Frequently Asked Questions – Nursing Home Planning

Sadly, elder abuse is a very real problem in the United States. Conservative estimates indicate that over two million seniors are the victim of some type of elder abuse every year and that you stand a one in ten chance of being victimized at some point. Although the most likely (3 out of 4) perpetrator of elder abuse is a family member, nursing home residents are also extremely vulnerable. Research from 2010 indicates that up to half of all nursing home attendants have admitted abusing or neglecting elderly patients. To decrease your odds of becoming a victim of elder abuse, visit facilities in your area now, while you have the opportunity. Put everything in writing within your nursing home planning component of your estate plan. Finally, talk to an adult child or other loved one about the subject of elder abuse. Make sure they know what to look for in case you develop dementia or are otherwise unable to express yourself.

For seniors who need assistance with the daily tasks of living or who require less extensive medical care, there are alternatives to nursing home care, including home health care, adult day health care, and assisted living facilities.

Most health insurance policies also exclude LTC costs. You can purchase a separate long-term care insurance policy; however, the cost of LTC insurance can be quite expensive unless you purchase the policy when you are fairly young and still healthy. You will want to weigh the cost of paying LTC insurance premiums for many years against the benefits the policy will provide down the road. Pay particular attention to what the policy covers, when it will start covering expenses, and for how long it will pay your nursing home costs.

Although you may depend heavily on Medicare to cover health care expenses as a senior, Medicare only covers long-term care following a hospital admission, and even then only for a short period of time. Knowing that, you cannot depend on Medicare to cover your nursing home costs if you incur them in the future.

One of the most important reasons to include nursing home planning in your comprehensive estate plan is the cost of that care. As of 2017, the average cost of a month in long-term care in North Dakota was over $10,000. Experts tell us that in 20 years that figure will increase to almost $20,000 a month. With an average length of stay of three years, it is easy to see how the cost of nursing home care can deplete a retirement nest egg if those expenses must come out of pocket.

The U.S. Senate Special Committee on Aging explained the difference as follows: “It [long-term care] differs from other types of health care in that the goal of long-term care is not to cure an illness, but to allow an individual to attain and maintain an optimal level of functioning….Long-term care encompasses a wide array of medical, social, personal, and supportive and specialized housing services needed by individuals who have lost some capacity for self-care because of a chronic illness or disabling condition.”

The average life expectancy in the U.S. has almost doubled in the last century. Living longer is certainly good news; however, the longer you live, the greater your odds of needing long-term care.  The lifetime probability of becoming disabled in at least two activities of daily living or of being cognitively impaired is 68 percent for people age 65 and older. Of those who do become disabled or cognitively impaired, about 40 percent will need nursing home care. Given the importance of the care you receive and the cost of that care, planning for the possibility that you will need to enter a nursing home at some point in the future makes sense.