Senior Living Checklist: Making the decision & financial considerations
JAYME: Jayme West here from Arizona’s Morning News from KTAR. We’re continuing our discussion about senior care for Mom and Dad. And once again, I’m with Donna Taylor from Lifestream Complete Senior Living and she is the expert on this and we’ve talked about how to start that conversation with your parents in Part One. In Part Two you helped us understand the options for care.
And now here we are in Part Three and what I’d love to know more about is how I go about making the right decision for Mom and Dad. What do I need to know? Because I love them and I want them to be happy and healthy and comfortable, so how do I make the right decision?
Insurance and Medicare and Private Funds…what are your options?
DONNA: Well, I’ll keep saying it, but the first thing is we’re going to ask Mom and Dad what they want. But then from there, resource becomes the next question that then families have to consider. So now we have to ask ourselves, “We know what they want, but how are we going to pay for what they want?” And when talking about Senior Living, there’s often that misconception that Mom and Dad have Medicare, so that’s going to pay for everything.
The reality is that Medicare only pays for a very small subset of what we have been talking about. So, starting with just a retirement community, Independent Living, we’re talking about private funds. Those are the dollars that you have saved up or your regular income that comes in from whatever sources. That is what is going to pay for Independent Living. There’s certainly a small percentage of our population that qualifies for some government subsidies for Independent Living…but that’s a very small group. So mostly we’re talking about private funds [in Assisted Living].
JAYME: So that’s for Independent Living. Then for Assisted Living, which is the next level, right? Is that also private funds?
Reading the fine print with insurance planning
DONNA: Assisted Living can be paid by private funds, and that certainly is going to guide the decisions that you’ll be making on the behalf and with/in partnership with Mom and Dad. If they have private funds available, then their options are a little bit broader. There are also insurance products, long-term care products that can pay for Assisted Living, but if you have one of those insurance policies I encourage you to go pull it out and go talk to your insurance advisor and ask the question, “Does this policy provide for us to live in Assisted Living?”
If private funds and insurance is not an option, then there are government subsidies that allow and support Assisted Living. It’s called Medicaid, it’s the other side of Medicare so we’ve likely all heard about it. Arizona’s is the Arizona Long Term Care System, or as you will hear people refer to it, ALTCS. That is an income-qualified and asset-qualified system that comes through the government.
JAYME: So if you have health insurance, as a Senior, is that typically something in your health insurance plan would be to cover Assisted Living?
DONNA: It is not. And that is where the misconception comes in, Jayme, where a lot of people think, “I have Medicare” or “I have a Medicare Supplement plan or a Medicare Advantage plan” and we think that that is going to pay for Assisted Living. It is not. That is where those private funds or those insurance plans become very important.
And thankfully there’s also support. That’s the thing that I think people feel so fearful about is they start looking at Mom and Dad’s finances and they say “They do not have enough money to sustain the big bill that comes with Assisted Living every month, how am I going to get through this?” Well there is help through the Medicaid system, ALTCS, and the state of Arizona. But recognize that is both income-qualified and you also have to medically-qualified for that as well.
Pro-active planning for you and your family
JAYME: So what would you tell people who maybe aren’t in that stage of life yet, say people our age…would you tell them that they need to start planning now for that? I’m just thinking about from my personal view.
DONNA: I’d say put a lot of money aside. So yes, I would at least have a plan. I’m not a financial advisor, so I would say talk to your financial advisor to be thinking about what that looks like down the road.
JAYME: I’ve never thought about that before. Because for all I knew, my health insurance would be paying for any type of Assisted Living. That is really good information. Now, what about when you get into the more comprehensive care that we’ve talked about?
DONNA: Similar to what we were talking about on Assisted Living for either Memory Care and Support or the Skilled Nursing Centers where we’re talking about long-term care; this is where you’re going to live long-term. Those we’re still talking about private funds, insurance, or Medicaid.
Now there is that side that I said Medicare only pays for a small portion. We talked about that short-term rehab stay where you’re going to get specific therapies to get you back on your feet after something…that is where Medicare pays. That is the one piece that typically is paid for by Medicare. Medicare is like your medical insurance; you and I have medical insurance and it pays for things like prescriptions and those kinds of things. But when you’re talking about going someplace to live, Medicare pays for the short-term stay only.
JAYME: Right, so it’s not the long-term skilled nursing facilities that we’ve talked about then. So it’s something you need to plan for and plan with your parents. It goes back to our original conversation of having that talk. Maybe starting the discussion with “What do you guys have available to you for the future if that situation presents itself? Can you help us out here?” I think it’s a great service to do for your kids as well to go over what you have and what resources you and have what will be available to them.
DONNA: And I think that those resources are going to guide the choices that we get to make.
Care doesn’t have to be a compromise
JAYME: That is sad. I mean, that plays such a huge part in the type of care and maybe the quality of care that your parents get. It’s financial.
DONNA: Actually, I’m going to make a little plug for Lifestream here, because Lifestream has been serving Seniors for over 40 years, and we are actually Medicaid certified for both our Assisted Living and our Skilled Nursing. Which means, we are able to take care of that portion of the population that doesn’t have extensive resources. We are able to come alongside to partner with families to provide good quality care with a provider who’s been around for a long time.
[We are] non-profit, faith-based and we are able to provide excellent care and are Medicaid certified. We have other options as well where we can help with long-term care insurance. We can file the paperwork and help with that. Certainly, private funds work as well. But you can find quality providers who deliver good quality care, even if Medicaid is the way you have to go.
JAYME: Ok so I don’t have to sacrifice comfort, quality of care, quality of life for my parents just because we are a little short on the finances.
DONNA: In fact, I would tell you, “don’t do that.” If I were out shopping for my Mom and Dad for retirement community, I would go looking for things that are important to them. This is where we have to work a little bit harder to not view this through our own lens of what we, the child, think is important. We have to go back to that conversation that we had with Mom and Dad where they said, “this is what’s important to me.” And I would go looking for a place that honors and values their choices. The same way that we’re looking to do that, you want to go to a place that provides a meaningful life by honoring and valuing their choices.
I would look for someplace that feels like a real home. A lot of times, you get this feeling when you walk in. Is the staff welcoming and engaged? Does the place look warm and welcoming? Does it appear that the elders are engaged and given the opportunity to do the things that they want to do? Those are the things that I would look for my Mom and Dad, and they exist. So I wouldn’t sacrifice those things that are important to Mom and Dad for finances.
JAYME: Throughout this series, I’ve been introducing you as an expert on Senior Living and making those choices. As COO as Lifesteam’s Complete Senior Living, you are. At Lifestream, you do offer the full spectrum of care, correct?
DONNA: We have four communities here in the Valley. And we have everything ranging from Independent Living, Assisted Living, Memory Support as well as Skilled Nursing Care and Short Term rehab.
JAYME: Thank you Donna, you have provided us with so much great information. It’s a topic that many of us are dealing with now or are going to be dealing with soon, so thank you so much for explaining the many aspects of Senior Care.
About the Organization:
LifeStream Complete Senior Living has a 40-year legacy of serving Seniors. As a faith-based, nonprofit organization, they offer a complete spectrum of accommodations and services for the Senior adult community in the greater Phoenix area. LifeStream has four unique communities across the valley, with a variety of living arrangements and services including Independent Living, Assisted Living, Memory Care, Long-term Skilled Nursing and Short-term Rehabilitation.