Draft 1_KofC Presentation #1.pptx

Long Term Care Insurance: Success With LTCi Part 1 By Karen Henderson For Knights of Columbus January 2021 Copyright © Age-Friendly Business® International Agenda – Learning Outcomes • The Beginning Of It All: The Canada Health Act • Long Term Care Misconceptions • What’s Wrong With Long Term Care...

Long Term Care Insurance: Success With LTCi Part 1 By Karen Henderson For Knights of Columbus January 2021 Copyright © Age-Friendly Business® International Agenda – Learning Outcomes • The Beginning Of It All: The Canada Health Act • Long Term Care Misconceptions • What’s Wrong With Long Term Care? • The Role Of Long Term Care Planning • Tool: 8 Long Term Care Planning Questions • What Governments Do/Do Not Subsidize • How LTCI Works • Why LTCI Has Stalled In Canada • LTCI—Why Now? • Tool: Care Planning Conversation • Summary • Resources Passed in 1884 Mandate: Provinces cover “medically necessary” or “medically required” hospital, physician or surgical-dental services Result: 13 different health insurance programs Funded: Acute hospital, physician care Unfunded: Long term care Results: ➧Confusion about long term care services ➧ Inadequate, fractured care ➧Hallway medicine-ALC beds ➧Inaction by Canadians Result: What All Canadians Are Facing Right Now* • As of 2018 over 430,000 adult Canadians had unmet home care needs – completely inadequate subsidized home care to enable people to stay in their homes • As a result thousands are forced into nursing homes • Over 40,000 Canadians are currently on wait lists for long term care/nursing homes And this was before COVID-19. *Canadian Medical Association 2018 5 Result: Care Varies By Province • 13 provincial and territorial health insurance plans – funded by health transfers from Ottawa • Some provinces also charge annual health care premiums • No national standards for long term care • All provinces subsidize some nursing home/home care • Terminology is different • Fees vary • Some jurisdictions include means testing Long Term Care Misconceptions Misconception # 1: The government will pay for my care Reality: The government ONLY: ➧ Subsidizes few hours of home care daily ➧ Subsidizes nursing home care/pays for food/care – resident pays for accommodation CARE IS NOT FREE: WE PAY THROUGH OUR TAXES OR OUT OF POCKET Long Term Care Misconceptions Misconception # 2: I won’t need care Reality: Too many Canadians think their present good health will go on forever. It won’t. 8 9 Long Term Care Misconceptions Misconception # 3: I understand the costs of long term care Reality: According to a 2017 Canadian Life and Health Insurance Association survey: Nearly three-quarters of Canadians have made no provision for long term care costs in their retirement planning They have no idea about long term care costs. *2017 Long-Term Care Marketing and Thought Leadership Research Survey 10 Long Term Care Misconceptions Misconception # 4: I’m too young to need long-term care Reality: 40 per cent of people receiving long term care are adults under age 64 Accidents, chronic illnesses and disabilities can occur at any age, requiring many to seek assistance with activities of daily living. 11 What’s Wrong With Long Term Care? 1. Too little societal attention put towards LTC in Canada - Canadians have ignored it for 20+ years 2. LTC home residents: vulnerable, relatively voiceless 3. Fragmented continuum of care = unequal, inconsistent access to necessary services across Canada 4. LTC sector resources unable to provide the quality of health and social care required 5. Bricks and mortar homes often unable to protect older adults, especially those with dementia. The Role Of Long Term Care Planning • Makes sure clients have their needs fully taken care of when they stop being able to care of themselves - avoids dependency • Includes completion/update of Wills, Powers of Attorney, Letters of Direction • Integrates the funding of long term care into a financial/retirement plan • Gives clients time to learn about services/accommodations and their cost • Allows them to make important decisions while they are still able. 1. What really is long term care? 2. How likely am I to need it? Tool: 8 Long Term Care Planning Questions 3. Who will take care of me? What if they can’t? 4. When should I start thinking about planning? 5. How much money will I need? 6. Where can care be provided? Cost? 7. How will I pay for care? 8. Why is long term care a woman’s issue? 1. What Really Is Long Term Care? Goal: To maintain quality of life • Provides care, accommodation and support to frail, ill, disabled seniors • Provides custodial care - assistance with activities of daily living (ADLs) or the supervision of someone who is cognitively impaired • Provided in nursing homes, assisted living facilities, community, the home • Chronic, full time care = expensive. ` 2. How likely Am I To Need It? • Age • Gender • Disability • Marital status • Lifestyle • Present Health • Family health history • Mobility issues • Major injuries • Living alone 3. Who Will Take Care Of Me? • • • • • A husband/wife? Adult children? Friends? The health care system? Single? What if they can’t? 4. When Should I Start Thinking About Planning? • Before a crisis occurs—a fall/broken hip, heart attack/stroke, diagnosis of Alzheimer’s /related dementia • Now – while you are both physically/cognitively able to plan NOW—Before you need it! 5. How Much Money Will I Need? • Cost of care in your area • Your present/future health • Personal objectives-where you plan/want to live out your life/type of care expected • Projected longevity (livingto100.com) • Current financial situation • How much can I afford? How big is the $$ gap?? 6. Where Can Care Be Provided? The Continuum Of Care 2. Retirement home/independent/assisted living/memory care  Independent living - self-contained apartment-style accommodation geared to seniors able to live autonomously  Assisted living/supportive housing/enhanced residential care Copyright LTC Planning Network 2020 1. Home/community care—ageing in place  Memory care 3. Long term care/nursing home/Alzheimer care 4. Hospice/palliative care 20 Home/Community Care • Public system offers a few hours per day; help with: • ADLs/home support services • Nursing • Dietetics • Physiotherapy/occupational/speech therapy • Palliative care • Medical equipment • Usually a wait list for assessment/service Hourly cost: $25 - $90 per hour depending on service Annual cost: $35K - $100,000+ (24/7) per year Average Home Care Equipment Costs Wheelchairs $200-$5,000 Electric hospital beds $3,000 to $5,000 Scooters $2,400 to $5,000 Walkers $100 to $450 Bath lift $1,200 Ramps $200 to $8,000 Medication dispensing machines $25-$300 22 Retirement/Assisted Living/Memory Care Homes • Privately owned/run facilities that provide accommodation, social events, meals, housekeeping etc. • NO government subsidies • Minimal care provided upon entrance; you pay extra for more care as needed over time • Apply directly to each home; wait lists vary. Cost: $3000-$10,000+ per month depending on accommodation type/care package if required. 23 Long Term Care/Nursing Homes • 24/7 care supervision for very frail, ill seniors • Owned/operated by municipalities, religious organizations, not-for-profit or for-profit organizations BUT regulated by the provincial government • Fees set annually by each provincial government Cost: Monthly accommodation fees (co-payment by residents) $0 - $4000 depending on province/accommodation type. 24 Hospice/Palliative care • A holistic approach to care for those at the end of life • Encompasses physical care, including pain control • Can take place at home, in hospital, in long term care homes or in free-standing hospices • Only about 15 per cent of Canadians have access to integrated palliative care. Cost: Provincially covered (some equipment, drugs may cost extra.) 25 7. Why Is Long Term Care A Woman’s Issue? Two words: 1. Longevity 2. Caregiving 8. How Will I Pay For Care? • • • • • • Government pension plans Government subsidies Company pension plan Personal savings Reverse mortgage Long term care insurance What Governments Do/Do Not Subsidize Subsidize: • Physician/hospital/diagnostics • A limited number of home care hours per week • Long term care food/care (residents pay for accommodation-copayment) • Some senior expenses e.g. Drugs, eye care • Veterans’ long term care Do not subsidize • Retirement/assisted living • Caregiver compensation • Prescription drugs • Dentistry • Optometry ` How LTCi Works • A living benefit that helps pay for extended physical or cognitive care • Policy is customized to client need/affordability • Bridges the gap between what you have and what care costs will be • Offers two coverage plans: comprehensive coverage, which covers care at a facility or in a home, and facility-only, which helps pay for nursing home or assisted living care • Kicks in when purchaser needs help with 2 or more ADLs ”Your money pays for it, but your health really buys it." Why LTCi Has Stalled In Canada • Canadians think the government will pay ➔ apathy • Inadequate insurance company support ➜ lack of advisor uptake • Difficult to determine long term care risk • Canadians perceive the premiums as too high • LTCi has to compete with other mandated insurance products • Laisse faire attitude of governments • Younger population often doesn’t have a long term horizon • Poor media coverage. LTCi—Why Now? Canada’s ageing population • Canada's population in the midst of a fundamental shift • By 2030 1 in 4 will be seniors • Over 65 – 70% chance of needing • Decreased federal health care funding does not match population ageing→increased care needs • As Canadians live longer, they also live longer with chronic illnesses • Last 10 years of life impacted by chronic illnesses. LTCi—Why Now? COVID-19 • Government funding stretched too thin • Shortage of health care workers • Consumers will avoid care homes - often less expensive than ageing at home with care • Fewer care beds available • Increased stress on family caregivers • Increased competition for care providers LTCi—Why Now? Alzheimer’s Disease/Dementia • Approximately 600,000 Canadians have dementia today; by 2030 1 million • About 9 Canadians are diagnosed with dementia every hour • The annual cost to Canadians to care for those living with dementia: $12+ billion • 65 per cent of those diagnosed are women • Most significant cause of disability among Canadians 65+ but can strike much earlier • No known cause/cure • Key is risk reduction. 33 Tool: Care Planning Conversation 1. Understand the need for long term care 2. Understand the care system/subsidies in your province 3. Understand available funding options 4. Accept that it can be a difficult conversation 5. Remain upbeat; position yourself as a problem solver 6. Plan presentation carefully; develop your process Session Summary • Most clients don’t understand the need to plan for getting old • Care/subsidies varies by province • Long term care is not just about a product, it’s about planning • LTCi – a living benefit - is an integral part of financial/retirement planning • LTCi has never been positioned properly as an estate planning tool • Use/customize the marketing tools • COVID-19 has presented a unique opportunity for LTCi – the market is ready. Resources • Long Term Care Planning Network www.ltcplanningnetwork.com • Why Are Canadians So Upset About The Abuse, Neglect And Deaths In Our Long Term Care Homes? © www.ltcplanningnetwork.com/2020/why-are-canadians-so-upset-aboutthe-abuse-neglect-and-deaths-in-our-long-term-care-homes • Alzheimer Society of Canada www.Alzheimer.ca • Canadian Hospice Palliative Care Association https://www.chpca.ca/about-us/ • CanAge www.canage.ca • Living to 100 www.livingto100.com Karen Henderson Speaker, Educator, Writer, Publisher, Consultant Founder, Long Term Care Planning Network 416.526.1090 [email protected] www.ltcplanningnetwork.com Specialist in helping professional advisors, consultants and their clients understand the implications of long term care on financial, personal and family well-being. Copyright © Age-Friendly Business® International