing that care. Or the family is concerned about finding a living arrangement that provides care support and supervision. Family and their aging loved ones are concerned about proper legal documents for the final years and for preparations for the end-of-life such as death, funerals, and burials. Aging seniors and their families are very much concerned about health issues and medical treatment and government programs to support health care and long-term care.
When assisting aging seniors and their families, Life Resource Planners focus on the concerns listed above. Planners and their team have valuable experience in dealing with these issues and using the Life Resource Planning Process will significantly improve the negative outcomes faced by most aging seniors and their families.
Long term care services are complicated and provider contacts are fragmented throughout the community. For many Americans, eldercare becomes a frustrating do-it-yourself process. This approach is unnecessary. Using aging care professionals is the most cost effective and efficient way to provide help for a loved one.
Engaging the services of professional advisers or providers to help with the challenges of aging is no different than using professionals to help with other complex issues such as car repairs, dealing with taxes, dealing with legal problems, or needing trained employees to help run a business.
With their education and training, aging care professionals also bring experience that only comes from dealing with countless hands-on, aging challenges. You should use this valuable experience.
The success of any life resource planning – whether for individuals who are wealthy or individuals who are not – relies on two key advisers. They are a care manager who specializes in providing care management for the elderly and an individual who understands finances and estate planning directed towards the final years of life.
However, the complex and wide-ranging challenges of aging preclude these two individuals from having, by themselves alone, the necessary experience or knowledge to provide all services for aging seniors. The key advisers will work with a cadre of other providers and advisers who can help provide all the additional support that the key advisers cannot provide by themselves. The key advisers provide a gateway to an entire team of professionals for care planning, financial analysis, legal work and so on.
Mary is taking care of her aging husband at home. He has diabetes and is overweight. Because of the diabetes, her husband has severe neuropathy in his legs and feet and it is difficult for him to walk. He also has diabetic retinopathy and, therefore, cannot see very well. She has to be careful that he does not injure his feet, since the last time that happened, he was in the hospital for four weeks with a severe infection. She is having difficulty helping him out of bed and with dressing and using the bathroom. She relies heavily on her son, who lives nearby, to help her manage her husband's care.
On the advice of a friend, Mary is told about a local organization that provides Life Resource Planning. The cost of an initial assessment and plan from the life resource planning team is $850. Mary thinks this cost is excessive and she is content to press on and solve her problems herself.
One day Mary is trying to lift her husband and injures her back severely. She is bedridden and cannot care for her husband. Her son, who works fulltime, now has two parents to care for. On the advice of the same friend, he decides to bring in the team and pay the fee himself. The key advisers of the life resource planning team consist of the following:
Jim -- a Certified Life Resource Planner CLRP
Sharon -- a care manager
Jim initially meets with Mary and her son and goes over the concept of life resource planning and shows them a sample plan. They agree that this sort of planning will be extremely useful to helping them manage Mary's increasing challenges. The plan will also uncover funding sources and sources of services that Mary and her son are completely unaware of. Jim does an intake questionnaire and starts the process of analyzing and completing the plan.
In the meantime, Sharon, the care manager, does a phone assessment of the family's needs. Based on Jim's planning survey and Sharon's input, a plan is put together and presented to Mary and her son. Jim and Sharon uncover a myriad of issues and have a number of specific recommendations. Because of the nature of this particular case, Sharon, the care manager, must be involved in directing the services of the other members of the team.
Sharon goes into the home and does a thorough assessment of the needs. She will be paid additional money for this service. She arranges for Mary's doctor to order Medicare home care -- another member of the life resource planning team -- during Mary's recovery. Therapists come in and help Mary with exercises and advice on lifting. Sharon advertises for and finds a private individual who is willing to live in the home for a period of time to help Mary with her recovery and watch over her husband. Sharon makes sure the new caregiver is reliable and honest and that taxes are paid for the employment. Sharon makes sure with the help of the team attorney that a proper care contract is in place for the services. Sharon enlists the support of the local area agency on aging and makes sure all services available are provided for the family.
Sharon also calls a meeting with Mary's family and explains to them the care needs and how they need to commit to help with those needs. Another member of the team, a mediator, is recommended to help the family come up with a family care agreement and provide their support and resources as well. Sharon makes arrangements with another member of the life resource planning team to rent or purchase medical equipment for lifting, moving and easier use of the bathroom facilities. Medicare will pay much of this cost.
Sharon suggests using a geriatric care physician she works closely with to help Mary in the care of her husband. The geriatrician meets with Mary and her husband and spends a great deal of time explaining the proper treatment and care of elderly with diabetes. He rearranges medications and puts Mary's husband on a new insulin regimen to better control his blood sugar. The physician starts a strict diet and insists on weight loss and exercise. The previous doctor seemed more interested in treating symptoms than in changing lifestyles. The geriatric physician feels that Mary's husband has a chance of improving his health with proper treatment. Sharon arranges for a non-medical professional home care provider to come in on weekends to spell off Mary and her employed caregiver and give them both needed rest.
Sharon also recommends another member of the life resource planning team who provides a medical alert device in case Mary has to leave the home and is not there in case her husband is having difficulties or falls.
Yet another member of the team, a remodeling and repair specialist comes in to install handrails and widen doorways so that Mary's husband can use a wheelchair instead of relying on Mary directly for his ambulation.
Jim, the certified life resource planner, meets with Mary and her son and goes over his analysis and recommendations for financing, taxes and legal needs. He arranges for an appointment with Kevin, the team attorney specializing in elder law, to prepare documents for the family including powers of attorney, a living will and to provide advice and assistance on preserving Mary's remaining assets. Jim recommends a reverse mortgage specialist on his team to help Mary and her husband tap unused assets in their home's equity. Some reverse mortgage proceeds are used to pay off debt. The remaining proceeds are converted into income with a single premium immediate annuity in order to provide Mary adequate income when her husband is gone and she loses one of the Social Security payments.
Jim discusses with Mary the possibility of other living arrangements for her husband in the event his care cannot be managed any longer at home. This potential move might require the services of other members of the team such as help with downsizing and moving and selling the property if necessary and finding the right advice about where to live. Jim goes into detail on end-of-life planning which could include funding for funeral and burial, the need for other services from the team such as a hospice provider and so on. All of these additional services are provided by members of the life resource planning team. Private and government funding options are also addressed. If Mary's husband needs to go to a nursing home, this is addressed also as well as the potential need for a Medicaid application.
Jim has put together a plan for Mary and her son to deal with Medicaid and the implications on her assets and property. Mary is very interested in preserving what few assets she has left from Medicaid spend down and recovery. She is extremely grateful for Jim's assistance in this area.
With the help of the life resource planning team, Mary's life and future have been significantly improved. Her husband as well, if he adheres to the care plan, may end up having a better quality of life for his remaining years.
In the above example, medical services, legal and financial services, government aging services, and government Medicare came together to provide improved long term care services with numerous bonuses for Mary and her husband that she was not aware of.
The following professional service providers or advisers can be part of the Life Resource Planning Team. Some of these people might work together on an ongoing basis by providing services that are common for all the cases that are encountered. This is called the "Core Planning Team." This core team might be comprised of 5 to 8 individuals or organizations. Most specialties below represent a list of trusted individuals whom the core planning team can call on to meet the needs of the community and the planning process.
1. care manager
2. elder financial advisor
3. aid and attendance specialist
4. elder law attorney
5. Medicaid planner
6. reverse mortgage specialist
7. geriatric health care provider
8. house call physician or geriatric nurse practitioner
9. long term care insurance specialist
10. Medicare supplement and advantage plan specialist
11. move manager or real estate agent specializing in seniors
12. downsize specialist
13. seniors moving company
14. home modification and remodeling
15. home maintenance, yard services and chore services
16. assisted living placement
17. home health agency
18. hospice provider
19. medical equipment
20. medical alert, home monitoring and home safety
21. funeral preplanning
22. tax planner/CPA
23. fiduciary services provider