Caregivers are just starting to receive more attention as our population ages and the burden of care increases. The fact is, many Canadians need care. And many Canadians are called upon to provide care while still raising their children. Full reference for sources: Alzheimer Society website, 2004 Statistics Canada, 2002 General Social Survey, Cycle 16: Caring for an aging society (Last three statistics)
Health Care spending Increases for people over age 65. 44% of total $ spent on over age 65.
World wide shortage of healthcare professionals 43% of total budget HC delivery is changing…delisting of services. Supreme court ruling in Quebec Copeman Healthcare Centre
No One plans for an illness let alone the concept of LTC Distinguish between Acute and LTC
Of course, it’s not just our senior population that is at risk. At every stage of our lives we are vulnerable to accidents and illnesses that can change the way we live. Full reference for sources: Multiple Sclerosis Society of Canada website, 2005 Canadian Paraplegic Association, Workforce Participation Survey of Canadians with Spinal Cord Injuries, 2000 Canadian Institute for Health Information, 2003 National Trauma Registry, Major Injury in Canada
Needing long term care shouldn’t leave you without choices. But if you don’t plan ahead, it just might mean someone else will make these choices for you. So b efore you need care, ask yourself: • What quality of care you want • Where you want to receive care (in your own home, a retirement home, a facility?) • How your family will cope, financially and emotionally, with care giving • Whether you really want to use your savings and investments for care
When you need money to fund long term care, there are two options: Pay for it out-of-pocket, using your savings or assets, or, if you’ve planned ahead, rely on insurance – after all, for pennies on the dollar, insurance money is always cheaper.
At 6% interest, savings of $200,000 would grow to over $350,000 in 10 years. But monthly care costs of $2,000 could deplete these savings in the same 10 years. As you can see, the assumptions we’ve used are conservative. Care could cost significantly more than $2,000 per month and inflation for long term care services could be significantly higher than 2%. Even so, savings can be quickly depleted.
Don’t kid yourself – becoming a caregiver will impact your life. Caregiving has its rewards, but it can also be costly. One third of caregivers incur extra expenses. Increased costs for babysitting if you’re looking after a parent and you have young children. Cell phone charges. Incidental expenses – the cost to hire someone to shovel the snow or cut the grass, prescription drugs you pick up – costs you cover off for a parent and just can’t bring yourself to recoup. At the same time your spending increases, you may lose income. One in 10 caregivers reduce their hours of work. And perhaps even more costly, your health can also suffer. One in ten caregivers report health problems. This increases to almost 3 in 10 (29%) if the caregiver provides personal care (such as bathing or toileting). Statistics Canada, 2002 General Social Survey, Cycle 16: Aging and Social Support - Tables
Long term care insurance policies help cover the costs of long term care services when you are physically dependent (that is, you need care). Physical dependency means that you require assistance from another person to perform 2 or more of the 6 activities of daily living (bathing, dressing, feeding, toileting, transferring, continence) or if you require continual supervision because of deteriorated mental ability.
Not all companies’ policies are designed the same. When you need care, some policies reimburse you for eligible expense you receive on a given day, up to a pre-determined maximum. Others – indemnity plans - pay a pre-determined daily benefit if you receive an eligible expense on that day. A third type of policy, the income plan, is the most flexible. It provides a pre-determined weekly benefit when you require care, and you don’t have to prove you received any eligible expenses. The income can be used to cover the cost of any type of service including care received from family members.
You need to plan ahead not just for your own care needs, but for those of your spouse or parents. If you want to ensure that you get the care you want or that your loved ones receive care in the setting of their choice, without causing unnecessary financial – and emotional – stress, it’s important to plan ahead.
Had a three foot fall and is now a quadriplegic. An even someone like Christopher Reeves who we perceive as having more money that most, went broke from his health care costs. If it wasn’t for his good friend Robin Williams (in picture) who has been paying or his care the last 6 years, he would not be where he is today in his rehabilitation.
Ruth Klassen et al - Facility Selection for Eldercare and Funding Operations for Eldercare
Because things change
A growing concern• 1 in 13 Canadians over age 65 is affected by dementia• 7% of Canadians age 65+ live in health care institutions• Another 28% of Canadians 65+ who don’t live in a health care institution receive care due to a long term health problem• 1 in 5 Canadians 45 years and over provide informal care to a seniorAlzheimer Society website, 2004Statistics Canada, 2002 General Social Survey
Demographics – Reality!By 2011 the number of Canadians over 65will increase by 40% to nearly 5 million.The over 80 group will almost double in size in thesame period.Source: April 1998 CARP News; www.50plus.comBy 2031 24% of British Columbians will be overage 65* ‘A Profile of Seniors in BC’, Ministry of Health
Health Care in BC• Health Care funding has doubled in the last decade• $3 billion added in the last 4 years• Total spending $11.6 billion 2005/2006• Health care costs in BC have increased twice as fast as the economy.• Increased demand from an aging population• Is this sustainable?
Long Term Care – What can cause it?Illness or Condition (Arthritis, MS, Stroke, Parkinson’s) There are 50,000 new strokes a year in Canada and 43% of the survivors require in-patient rehabilitation or long term care. 1Accident or Injury (falls leading to a broken hip, car accidents) Hip fractures result in a disability in 50% of those who survive. 2Deteriorated Mental Abilities (Alzheimer’s, Senile Dementia) Alzheimers Disease and related dementias affect 1 in 13 Canadians over age 65. 50% of Canadians with dementia live in nursing homes, homes for the aged or retirement homes. 5The Aging Process1- Heart and Stroke Foundation of Canada2- Osteoporosis Society of Canada3- Health Insurance Association of America Guide to Long Term Care, 19994-Alzheimer Society of Canada.5-Statistics Canada
A life altering event can happen at any age 97% of spinal cord 30 is the injuries occur before age average age of diagnosis for 50. Multiple Sclerosis. The average age of major trauma patients is43.MS Society of Canada website, 2005Canadian Paraplegic Association, 2000Canadian Institute for Health Information, 2003
If your clients need care• What is the quality of care they want to receive?• Where would they like to receive the care?• How will their families cope?• How will they pay for the care they want to receive?
How much does home care cost?• Nursing care in the home ranges from $40 to $60/hr• Personal care in the home can cost between $15 and $30/hr• Homemaking can cost from $12 to $25/hr – Weekly Costs = $300.00 - $600.00 – Monthly Costs = $1,200.00 - $2,400.00 – Yearly Costs = $24,000 - $36,000.00
How much is Facility Care?Government• Public Facilities: In BC cost is $4500. You pay according to your family income – government subsidizes the remainder• Current rates – based on a per diem starting at $29.10/day ++ or ($873 - $2200 /month)Income Testing / the higher your income the more you payPrivate• Assisted Living: $1500 - $2500+/month• Private Facilities: $3000 - $5000+/month (Annual Costs = $30,000 - $70,000)
How long will savings last? $400,000 No care needs Care needs $300,000 Assumptions: • 6% rate of return $200,000 • Initial $2000 monthly cost of $100,000 care indexed to 2% inflation $0 • No tax on 0 2 4 6 8 10 withdrawals Year
Costs for caregiversMore than 1/3 incur extra expensesOne in 10 reduce their hours of workOne in 10 report health problems Statistics Canada, 2002 General Social Survey
WHERE WILL THE MONEY COME FROM?Are you confident thatour Government can pay for all Health Care costs. For everyone? Forever? Or will you be partially or wholly responsible?
WHO WILL PAY YOUR CLIENTS OR THE GOVERNMENT?“British Columbians should be encouraged to purchase LTC insurance to provide for their future health care needs”.Patients First Report: Renewal and Reform of British Columbia’s Health Care System.Select Standing Committee Report on Health (2001)
What is long term care insurance? Helps cover the costs of long term care services Benefits are payable when you are physically dependent: • Require assistance from another person to perform 2 or more of the 6 activities of daily living (bathing, dressing, feeding, toileting, transferring, continence), or • Require continual supervision because of deteriorated mental ability
Not all policies are the same When your clients need care: 1. Reimbursement plans pay you back for eligible expenses you receive on a given day, up to a pre-determined daily maximum 2. Indemnity plans pay a pre-determined daily benefit if you receive an eligible expense on that day 3. Income plans provide a pre-determined weekly benefit, and you don’t have to prove you received any eligible expenses
Can a Long Term Care Situation Happen toOne of your clients?
If an accident or illnesschanges your clients life…If your clients or their loved ones need helpwith everyday activities . . .Do they have a plan?
We all would like to think that we are invincible…