LTC Transcript from Otter.docx

Since yesterday, there's a huge opportunity before you as field agents in Canada today who are able to sell long term care insurance. But a good deal of this opportunity, unfortunately is the result of COVID-19 and its effect on Canada's long term health care system. Canadians are worried about this...

Since yesterday, there's a huge opportunity before you as field agents in Canada today who are able to sell long term care insurance. But a good deal of this opportunity, unfortunately is the result of COVID-19 and its effect on Canada's long term health care system. Canadians are worried about this system and are now looking for ways to better understand and finance their long term health care needs. One of the ways that this can happen is through the purchase of long term care insurance. This living benefit product, however, can be confusing for both agency clients. So in this webinar, we will be looking at some background to help you better understand the evolution of long term care in Canada by firstly reviewing the Canada Health Act. We will consider consider a few of the numerous Long Term Care misconceptions. We will then move into several aspects of long term care planning, followed by discussion about what governments do and do not subsidize a very critical area. Then we will move on to our examination of long term care insurance, touching them on the client planning conversation, and we'll end today with a session summary and resources for you and your clients. However, before we begin a brief introduction to my dad, the reason that I do what I do professionally, he suffered from Alzheimer's, stroke disease and crippling spinal arthritis, which put him in a wheelchair for the last two years of his life. My dad died of the flu in a long term care home 20 years ago, work conditions and staffing should have been better. And I'm so sad to admit that in the years since my father's been gone nothing as approved for aging Canadians and care. In fact, COVID has revealed just how much long term care has deteriorated in this country. So let's begin at the beginning with the Canada Health Act. The principles were developed during the 60s and adopted this law in 1984. If the provinces follows certain criteria and conditions, which I apologize are not very clear on this slide, they was health transfer payments to fund their own health care systems from the federal government. The provinces were and are mandated to cover medically necessary care delivered in hospitals and care provided by physicians. But each province has taken their health care money and use it differently to fund their care services, resulting in essentially 13 health care systems in this country. However, the Canada Health Act did not mandate funding for long term care. And the results of this huge oversight were and our confusion about the availability of long term care services in adequate fracture care in every province. Something we call hallway medicine or alternate level of care. In this means that there are so many seniors who need long term care, but they are still stuck in hospitals in beds in hallways. Because of our inadequate care system. And all this has resulted in in in apathy and inaction by Canadians, who quite frankly, really don't know where to turn. And here are some more concrete follow ups for seniors and what they're facing right now. According to the Canadian Medical Association, as of 20 tene, over 430,000 Canadians have unmet homecare needs and now I would suggest that that numbers over half a million over 40,000 Canadians are currently on waiting lists for long term care or nursing homes. And again, those numbers are shy and this was before COVID-19. How does care vary by province? As I mentioned earlier, we have 13 Different insurance plans funded by health transfers from Ottawa. Some provinces like Ontario, also charge annual health care premiums. There are no national standards for long term care in this country and this is one of the things that advocates claiming to change all provinces subsidize some nursing and home care which we will address. However, terminology is different from province to province fees and service vary, and some jurisdictions included means testing, which influences how much citizens pay for their long term care. Let's look at some long term care misconceptions. The first is the government will pay for my hair. The reality is the government only subsidizes a few hours of homecare daily, and subsidizes nursing home care, food and recreation. The resident pays for his or her accommodation. The message here is care is not free in Canada. We pay through our taxes or we pay out of pocket. Some provinces offer alternative accommodation funding formulas. You could learn more at this website to find the link. Go to the ASB modules on the CPA website CPCA website. Below my lessons you can click on the access care info sheets option, but if you have an issue I know Rhonda is ready and waiting to guide you. Risk Misconception Number two I don't need care. The reality. Too many Canadians think that their present good health will go on forever. It wounds here is a Health Canada infographic describing the prevalence of chronic illness in Canada. I was surprised to learn that those over the age of 20 have at least one of these illnesses, the most prevalent being cancer and mood disorders. Equally expected is that those over 35 often suffer from COPD, which is a type of obstructive lung disease. Those over 40 mainly women often suffer from osteoporosis, and those over 65 often suffer from some sort of dementia, such as Alzheimer's. Our third misconception I understand the cost of long term care reality. According to a 2017 survey, nearly three quarters of Canadians have made no provision for long term care in retirement planning. And they have no idea about long term care costs. And Misconception Number four, I'm too young to need long term care. Reality 40% of people receiving long term care are under the age of 65 because of accidents, illnesses and disabilities. You may recall that Michael J Fox was diagnosed with Parkinson's at age 29. And the famous actress Selena Gomez suffers from lupus and as a result has had to have a kidney transplant. Long term care is not just for old people. So what has caused these misconceptions? What's wrong with long term care? Firstly, there has been too little societal attention paid towards long term care in Canada. It has been ignored for over 20 years. And to this point, I reminded you that my dad died 20 years ago in long term care. And even though every three few years there's been a public uproar about conditions in care facilities, nothing has ever been done by any government in power. Why? I think because the public accepted the status quo that old people needed to live in and no matter what their condition I fear that Canadians absolutely looked the other way. Long term care home residents are vulnerable and voiceless. There's no there hasn't been until recently, a national advocacy organization to support people in care we have such a fragmented continuum of care if the care is unequal and inconsistent from province to province. sector resources are unable to provide the quality of health and social care required. And finally the bricks and mortar homes. The institutions are often unable to protect older adult adults, especially those with dementia and those with COVID Because too many of them are housed in board level rooms with at least four other people let's talk about long term care planning. And may I say that this needs in my mind to precede the sale of long term care insurance. Long term care planning ensures clients have their needs taken care of when they stop being unable to care for themselves. It helps people avoid dependency, which is one of the things we fear the most as we age. It includes the completion and update of wills powers of attorney letters of direction and so on. The planning integrates the funding of long term care into a financial or retirement plan. It gives clients enough time to understand and learn about the services and accommodations and their cost. Where they live. And finally, it allows them to make important decisions while they still can. Well they are healthy, both physically and cognitively. And in my view, it's difficult to sell long term care insurance without this conversation. Unless you and your client understand why he should be buying Long Term Care Insurance. A sale may not happen. So now let's look at our first tool. The aid of the long term care planning question tool. This tool enables your clients to actually ask themselves specific questions they need to answer based on their personal situation. In using this tool, you are in essence having the client establish his own need for long term care insurance. Remember, first you sell the need, then you sell the product. Let's look at the questions. One, what really is long term care to how likely am I to need it? Who will take care of me and what if they can't? When should I start thinking about planning? How much money will I need? Where can care be provided and how much will it cost? How will I pay for care? And finally, why is long term care a woman's issue? So this process these questions engage clients even more deeply so they better understand what they need to know and need to act on. So let's answer each of these questions. The goal of long term care is to maintain quality of life until the end of life. It provides accommodation support and service to frail, Ill disabled and cognitively impaired individuals. It provides what we call custodial care. As opposed to medical care, which is the assistance with the activities of daily living ADLs or the supervision of someone who is cognitively impaired. And those of you who are familiar with Long Term Care Insurance certainly are familiar with the activities of daily living. Long term care is provided in the home or community retirement homes and long term care or nursing homes. It's chronic, and it's full time to better understand long term care. Think of the activities that you perform when you woke up this morning. You probably got out of bed, went to the washroom use the toilet, brushed your teeth, took a shower, got dressed in nature breakfast. When you're healthy, it's easy to take for granted these ADLs however, when you are a loved one is stricken with a condition such as a stroke or Alzheimer's. Performing these ADLs becomes impossible without the assistance of another person. This type of chronic care is chronic full time as opposed to acute care and thus becomes very expensive. Question number two, how likely am I to meet it? Age will age generally increases your risk. women live longer and so are at higher risk. 69% of people overnighting have at least one or more disabilities. Single people obviously are more likely to need care from a paid provider. How's your lifestyle been? Have you looked after your diet and your exercise? Having a chronic illness like diabetes or arthritis or a family history like Alzheimer's or cancer can increase your risk? If someone has difficulty walking or transferring or has had a broken hip, the risk actually skyrockets and finally living alone. Couples tend to care for each other as they age. But when one passes away, the surviving spouse is more likely to need paid care assistance. Question three who will take care of a husband, your wife, the adult children, friends, the health care system? Well we know there's problems there. And what if you're single, but what if any of these can't care for you? What are your options? Will you the client have enough money to hire a caregiver if you want to stay in your own home? Next, When should I start thinking about planning for care? Well clearly before a crisis occurs a fall a broken hip, such as my father had a heart attack stroke or a diagnosis of dementia. Now when you are physically and cognitively able to plan before you need it, let's go back to my dad for a minute. He was living in his own home with the help of Kip homecare. He was doing quite well. But one day he stood up. He caught his foot in an area rug which by the way, he wouldn't let me move. He twisted, broke his hip and went down. It happened in a matter of seconds and it changed everything for my job. He was never the same again. And his physical and mental health began a continual downslide. It's hard to understand how once health can so quickly deteriorate. How much money will I need? Well, that depends on the cost of care in your area, your present health or how you see your health changing in the future. personal objectives where you want to live out your life and the type of care that you expect and want your longevity. And I would encourage you and your clients to visit living to one hundred.com This is a terrific site and when you go there, you fill out a series of questionnaires which are actually quite fun to do. And what ends up is you have a figure of how long you're going to live. And it can present some peace of mind to help people understand how long they need, or how much money they need to have in order not to outlive their income. your current financial situation will influence things and quite frankly, how much can I afford? So the big question here is how big is the gap between the assets? You have your client has in the money you may or may want or need for care. Remember that long term care insurance has been designed to fill the gap between what the client has and what he may need. And how can you use this tool we'll cover that at the very end. Next question, Where can care be provided? And what we're going to look at here is what we call the care continuum. The path an individual takes through the system as he needs more care and support. Here are the four stages of the care continuum. The first is Home and Community Care what we call aging in place. The second is retirement independent living or memory care. Three is long term care, nursing home care or Alzheimer care. And the last phase is hospice palliative or end of life care. Now I am going to be giving you a bit more detail on each of these phases, but you can keep things much simpler for your clients as they're laid out in your long term care Canada sell sheet. So let's spend a moment on home care. As I said earlier, people are lucky to get a few hours of care a day help with the ADLs nursing nutrition therapy of all kinds end of life care and some support with medical equipment. There is a waitlist or assessment in service and the cost varies. Most people do not get enough subsidized hear from the system. They end up paying out of their own pocket. And when they do the hourly cost ranges from 25 to $90 an hour depending on the service required the annual cost can range from 35,000 to over 100,000. And let me give you an example of that. Five years ago, a neighbor of mine down the street was dying and he wanted to stay in his own home. So his family hired two caregivers. 12 hour shifts, seven days a week, and they paid $10,000 a month for this care. Very few Canadians understand how expensive extensive home care can be. Also expensive can be equipment that one may need. My dad's wheelchair was over $5,000 Because he was in it so much and he needed all the bells and whistles, electronic hospital beds scooters, and ramps also can become very, very expensive costs. Let's now look at retirement or assisted living in memory care. These facilities are privately owned and one. They provide accommodation, social events, meals and housekeeping. They are tenancy situations like apartments. There are no government subsidies for retirement living. When most people move in, they are independent and they probably don't need care. However, over time, if they do, they will pay extra for the care that is needed. People apply directly to each home. wait lists vary from home to home. The cost across Canada ranges from 3000 to over $10,000 A month depending on accommodation type and care package if required. And please note that retirement homes can be called personal care homes or large or supportive housing depending on where you live. Long Term Care Nursing Homes these profiles provide 24/7 care and supervision for extremely ill and frail seniors. They are owned and operated by municipalities, religious organizations, not for profit. Or for profit organizations, that genes that you probably heard of, like Extendicare, Chartwell and Sienna, but they are regulated supposedly by the provincial government. Fees are set annually by each government and quite frankly, there are years that people wait for waiting lists in Ontario actually right now. The latest figure I saw is there. The waiting list is now 38,000 People the cost across Canada for accommodation fees range from zero in the north to 4000 in provincially subsidized homes, depending on the province, and accommodation types. The last stage in the care continuum is hospice or palliative care. This is a holistic approach to care for those who are very critically ill or at the end of life. It encompasses physical care, pain control, emotional care and psychological care. For both the patient and the family. And it can take place in the home and hospital or long term cares care homes or freestanding hospices. Sadly, only about 15% of Canadians have access to integrated palliative care. The cost is usually covered by the province, although there may be costs for some equipment and drugs. As far as my dad went the home where he was said they offered palliative care, but in the end they didn't I had no support from the home when my dad was dying, and we need to do a much better job here. Why is long term care a woman issue? Well in two words, firstly, longevity, women live longer. than men. They spent twice as many years in a disabled state at the end of their lives. And more than 70% of nursing home residents are women, which quite frankly, makes the men happy and their average age at admission is 80 As for caregiving. Women make up the majority of family and professional caregivers in this country. In fact, they provide $25 billion of unpaid work every year. When husbands die or need lots or need long term care wives are there. Unfortunately, because many women end up widowed, the question is who's going to be there to provide their long term care if a woman is a family caregiver for a parent, a spouse, maybe an adult child they may have to leave work and possibly forsake salary and benefits which impacts their retirement. If they're professional caregivers, they earn inadequate salaries to support themselves, let alone saving for retirement. And finally, the strain of caring over many years can destroy the health of a family caregiver. And let's not forget women living alone. These women will ultimately need care, but who will provide it and how will it be paid for our last question How will I pay for care? It is for our purposes, probably the most critical government pension plans such as OAS, CPP and G I 's. government subsidies which we know can't do the job. A company pension plan if you happen to be lucky enough to have one, personal savings, a reverse mortgage, and if a client is considering or looking into a reverse mortgage, I would highly recommend legal advice. And finally, long term care insurance. So by the time these questions are answered, I think a client will be looking forward to your solution. And how can you use this tool? Well, I would suggest creating a PDF document with your logo at the top and giving a copy to your client and sitting down and asking your client these questions and together coming up with the answers. So now let's move on to one of the most misunderstood issues in this country regarding long term care who pays for what I need the government or need and here is your summary. On the left. We see the government subsidized through the Canada Health Act, physician hospital and diagnostic requirements a limited number of homecare hours we know that we know the government pays for food and care. And we know residents pay for their accommodation which is called by the way to co payment. Some other expenses such as drugs and eye care are covered and the federal government covers that trends long term care and by the way, they do a fabulous job. What is not subsidized is retirement and assisted living. And so we have seen caregivers are not paid to provide care even though they may have to give up the jobs. Many prescription drugs are not covered, nor is dentistry for Optometry. It's critical that you and your clients understand the small role that the provincial government pays in subsidizing long term care. Now we move on from long term care planning to long term care insurance. The second part of the equation and your huge opportunity. here briefly is how LTCI works. It's a living benefit. That helps pay for extended physical or cognitive impairment. Sorry, cognitive care. And it's important that clients know the difference between how and when they benefit from life insurance, as opposed to long term care insurance. The policy is customized to client need and affordability. This must happen as clients need to afford the premiums for years to come. And why sell a Cadillac version of a policy when a Volkswagen will do the job. It bridges the gap between the resources your clients have and what care may costs. And remember we talked about this gap in the long term care planning section. Two coverage plans comprehensive which covers care in a facility or in the home and facility only, which helps pay for nursing home or assisted living care. And finally, long term care insurance kicks in when the purchaser needs help with two or more activities of daily living. But remember this your money pays for it, but your health really buys it. If a client waits too long, an unexpected health event can prevent application approval or postpone approval, leaving your client unprotected. Remember my dad and how quickly his world changed with just one fall. So long term care has been in Canada since the early 2000s. But it hasn't taken off. Why has long term care insurance stalled in Canada? Firstly, because Canadians think the government will pay and as a result, they become apathetic. We know this isn't true. There has never there's never been adequate insurance companies support of their product which has resulted in a lack of advisor uptake on long term care insurance. Have you ever seen an ad for long term care insurance in any major press across Canada? It's difficult to determine Long Term Care risk. The biggest challenge with anticipating or insuring against long term care costs is trying to estimate them. Someone may be healthy until they're 100 and go to sleep and not wake up. Or they may develop a lengthy health issue at a young age requiring assistance beyond what family and government may cover the significant out of pocket costs. Canadians perceive the premiums as being too high. And I think this is because policies have not been designed consistently enough. To meet the budget of the buyer. Long term care insurance has to compete with a lot of other insurance products. And at one point I sat down and calculated it counted up all the insurance policies I have home auto cottage critical illness, long term care, dog insurance and cat insurance. Yes, there is competition. Laissez Faire attitude of governments. All levels of governments know our healthcare system has been in deep trouble for years. But once again, have you ever seen any level of government warn Canadians that it's our job to plan for our own aging that governments simply can't afford to cover the cost? The younger population often doesn't have a long term care horizon. This is true. But with your planning tools and expertise, you can gradually turn this around. And finally, for media coverage. There has been barely a mention of long term care insurance in the media, with the subject of coping with long term care costs is being discussed. Having now just seen why Long Term Care Insurance is stalled. Why should we be talking about it and excited about it now? The first reason is our aging population. We are in the midst of a huge shift in this country. By 2031 in four of us will be seniors and once we hit the age of 65 we will have a 70% chance of needing some kinds of care. Unfortunately, they help the federal health care funding transfers continued to decrease and are not matching the population aging and the increased health care needs. As Canadians live longer. They're also living longer with chronic illnesses. And I'd like to talk to you about something called Disability free life expectancy. The average age or sorry the average life expectancy for the Canadians right now is at 2.52. And the disability free life expectancy is the average number of years an individual is expected to live free of disability as they age since the average Canadian can expect to live with one or more chronic conditions for the last 10 years of their lives. Their disability three years and at about age 72 Which is another reason to ensure that the long term care insurance conversation happens well in advance of these last two years. Why now? Why else in the world COVID-19. Government funding was stretched way too thin but before COVID And now it's reaching the breaking point. We have a huge shortage of health care workers. They're falling ill like dominoes. We have fewer care beds available because care homes are being forced to close down the ward level rooms too. Prevent seniors from living for to a room and catching COVID. Consumers now are thinking about how they're going to avoid going into a care home. But the reality is that a care home can be less expensive than aging at home with care as we have seen. There is huge stress on family caregivers, either those who are caring for loved ones at home, or those who have loved ones in a care facility. In fact, it's absolutely criminal, which was happening to those isolated seniors in care homes. And finally, there is an increased competition for care providers. These are all reasons that Canadians need now more than ever to plan for long term care to ensure they have the funds they need to be able to care or to sorry to purchase the care that they want and the care that they need. The final line now Alzheimer's disease and related dementia is approximately 600,000 Canadians have dementia. By 2030. That number will be 1,000,009 Canadians are diagnosed with some form of dementia every hour. And what Canadians are paying to care is $12 billion a year 65% of those diagnosed are women. And Alzheimer's is the most significant cause of disability in those over 65 But it can strike much earlier. In families. We call this early onset dementia or familial Alzheimer's. There is no known cause or cure. And the key is risk reduction. But that's a topic for another time. Again, I remember my dad I thought we had lots of time to talk about the things that we needed to talk about, such as his end of life care, but the disease moved so quickly that we never had the time. So here is your second tool, which revolves around having the care planning conversation. It will help you understand that this conversation can be challenging. So I asked you to keep in mind the following when you approach your clients. One, understand the need to plan for long term care which we have just reviewed, you need to understand and accept. Understand the care system and subsidies in your province, which you can do from the link at CPCA. You need to understand all the available funding options specifically in this case, long term care insurance. And you really need to understand that this talk can be tough, it can be difficult. Some clients will be ready even eager. Others will find confronting aging and its realities, very emotional. And some may be in the middle of a difficult caregiving experience with a parent or have a loved one in a care home. Your job is to really remain upbeat and position yourself as a problem solver and a solution provider. I urge you to plan your presentation carefully. Develop your process because by following a process, you will deliver a consistent presentation every time you'll know that you're covering the same points. You won't forget the key points and you'll feel more confident. And finally I urge you to practice your presentation. Practice makes perfect. So here we have arrived at our session summary. Firstly, most clients don't understand the need to plan for getting old. They avoid care and care subsidies vary by province. We've seen that but they're all inadequate to meet the care needs of Canadians. And as we know long term care isn't just about a product. It's equally about the planning. Long Term Care Insurance is an integral part of financial and retiring retirement planning and unfortunately has never been properly positioned as an estate planning tool. I asked you I hope that you will use and customize the marketing tools that I have provided. And I remind you that COVID-19 has presented a unique opportunity for long term care insurance. That market is ready. Take advantage of this once in a lifetime opportunity to educate your clients and sell them a product that will offer security and peace of mind. And lastly, I am referring to Toronto Star. The headline article reads, I was at a breaking point and the subtitle Canada lacks a plan for its aging population. That leaves many exhausted caregivers little choice but to move their loved ones to long term care if they can find a space. It was too late for this family in the article, but it isn't too late for many, many families. So I urge you to use the wonderful long term care insurance product your clients need it very, very much. I would also like to know that January is Alzheimer's Disease Awareness Month. Here are my resources for you. My website which has lots of information. I wrote an article about why Canadians are so upset about the abuse, neglect and deaths in long term care which you can find on my website. Here's the link for the Alzheimer Society of Canada and the Canadian hospice Palliative Care Association. If you want to learn more about Alzheimer's and palliative or end of life care. Kenny age is a relatively new organization and is I think, the only national advocacy organization for Canadian seniors. I urge you to visit enjoy. And finally the previously mentioned living to 100