Seven Important Reasons to Invest in a Long Term Care Insurance Policy (No matter what your wealth is) Part 2

Today, the risk of losing control over physical or mental faculties must be factored into every adult’s planning. As the population ages and medical science advances, we all have a strong chance of living longer than our parents and grandparents did. The longer we live, the more likely it is that our mental and physical conditions will weaken and we will need additional support. Here are the next two good reasons to consider investing in long term care insurance now.


Taking responsibility for your future by investing in a long term care insurance policy makes it easier for your family and those you love to have the difficult, vital conversation about your care. The implementation of that investment will get you care faster than if your family and loved ones have to struggle with how to have that conversation, figure out how to put the right plan in place and then how to implement it.

Very often an adult child will come to my office to discuss his or her parent’s declining health.  S/he may have noticed that his/her parents are getting along in years, that they’re forgetting things or that they do not have their affairs in order. The adult child would like to talk with his parents about this, but is afraid to appear greedy, even though his/her concern is to make sure that his/her parents are taken care of and that what they have worked so hard to build will be preserved. But s/he doesn’t know how to start the conversation with his/her parents.

Since the burden of ensuring that the parents are cared for will, in all likelihood, fall on the adult child, it is prudent for the adult child to ask this question. The condition of the parent’s financial and legal affairs will impact his/her life directly. The probability is that s/he will be dealing with his parents’ health concerns and their financial and legal concerns—a daunting task as the child’s life is already full with his/her own responsibilities.

While it is true that once the parents’ affairs are in order, the child’s tasks will be easier, achieving that state can be easier said than done. Bringing disability, death and inheritance into a discussion with elderly parents can be an emotional land mine for everyone.  Because it can be so emotionally difficult to have that conversation, it is normal to put it off until it is painfully clear that the conversation should have occurred a long time ago.

When planning has not yet been done, a good first step is to talk about the legal mechanisms that the parents should put in place to protect themselves and each other in the event of disability or incapacity.  It is important to update health care proxies that name who will be in charge should parents lose the capacity to make their own medical decisions.  If the health care proxy is more than five years old, it is out of date since it does not contain the HIPPA privacy waivers, and should be updated on a regular basis.

Under federal law you can name one person at a time to act as your health care agent. You can, however, name successors. It is important to name as many successors as you think advisable. If one parent names the other and capacity is in question, the alternate’s role has increased importance. It is also important to put the health care agent’s phone numbers, including cell phone numbers, on the document so that if there is a crisis, the health care agent will be called. It is crucial to know how to reach the health care agent immediately. A copy of that document should also be provided to your primary care physician and maintained as part of medical records. The caregiver/agent may also want to carry a copy of the parents’ health care proxy with him/her so that if there is an emergency, the document is on hand and can be readily shown. It can also be electronically stored and emailed to wherever needed,

It can also be useful to discuss the impact federal and state estate taxes will have on their affairs. Most elderly parents want the tax impact minimized and their assets passed directly to their children.  Sometimes it is helpful to leave them with copies of articles or books that discuss these issues in an impartial manner. Depending on the family dynamics, it may also be helpful for you to discuss this with your siblings, followed by an inclusive family meeting where the issues are all put on the table and openly discussed. Once the topic is on the table and discussed, the absolute first step is to obtain a listing of their assets, including whose name each asset is in and the approximate values. That is a mandatory starting point to the planning process, avoiding probate, reducing administrative costs and reducing taxes.

Implementing the plan that the parents have put in place is a far easier task than creating the plan for a parent who is in a stage of decline. When the parents have had that vital conversation with their own attorney and financial advisor, and their affairs have been put in order, the other family members are not then making substitute judgment choices for the parents. The choices have already been made. The documents have been signed. The risks have been evaluated and covered in a way that the parents have chosen. Any conversation about what to do is not awkward because the plan is in place.  When the parents’ health declines, the implementation of the plan becomes a business decision, the focus of which becomes how to implement it.  Inevitably, that means the appropriate and proper care will come faster.

When the plan includes an investment in a long term care policy, when it is time to implement that policy, because the system already exists, it is my experience that the person in need of care gets better and faster care. That is why a long term care policy is a prudent investment even for those individuals who are more than able to carry the cost of the long term care themselves.  Otherwise, if the family care givers have to deal with the denial, figure out how to have that vital conversation, get the plan done and then implement the health care component, it is virtually impossible to put the right care in at the right time. With the plan and the system already in place, better and more appropriate care happens faster.


At the beginning of a parent’s decline, family members and loved ones focus on the person who is declining. Everyone wants to do whatever they can to ease the pain, stop the slide,  make life better. In most families, one or two individuals shoulder most of the burden of that care. When the primary caregiver is the spouse of the declining elderly parent, s/he may not have the physical and mental stamina needed to be a primary caregiver. Not only might s/he have to dress, lift or bathe the declining person, but also keep the ship upright—cook, clean, do laundry, run errands, etc. If the declining spouse is waking up at odd hours or randomly wandering, the healthier spouse, in addition to all the stress, is not getting enough sleep.  And while the spouse is shouldering more and more responsibility, s/he is losing his/her best friend and constant companion.

Even if the spouse is overwhelmed, s/he may not tell everyone what is really going on because s/he hasn’t yet faced up to it.  S/he may fear that the decline is more significant than can be handled, that privacy will be invaded if someone else comes in to the home and disrupts the routine, or that the spouse will be taken away from the house. All those burdens and fears leads to tremendous physical and emotional stress and trauma for the healthier spouse and can result in his/her own decline.

It is also problematic if the family care giver is an adult middle-aged child. Because of the time and burden involved, questions of compensation could arise. Should the child be paid for care giving or would s/he feel guilty for taking the money? The adult child may resent the burden, but also be angry at himself/herself for feeling that way. S/he may think that since the parent took care of him/her when sh/e was little, that s/he owes them the care.

In addition, the adult child care giver probably has his/her own levels of responsibility— spouse, children, work. If the caregiver child’s spouse and children start to act out, stress fractures can arise in the marriage. Time may have to be taken off from work in order to take a parent to a doctor’s appointment or to rush to the house because a situation is out of control. When the care needs are extreme, sometimes an adult child quits his/her job or takes a leave of absence. All of the financial consequences of that decision should be explored first.  Leaving a job results not only in a loss of income, but also a loss of employee benefits, health insurance, family leave policy, flextime options, job security, retirement plans, and the break from the skill/education component of what the adult child is doing.

As a result of all these stresses, the caregiver child could also become worn out.  In a recent study conducted by the Department of Psychiatry and Behavioral Sciences at the John Hopkins University School of Medicine, fifty-five caregivers of patients with dementia talked about their feelings. The majority (48 of the 55) said they felt sad, angry, frustrated, depressed and tired most of the time. Over half of those interviewed had given up their friends, jobs or volunteer work. Being a responsible family caregiver is hard work and a lonely job. The combination of dealing with the extreme emotion and loss, exhaustion and challenging work is very stressful.

When the entire system is based on overloaded family caregivers who do not have respite, the system can break down. Nothing can break a family apart quicker than money issues, guilt and resentment over care giving. The burden of care giving needs to be shared not only with other family members. By paying professional aides/caregivers, the adult child can be involved and oversee the tasks without taking marital and financial risks. Sharing the care with professionals, aides and professional companions who are being paid because of the investment in a long term care insurance policy preserves not only the health of the declining parent but also the health of the family care givers.


Patricia Annino is a sought after speaker and nationally recognized authority on women and estate planning.  She educates and empowers women to value themselves and their contributions in order to ACCOMPLISH GREAT THINGS in the world – and in so doing PROTECT THEMSELVES, those they love, and the organizations they care about.  Annino recently released an updated version of her successful book, Women and Money: A Practical Guide to Estate Planning to include recent changes in the laws that govern how we protect our assets during and beyond our lifetime.  To download Annino’s FREE eBook, Estate Planning 101 visit,

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