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Caring for an elder family member

When you think of family, your loved ones come to mind a spouse, children, parents, grandparents, perhaps an aunt or uncle, or even someone special whom you consider "family." And, if you're lucky, these people are with you today, sharing in and contributing to fulfilling family life.

According to statistics, there's a good chance you will be enjoying their company for many years to come. Thanks to healthier lifestyles, advances in medicine and improved living conditions, the average life expectancy of a man today is 72, and it's 79 for a woman.

But with individuals living longer, the role of many adults has changed. Even if your loved ones are self-sufficient today, there is no guarantee their independent lifestyle and good physical health will continue. Eventually you may have the responsibility of arranging for their care. No one likes to think about the consequences of growing old, so this isn't an easy subject to bring up. But if you prepare and make plans now, you can lessen the stress and guilt during a crisis situation.

Evaluate their financial picture
For starters, take a good look at your loved one's financial picture. Explain that, not only do you want him to be comfortable in his retirement years, but you also want to arrange for his assets to be transferred according to his wishes upon his death. Talk with your loved one about his intentions, and include other family members in these discussions.  Be direct and honest. Tell him your concerns, listen to his. That way if the time ever comes when your loved one cannot participate in the decision making, you'll know you are not acting alone, but carrying out his wishes. Review the checklist to help you in this process.

Long-term care considerations
Next, have a discussion with them about long-term care and their wishes. It's important that you understand what Medicare covers and what Medicaid requires in order to provide these services.

Have you considered how you would pay the bills if you or a member of your family ever needed long-term care? If you're like many people, you may think that your health insurance coverage will pay, or Medicare, or perhaps Medicaid.

In fact, regular health insurance policies, Medicare, and Medicare supplement insurance don't cover most long-term care services. Specifically, Medicare only covers up to a 100-day benefit period for skilled care in a nursing facility if you're admitted after at least a three-day hospital stay and your doctor prescribes skilled medical care.

That means Medicare doesn't pay for any nursing facility care unless you were in the hospital first. And it doesn't pay for the custodial care that is more commonly needed for long periods, such as help with bathing, dressing, or eating.

Moreover, Medicare generally doesn't cover care in assisted living facilities. And Medicare doesn't pay for personal health care at home unless you're also receiving skilled care, such as nursing services or physical therapy.

What about Medicaid? The Medicaid program is intended only for those who meet federal and state poverty guidelines for income and assets. Plus, the government has strict rules to discourage people from giving away assets to qualify for assistance.

That's why you may want to check into long-term care insurance. Today's long-term care policies typically offer coverage for all levels of care skilled, intermediate, and personal in varied settings, including nursing facilities, assisted living facilities, adult day care centers, hospice facilities, and at home. Whether you're a candidate for coverage depends on your age, health, income assets, and personal situation.

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