Steps to take to plan for long-term care needs


By Cathleen Summers

Statistics can be sobering, particularly when we are talking about long term care. According to a January, 2005 AARP article entitled A Report to the Nation on Independent Living and Disability, the lifetime probability of becoming disabled in at least two activities of daily living or of being cognitively impaired is 68 percent for people age 65 and older.

Additionally, the aging of the population, especially those 85 plus, the most in need of long-term care, is expected to result in a tripling of long-term care expenditures, projected to climb from $115 billion in 1997 to $346 billion (adjusted for inflation) annually in 2040. (Niefield, M., E. O’Brien, and J. Feder, Long-term Care: Medicaid’s Role and Challenges, Washington, DC., Kaiser Commission on Medicaid and the Uninsured, 1999). It is important for all of us to prepare for that day when we will need to help loved ones or ourselves with elder care.

Preparing for an unexpected disaster is not a new concept for many of us. As a matter of fact, we prepare without even thinking twice by covering our homes, automobiles and health with insurance policies. But with a price tag of between $11,000 and $13,000 per month, no other life event can be as devastating to our lifestyle, finances and security as needing long term care and yet few plan as completely as they should.

This lack of planning has an adverse effect on the older person’s family, with sacrifices made in time, money, family lifestyles and even affecting the family’s or caregiver’s medical and emotional health.

Because of changing demographics and potential changes in government funding, the current generation — more-than-ever — needs to plan for long-term care.

If you have spent time helping a parent or loved one cope with a disability resulting from aging, you know the frustration of balancing what you feel they need to do and what they want to do. Communication can often be strained, and an elder and their adult children can often find that their life roles have changed. When you make directives, assignments and arrangements in advance of needing elder care, then everyone involved can follow the prearranged care plan.

Utilizing the services of an elder law and life-planning attorney can help you address many of advanced planning issues, such as:

•What do you want your children or friends to do on your behalf?

•When it comes time for them to help, what if you can’t say what you want because of a physical or mental disability? This is where a written long-term care plan comes into effect.

•Do you have a financial plan or long term care insurance? Retirement savings can disappear quickly when used for care services.

•Where is your paperwork; insurance policies, living will, medical directives, Armed Services discharge or disability papers? Is there someone designated to know the location?

•What are the legal documents that are needed for power of attorney, estate planning and disbursement of assets? When do they have to be completed?

•What types of care services and facilities are available and what are the costs?

•What will government programs pay for and how do you qualify?

There is a lot you can do now to put together a plan for your own long term care. You may have limited resources in the future or health problems that will inhibit your ability to take care of things you could do now.

Cathleen H. Summers is a founding partner of Summers, Summers & Associates, P.C., an elder law, estate and life planning law firm located in Acton, MA. She may be reached at or by calling 978-263-0006. Archives of articles from previous issues can be read at