Tennessee Commission on Aging and Disability
Mike Hann, Executive Director
Financial Planning
Alzheimer's disease promises to be one of the most costly chronic illnesses in America
with a far-reaching impact on elderly persons, their families, and society.
The once seemingly unlimited resources of Medicare and Medicaid are diminishing.
Medicare, Medicare supplements, and Medicaid may reimburse many of the expenses
for actual health care. However, drug costs are often a problem as Medicare does not cover
drug costs. Medicare supplement insurance policies may provide some assistance, but
the coverage of these supplements for drugs does not seem to be extensive. Income eligible
recipients may get some assistance for drug costs from Medicaid, as well as
waivers for home and community based care.
The supportive health and social services of long term care in the community is
not ordinarily covered by Medicare and Medicaid. Various supportive services are funded
under the Older Americans Act, the Community Services Block Grant, and state and local funding.
The Veterans Administration sometimes may be able to assist. Some individual communities may
have local resources and programs, although resources are scarce and
waiting lists can be long. Typically these programs are available to low income
clientele, whereas persons with incomes in the middle range may not qualify.
Families with substantial resources oftentimes plan for the expenses of long-term
care with the assistance of attorneys, trust officers, and financial advisors.
Long-term care insurance can be an effective vehicle to protect assets.
Professional health care and social services which offer independent case management
or geriatric care management can assist families
and individuals assess needs, arrange for services, and monitor the quality
of care. Assisted living and continuing care facilities with an assortment of
support services can provide care in a congregate setting.
Long term care in the community setting or in the institution is expensive.
Depending on the facility, nursing home costs may exceed $35,000 annually.
The Medicaid Program is a major funding source for institutional long-term
care. But again, Medicaid serves a low-income population, and income and assets are
subject to spend-down requirements.
It will become increasingly incumbent upon family members to finance the long-term care of the Alzheimer's patient. This care might be provided by a family member, a hired homecare giver or a nursing home. Some employers, like the Federal Government, may even provide long term care insurance. It would be wise to investigate employee benefits by contacting the human resources department. At any rate, providing care for the Alzheimer's sufferer will represent an expensive endeavor that can only be met with careful and organized planning.
Who will make the necessary decisions?
Alzheimer's disease is a progressive dementing illness. It is important to begin financial planning BEFORE the patient loses their capacity to make important decisions. The other option is to designate someone else to make the decisions. A Power of Attorney will give the appointed decision maker the authority - that is, as long as the patient is still lucid and able to make this decision. A Durable Power of Attorney is the most comprehensive directive for gaining authority, however, it is not available once the patient has become incompetent due to advanced dementia. This key difference highlights the importance of taking care of financial planning early, when a diagnosis is first made.
Take an assessment of resources
You will need to make a comprehensive assessment of resources and income. Doing this will allow you
to ascertain what is available for meeting expenses. You also will want to take the time to determine
which community, state or government programs apply to your situation. Facing reality concerning
finances is important, because some expenses are extremely high. Usually family members can ascertain which assets exist, which long-term
care options are practical, and the value of resources; but if not, there are agencies that can help
you discover this information. Contact your local Area Agency on Aging to perform a care needs asssessment.
Check out these sites for additional information
The Alzheimer's Health Assistance Foundation
Financial Planning for Alzheimer's Care
Center for Medicare and Medicaid Services
Social Security Information
Comparing nursing homes
