Tag Archives: LTC

Long-term care (LTC) insurance policies: Rejection hurts.

An insurance agent from a large, widely-known insurance company recently told me that 50% of all applicants for long-term care (LTC) insurance are rejected.  Boy, with those statistics, it’s hardly worth pursuing, knowing that the hurt of rejection might be in your future.

John Matthews, Caring.com senior editor and attorney gives all of us a reality check:

“No one has a ‘right’ to buy long-term care insurance.  That results in insurance companies refusing to sell policies to people they think are likely to collect on the policies soon, or who might collect for a long time.  If an insurance company thinks the odds are that it might not make money on you, it won’t sell you a policy.”

WOW – that’s encouraging isn’t it?

While doing research for this article, I found the information provided by insurance brokers about LTC insurance was very enlightening.  Apparently many LTC insurance companies will accept you as an insured if you have had open-heart surgery, but will balk at covering someone who has arthritis.  Why you may ask?  I was told it is because the insured with heart issues will die before needing benefits whereas the person with arthritis will most likely become disabled and therefore cost the insurance company too much money in benefits payout.

Wow – that’s depressing, and somewhat maudlin, isn’t it?

I stand by my earlier article, Long Term Care Insurance Scares Me.  Insurers are trying to sell a product for which so few are eligible.  I thought I was scared before.  Now that I’ve done my research, I’m petrified!

Please share your experiences trying to obtain LTC insurance.  Whether you were accepted or rejected – we want to know.  If you were rejected and appealed the insurance company’s decision – we REALLY want to hear about it.

Long-term care facility heartache.

More often than not, a senior citizen moving into a long-term care (LTC) facility is doing so under duress.  “My kids said they’re not comfortable with me living on my own anymore.  Well I’m not comfortable living in this old folks home!”

SENIOR CITIZENS FIND THAT NEW ULM, MINNESOTA, ...

(Photo credit: Wikipedia)

Sound familiar?  It should.  I am a LTC Ombudsman in Washington State and I can’t tell you how often I hear residents who provide nothing but negative comments about their living conditions.  Regardless of how good the building; regardless of how fabulous the food; regardless of all the fun activities in which the residents participate, they are still not happy because the overriding dissatisfaction of not being in control of where they want to live colors all that they do.

And I agree with them.

Losing control and losing independence – a natural outcome of getting older?  Gosh, I hope not.  For the most part, a person moving into a long-term care facility has been in charge of their life – managing finances, choosing when and where they want to drive in their vehicle, eating whatever they want, whenever they want – in short, doing whatever they damn well please!  Suddenly someone else, regardless of how well-meaning, takes those freedoms away and those choices because they’re not comfortable leaving mom and/or dad alone in their own house.

English: Alarm clock Polski: Budzik

In my article: “Adjustment disorder: a long-term care facility side-effect,” I talk about the difficulties that befall the elderly as they endeavor to acclimate to senior living.  Think about it!  Going from a schedule-free life to a regimented one is difficult – whether you’re a young adult going into the military, or a senior citizen moving into an institutional living situation.  Both generations suffer greatly during this adjustment period but the adjustment takes longer when you’re in your late 70′s and upward.  And don’t forget, if the senior citizen wasn’t the one making the decision – choosing to move out of her home and into a senior housing community – the adjustment period will take longer still.

How can the adjustment period be made easier?

As advocates for residents in long-term care living situations, LTC Ombudsmen  emphasize and promote a resident’s right to make choices about pretty much everything that goes on in their new “home.”  What a novel idea!  Some of the choices that we know are important to residents are:

  • Choosing the clothes they want to wear.
  • Choosing what time they want to go to a meal.  Even if the resident wants breakfast after posted dining room breakfast hours, the culinary staff must make reasonable accommodation and provide some sort of breakfast item for that resident.
  • Choosing which activities – if any – in which the resident wants to participate.  No one should be forced to go somewhere against their will – that’s called coercion.  “Come on sweetie, you’ll like it once you get there.”  No!
  • If the resident is on some sort of care plan in the facility, the resident has the right to refuse care, even if it might be to that resident’s detriment.  When she was living in her own home, she had that right – nothing’s changed – only her environment.
  • The resident can even choose to move out of the long-term care facility if she chooses.  Don’t forget, it wasn’t her decision to move there anyway.  Long-term care housing isn’t a prison – she can leave if she wants to, even if doing so goes against the wishes of the family, and against the advice of her physician.

The bottom line is that residents in long-term care facilities aren’t children who need someone else to make decisions for them.  Granted – some residents with major cognitive decline may rely on others, such as a Power of Attorney (POA), to make decisions for them – but even then, that POA should be making decisions that the resident would have made if he/she were still capable of doing so.

Put yourself in your parent’s or grandparent’s shoes.  How would you feel if your opinions, wishes, and rights were dismissed?  Feels lousy, doesn’t it?