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My father is 78 and has numerous health issues including osteoporosis of hips. He has fallen 6 times this past year and receives PT 2/week. He has medicare a&b and supplemental 1 (MA). We will not put him in a nursing home. He wishes to remain in his condo but at some point he will need more care and I feel like we should start getting someone in there now so he is not alone late afternoon for too long. Can he even qualify for a policy to help with home health care or are we too late and he needs to manage out if pocket? Thank you.

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If late afternoons are a problem, look up "sundowning". Also look around at Assisted Living, some of these places are very nice, activities all day and bus trips weekly or more. It was like sending mom on a cruise.
Forget LTC insurance. That is the sort of thing he should have gotten 20 years ago.
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It is too late. At this point, he is uninsurable. If he'd had a policy already, I would be advising you to initiate the claims process now because it sounds like he qualifies for benefits under a long-term care policy's definition of needing "stand by assistance".
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For insurance, he is 20 - 25 years too late.

Realistically at 78, dad has another decade or so. that is a long time to private pay for care. Does dad have mid 6 figures in assets to private pay for care?
Home health from an agency with some training can work for awhile and run $20-25 hr usually with 3 days@ 4 hr block minimum. Even if your just getting a sitter that is going to cost. It's not unusual to pay 25K-60k a yr for @ home care.

I understand that you all don't want a NH but at some point in time the level of care he needs will require 24/7 for his safety & medical needs. Does he & family have the ability to commit to doing that along with paid home health? If dad is having fall issues atop other health concerns, he is likely to break a hip, then have surgery followed by rehab in a NH; they can't progress in rehab to move back home so stay in NH. This is the classic scenario for the elderly to end up in a NH. NH run 5K-15K a month.Whatever path is taken whether stay at home or AL or Nh, it is all horrendously costly both financially & emotionally.

If dad has fallen 6 times this past year, the fall that breaks or shatters a hip is just a matter of time realistically.
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Having just gone through the application process for LTC a insurance I can assure you he will not qualify. The diagnosis of osteoporosis and fall history is enough to knock him out . So yes, he will have to pay out of pocket. Your question raises the question for others on this site who are caregivers and might want to apply. The sooner the better.
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Long term care insurance? Anybody that has someone with a policy make sure the payments are setup to come from an account that your loved one will not have access to. Early in Alzheimer's people begin to make very unwise financial decisions. In my Mother's case she either forgot to pay the premiums or decided she would not need LTC insurance. I have no idea how many years she paid into it. But it lapsed, she is entering late stages of Alzheimer's and will now have to private pay. She had wanted to leave some assets for her children, remain in her home, and that was to be taken care of my LTC policy. Now we hope there are enough assets to pay for necessary care for five years.
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LTC insurance is granted either while a person is well or if they are fortunate enough to be covered through employment even if they are not totally fine. I have been on disability since my early 50's due to degenerative disc disease that has progressed to the point I have nothing but bone on bone. My husband also has a history of DVT's due to a clotting factor that is hereditary but he qualified and I didn't because he was the employee and I wasn't. Sorry to tell you that it is too late for your dad. In fact, knowing what I could potentially be dealing with down the road, I began right away checking on ways to stay healthy and to work on avoiding being in the same position. My mother in law passed away last year at 93 and was wheelchair bound for about 5 years due to a couple of falls that did shatter her hips and render her unable to walk at all. She never did anything in the way of consistent exercise for years and also was stubborn and did things that were not sensible when dressing, i.e., sitting down rather than standing up and holding on to the door jamb to put on her pants. Agree that LTC is worth the money as is all planning for old age. The more you can do to prepare for quality of life, the better. I say this only because at this point while it may be too late for this gentleman, we can all learn and do better. On the bright side, I have been doing well, take good care of myself and we met with a financial planner who helped us with some annuity options that offered some of the benefits that long term care would have provided for me, since I cannot get it.
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Save your money. Insurance will pay for most, and the money you would have spent on a LTC policy can be used for anything insurance does not cover. Osteoporosis is a disease of brittle bones, and therefore one cannot predict WHEN one will fall. One does not fall and break a bone. Usually, the bone breaks and THEN one falls. Tell your father to lift weights (like a gallon of water/milk). I have osteoporosis, fractured both wrists, my L1, and I lift 15 gallons in water when I refill them every three days. Plus I lift the gallon jug every time I refill our water container. Taking calcium supplements will give him constipation, so try lots of green vegetables.
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The time to buy LTC ins is before you are 61. Huge difference from 60 to 61. Pretty sure at this point your dad would be uninsurable for LTC. Just went through the process myself and they did a cognitive assessment as well as getting all my med records for 5 years back. It is expensive but they now have hybrid policies that are very good from an investment point of view.
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I have a very nice person living in with my mother. She is responsible for 25 hours of care per week, but actually just integrates with out family and does whatever, whenever. We only pay $250 per week. It gives both flexibility. Sounds like your dad might benefit from this type of situation for now.
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Too late for LTC insurance, as everyone says. If he does not have the financial resources and you want to help him stay home, you'll have to look for some volunteer services. Does he belong to a church? Some offer volunteers to sit and assist. Look up your local aging associations. Is he a veteran? Vets organizations may offer some help too. If family has to come in to be with him, then consider day care programs, so he can be with others for 4 hours or so per day, or on certain days a week, to give family members a break. If you live in a college town with a nursing or health care program, you may be able to find a student in that specialty to 'live in' for room and board, and assist during non class times. Or try to get references for a private pay aide to come in.... Agencies in our state run $25 to $30 per hour. We had a private aid, recommended by our law office, who only charged $20 but was cpr and elderly and dementia certified on her own. The problem with answering ads in the paper is worrying about someone who might steal from him or have other ulterior motives for wanting a job with an elderly in their homes....taking advantage of them for example...so I would only go by references. Agencies are bonded and insured but more $$. But if he's fallen so much....you DO need to get the family together and come up with a plan. Once he breaks a hip at his age, he may not get ambulation back and keeping him at home and healthy will be much harder.
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My mom has LONG TERM CARE insurance from 1985, she is 93 gets dialysis. Her insurance for Long TERM CARE sucks she gets paid only after 30 days in assisted living. 100 dollars a day. She continues to pay 860 every 3 months
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If he has Medicare as my mom does, we have home health paid by Medicare, two RN'S a week, one PT a week and two CNA's for baths twice a week. Any sitters we had to get was out of pocket. As for a private sitters we used referrals from church and friends. Have paid 250.00 to 350.00 a week but even that added up over time. Many are in between CNA jobs so it always seemed after 6 months looking for another so finally in our case my partner just started doing it and of course for free so moms money can slowly build back up.....yes I should have looked in to LTC insurance for her a long time back but hinds site is 20/20 so have been checking on it for myself and partner so not to be a burden on my children.
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at age 78, he will be lucky to qualify for a long-term care insurance, as we all know, age and health are the most decisive factors when qualifying for an ltci policy. In addition, buying while young and healthy you can get more coverage at a more affordable price. Considering that he already had numerous health issues, even if he qualify, he may be paying a very expensive long-term care insurance rate at his age (ltcoptions/long-term-care-insurance-costs/).
You may explore other options like govt. ltc programs, pace, if he is a vet, then check with your local va office or he might have a life insurance which you can convert to pay for his long-term care expenses.
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You are going to have to manage out-of-pocket. If/when he qualifies for Medicaid, there may be some in-home care available from that source. In addition to paying for nursing homes, Medicaid has a program where they keep people out of nursing homes by providing various services in their homes. This is never 24 hour coverage, because at that point a care center is more cost-effective. But if someone can get along with several hours of care a day and delivered meals and maybe a bath aide and a housekeeper weekly, that can be covered.

If all your father has is "age related decline" he may never need a nursing home. But if he has or develops dementia, or if he breaks a hip, he may need round-the-clock care. Be realistic about what he can afford long term. Try to figure out what your options are if "we won't put him in a nursing home." Now you realize that LTC insurance isn't an option. Keep working on other possibilities.
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