photo credit: heureuy

One of my friends mentioned the other day that we’ve reached the age where we worry as much about our parents as they used to about us.

Aging isn’t for sissies, as Bette Davis aptly noted, and our parents face a fleet of health, housing and cognitive issues as they grow older. Sometimes, dealing with those issues is too much for them—and for us, whether we live next door or 3,000 miles away.

Enter the geriatric care manager, a kind of case worker for the elderly who can assess virtually every kind of problem and offer solutions.

The New York Times had an excellent piece about these professionals in its Patient Money section: “When elder care problems escalate, you can hire an expert.”

The article offers this good advice:

Be sure to ask about backgrounds and credentials. If your parent has complicated medical issues, a care manager with a nursing background might be best. If the parent has cognitive problems or is just plain ornery, someone with a master’s in social work might be better.

Find out whether the person is a member of the national care managers’ association, which has strict requirements: members must have a master’s degree in a field related to care management, like nursing or social work, two years of supervised experience and certification by one of three accrediting agencies. Ask for a brochure and a fee schedule. Learn whether the care manager works alone or in a group practice and if they will be available to you 24 hours a day or just on weekdays.

A geriatric care manager, who I found via CareManager.org, was a godsend for us when my father suffered a massive stroke while visiting his sister in Florida. Her background in nursing was invaluable as she translated what the doctors were saying into layperson’s terms and then gave us a clear idea of Dad’s likely prognosis. She helped us find a rehab facility for him and monitored his progress. It was her sad duty to let us know that he was failing, and she even helped with the funeral arrangements.

She was worth every penny—but her services didn’t come cheap, and this is one bill for the elderly that Medicare and insurance typically won’t pay. A one-time assessment can cost a few hundred dollars, while ongoing services can quickly run into the thousands. We paid $90 an hour for many, many hours, although the cost can range from $50 to $200, according to the NYT.

Some families make the cost more manageable by splitting the bill among the siblings or using the parents’ savings, if available.

If you really can’t swing the cost, the Times article mentioned other options, including the Alzheimer’s Association, which offers free care consultations for people with dementia, and the Eldercare Locator, a service of the Department of Health and Human Services, which can link you to local agencies on aging.

For more, read:

• 3 steps to helping parents grow old gracefully
• Look for a financial advisor who can wear many hats
• Should you bail out spendthrift parents?

photo credit: itspaulkelly

Here’s one rate that hasn’t dropped. The 2009 Long-Term Care Insurance Price Index — published by the American Association for Long-Term Care Insurance (www.AALTCI.org) — shows that costs for coverage have increased about 2 percent compared to a year ago. For the full report, CLICK HERE.

What is long-term care insurance? It covers expenses that health insurance and Medicare typically do not, including the cost of a nursing home or home care if you need help like feeding, dressing or bathing yourself.

The cost for long-term care insurance is closely tied to interest rates that have significantly declined in recent years.

“Investment income comprises between 40 and 60 percent of the dollars used to pay eventual long-term care claims,” said Jesse Slome, executive director of the trade organization that conducted the research.  “Premiums paid by policyholders make up the other portion and as interest rates have declined, insurers have found it necessary to raise premiums for protection.”

The industry paid out $5.8 billion in claims in 2008 to some 180,000 policyholders.

The index published annually measures costs for top-selling long-term care insurance policies that offer consumers approximately $115,000 in current benefits, with protection increasing yearly as the individual ages.

The survey compared costs for individuals age 55 with those age 65. “A married individual purchasing $172,000 in current protection will pay about $20 a week ($1,084-per-year) by qualifying for available good health discounts,” Slome explains. “By waiting until they are age 65, they’ll likely pay $63-a-week because they will need to buy more coverage to keep pace with inflation and will likely no longer qualify for the good health savings.

Does that mean you should buy now? Not necessarily.

For one thing, not everyone needs or can afford long-term care coverage. If you don’t have much income or assets, your expenses could be paid by Medicaid, which covers such costs for the poor. If you have millions and aren’t worried about protecting your kids’ inheritance, you can self-insure.

Those in between these extremes should at least explore the option of buying some coverage, usually between their mid-50s and mid-60s. For more information, visit AARP’s excellent long-term care site by CLICKING HERE.

More from my columns on insurance:

• Retiring? Here’s the insurance you still need

• 11 keys to choosing the right retirement home

• 3 costly myths about insurance