I don't have an answer to your specific question but have you contacted the insurance company or broker to see if you can reinstate? I would do so ASAP. Go to a higher level if needed than just the first person who answers the phone. Perhaps the State Insurance Commissioner could be of some help?
I do have a warning to others who either have or their parents (or elderly relatives) have such policies.
Make sure that a responsible person, for example, an adult child, accountant, lawyer, or financial adviser is designated to be cced on premium reminders and contacted in case the insured person fails to pay a premium or tries to cancel it. Unfortunately, as dementia sets in and/or an older person doesn't understand the ramifications, the policy can get cancelled just when the person is going to need it. If the insurance company is ccing another responsible person, steps can be taken to avoid a situation like yours happening. I understand your distress but be kind to your mother-she was trying to take care of herself financially and didn't understand the consequences of her behavior. It's very hard to be old and worried about everything and not feel like you're in control. And it's not easy being the caretaker either.

Does she have limited financial means? Could it be that she was making a thougtful spending choice because of money limitations?

Are you able/do you already help her financially? If the premium cost became a non-issue because (for example) you paid it, would she continue with the coverage?

It may be precipitous to think the decision wasn't a rational one.

neighborgirl has given you several points that you need to follow up on, asap.

I am 90 years old and live in an Independent Retirement Community, which also has Assisted Living and Alzheimer care as part of the campus.

I hope you will be able to get her request over ridden, possibly by her doctor, or that you will be able to take over the payments.

I feel for your mother. I have my daughter near by and she is , thankfully, knowledgeable about all the "paper work" that goes along with aging parents, such as the DNR forms, my will, all of my financial circumstances, etc.

Good luck, and please be gentle with your mother.

Sue

This post was edited by Sue-va on Fri, Dec 5, 14 at 14:14

We have Long Term Care policies and if, for any reason we don't make the payments or cancel they have to contact our children, whose names and addresses are updated once a year, who then can pay the premiums themselves and the policy remains intact. Maybe it's a California thing, but it might be your savior in this case.

I do not have that insurance and do not need it. When I put my husband in a care home, I did a division of assets. I got to keep the home and the car of my choice. SRS added up my assets and I got to keep half of those. I did a spend down to half of our assets then he went on medicaid. Now that I am a widow I do not need the insurance because I will use our savings and go on medicaid when I am out of money.

Before you assume the in-home nursing care is the answer to your worst fears, you want to investigate exactly what they cover.. It may be just what you think, or it may be relatively useless.

Call them and pick their brains about specific situations to get an idea and then get it in writing. In our case, my parents knew best and I was deluded to think the care would be helpful ... your mileage will vary as every policy is different.

I respected my Mom's wish never to go into a nursing home and she was the same way every time we passed or discussed one, absolutely not. It is a painful decision for someone to face end of life scenarios and in our case it simply did not happen.

If you are looking for her to say when you can relieve yourself of the duty or how much she will be satisfied with, that is IMO your own decision, as what you call tying your hands, to her may be a decision she can make and with it feel independent. When she can't make those decisions anymore she may well lose her desire to live.

You can just be supportive and if she is not pleased to think about being an invalid with in-home care, rather than feel your hands are tied, I suggest you work out haw far you are willing to go and what you will do, since evidentially she is still mostly lucid and in control of her actions. In the end, the decision on how much you are prepared to do is yours. My mother couldn't stand the thought of being a burden to anyone. So we never spoke. Others are different, dotting i's and crossing t's and working on an end of life care decision tree.

The problem with all of these things is the intentions when writing these things are not always reflecting how the loved one feels once they are in the situation. Everyone can change their mind and as has been said dementia confounds it all further. It is a difficult situation and the only answer is support, unconditional love, and for you to decide how far you can go, and then you may need to make the decision whether to end her life, if it becomes your responsibility.

Good luck and pay the bill yourself if it makes sense and you can stretch your own budget. My recommendation is that you steer clear of any government intervention, but you can see others that don't agree above, so that will depend on circumstances, resources, and caregiver energy level.
You can never do enough, and the day Mom is no longer there, you will not regret anything you did. But be smart and watch your own health. If it begins to seriously deteriorate, then it's time to respect the natural order of life after exhausting all other methods your Mom is comfortable with.

Mentally, you must keep the positive attitude at all times, and they can cause stress, but it is nothing compared to the things that may be going through your Mom's mind.
I wish you the best, and respect you for stepping up. That is the biggest way anyone can tell their Mom they love her!

I hope you were able to reinstate her policy but I know that once 30 days have passed after a cancellation there is no recourse allowed.

There is the fact that it sounds like her policy was an older policy (they don't write LTCi on anyone 79 yrs or older). Many of those older policies weren't particularly good ones from a consumer standard; e.g., low daily benefit (although of course any amount helps when you need it!), limited payout periods, no inflation rider or home healthcare option.

Have you actually read the policy provisions -- not the short summary of benefits, but the actual policy? It may be what she was paying for was a Cadillac but what she'd receive would be a Chevy subcompact! That's common with many older LTCi policies, unfortunately.

There are two legal issues you should investigate immediately:
(a) Irrevocable assets trust. You didn't say whether your mother lives independently or with someone (such as you). If she owns her own home, you may want to talk to an attorney who specializes in protecting family assets to pay for medical/LTC expenses.

(b) Whether your state is one of the 22 states that has the right to go after any children of a senior who has incurred LTC costs under the state's Medicaid program, to force them to reimburse the state. This issue arose in 2012 and at least in Pennsylvania, was confirmed by that state's Supreme Court to be legal.

I read this thread again and was wondering why you are so worried about the insurance. Insurance does not protect your Mom, it only protects your inheritance. She can go into a good care home without money. She will have to pay her bill until the money runs out then go on medicaid. They will not kick her out because she has no money. Even with insurance it doesn't make the care home any better.

Emma -- I'm concerned because not having a LTC will affect my Mom's wish of staying in her home as long as possible. If she didn't mind going into a care facility, I wouldn't be so concerned that she cancelled the LTC. However, since she's vehemently against it, I am frustrated that she cancelled one of the primary tools she had to stay in her home longer.

Now, there's the added worry about whether my Mom's state (which is one of the 22 jkom52 mentioned above) will try to recover costs of Mom's care from me. The will happen right about the time we'll still be paying our youngest child's college tuition and when my husband would like to begin his well-earned retirement.

This post was edited by Jewel654 on Sat, Dec 6, 14 at 16:29

My understanding is that the state (at least the 22 of them) will go after children of an elderly person who was financially able to pay for their own care from their own estate but found a way to get on Medicaid instead.

If you have not signed any documents indicating that you are the responsible party for your Mother' expenses, your Mother is the responsible party.

Being an in-home care giver for my Mother for 7 years, the income from her survivor's pension and trust paid for her expenses as they were designed to do - as well as the property taxes, taxes, medical care, food clothing, utilities, all the goods and services one at home is responsible for. She remained a private pay person her final year in a nursing home. Medicaid never entered the picture so in my case the state, etc. couldn't make any claims on me jeopardizing my personal estate.

I really do understand your frustration and concern. But I think that rather than worrying about "what might happen"
it would be best if you went to a good elder care attorney who specializes in long term planning/financial concerns re elderly and getting the facts. You need to figure out what you can or can't do to take best care of your mother and protect your own marital finances. You need an attorney who specializes in this type of law: your local bar association can give you a referral; Senior Resource Centers probably have referrals, etc. You (and your husband) can go on your own and then determine how much you want to involve your mother in the decision making. Perhaps the situation is not as "bad" as you think it might be. But you won't know until you discuss it with someone who can look at the overall picture and give you some guidance. Those of us on the "blog" can only give general information - you need to present your "picture" to someone who can evaluate and guide within the rules/laws of your State.

If you put the premium money aside (assuming you can't reinstate the policy) that may cover at least some months of in-home care when needed. Also, depeding on what State/jurisdiction you live in, the County/State may provide some financial relief that you might be unaware of.

I also just want to add - many of us have had elderly parents who absolutely did not want to go into a nursing home. Yet, sometimes that is where the best care is provided. My siblings and I did everything we could to keep our mother at home including 24/7 care with terrific caregivers. However, our mother's situation deteriorated to a point where she hated being in her own home "with strangers" plus the necessary care became impossible to provide at home. The transfer to the nursing home was the best thing we could have done for her - she was much more relaxed and "at home" there than in her actual home. In retrospect, we should have made the move earlier.

I know you'll treat your mother with kindness She's scared (and so are you). She doesn't want to be a burden on you. Tell her it will all work out for the best. No need to "threaten" her that she may not be able to stay in her home because she cancelled the policy, Tell her you'll do everything you can to respect her wishes and that it will all work out in the end. Because it will.

Best wishes.

M.

I did not know long care insurance paid for in home help. I checked for nurses before my husband went to a care home and it cost around $20 and hour. If I figured right at $20. an hour for 24 hours then time 30 days that's 3 times what a care home cost. Long term care insurance is very expensive just for a care home, it's hard to believe they cover in home care.

Yes, long term care can cover in home care- a good insurance broker who is familiar with different carriers and their policies can help you sort through the coverage options. There are usually limits on how much is paid for different types of care.

From the www.aarp.org site:
Policies offer many different coverage options. Since you can't predict what your future long-term care needs will be, you may want to buy a policy with flexible options. Depending on the policy options you select, long-term care insurance can help you pay for the care you need, whether you are living at home or in an assisted living facility or nursing home. The insurance might also pay expenses for adult day care, care coordination and other services. Some policies will even help pay costs associated with modifying your home so you can keep living in it safely.

EmmaR, We took care of my dad for 5 years until he got to be too much to handle. I put him in an assisted living to start. That lasted 6 months and he had to go into a nursing home. Medicaid does not provide the best care. he had to move to a different wing when he dropped down to Medicaid. His care was different there and the nurses were less caring. Coincidence? I don't know,but I wouldn't recommend counting on Medicaid to anyone.

I don't know if all LTC policies cover home care, but my dad's does. His covers home care at a lower rate per day than facility care. When it became obvious that we needed to do something, we looked into home care vs. a facility. 24/7 home care is VERY expensive, much more than a facility because of a dedicated caregiver. I think the lowest price we found was $15/hour.

Zackey is right about Medicaid in a facility. Nursing homes must maintain a certain "bed mix", at least in my state. They must have a certain number of beds for Medicare patients who are using the Medicare skilled days they have (very limited and only after a three day hospital stay), private pay, and Medicaid. Medicaid, of course, pays less than the others.

You should talk to an attorney who specializes in this. Be careful, though. Some of them do a lot of flashy advertising but apparently aren't very good. I asked several friends who were attorneys for recommendations. You may want to ask your own attorney or friends. In the end, we didn't need to use this option because of the way events unfolded.

If your mom didn't need actual nursing care all the time, you might be able to hire a private caregiver at a lower rate than going through an agency. I would only do this if I could find someone recommended by friends/family.

Would you and or your family be able to provide care some of the time so you wouldn't need to hire someone 24/7? What about your mom's income/assets? How much of her income or assets could be used to pay for a caregiver and still pay utilities, etc?

Her home itself may be a problem (it was for us). I'm not sure how mobile your mom is now or how handicapped accessible her home is, but if she becomes wheelchair bound or is unable to get in and out of a bathtub, staying in her own home may be physically a problem. My dad's house, built in the 70's, was not at all handicapped accessible and would have required extensive remodeling for him to remain there.

Sometimes we are not able to honor our parents' wishes, no matter how much we want. My father was also vehemently against going into a facility and wanted to remain at home. However, the cost of a 24/7 caregiver was just prohibitive. This was after looking into applying his retirement income and SS plus the LTC home option. That plus the cost of the remodeling just made it impossible. If it comes to that, you should know that you are doing the best you can to provide care for your mom, even if it is not following her wishes. She has done very well to remain at home until age 90. My dad was not happy when we first moved him, but he has adjusted and is fine now.

A few more items:

- LTCi is NOT, I repeat again, written on anyone older than 79. Even if you are in your 60's the premiums may be prohibitively expensive. If you get it, make sure it's a top-rated company and don't let the premiums lapse. We have them automatically deducted via ACH on our checking acct.

- LTCi is a complex product. Home healthcare and inflation protection are two optional riders. There is simple inflation and compound inflation. DO NOT even bother with simple inflation riders; get compound or nothing. I will warn you now that home healthcare and compound inflation options added to a basic LTCi policy will double the premiums....but without them, I wouldn't even bother buying a policy at all. Worse than useless. Like any insurance, you buy precisely what you need to reduce your financial risk; cheaping out with a bad company or a policy that won't pay for what you'll probably need, is always going to be a waste of $$$.

- Home healthcare can actually be much more expensive than a facility. If you are going to allow unbonded gray workers into your home or your parents' home, prepare for theft. It happens, and often. Agency help is not always the answer either - if complex care is required, it isn't unusual for agencies to turn down requests because they don't have the licensed personnel to fulfill such duties.

I frankly don't think anyone should be allowed to be blackmailed - and that's what it is, emotional blackmail - into promising someone will "never" go into a nursing home.

First of all, the most important factor is social. My MIL didn't realize this, but it is the single real reason she loves the care facility where we moved her last year. She was highly reluctant to go but I insisted. She was becoming increasingly isolated as friends died off/fell away/moved out of state.

She went from being anxious and depressed to smiling and laughing again, enjoying the simple sociability of other seniors to eat meals with along with smiling, helpful staff. She knows all their names and they know her. The daily routines give her a reassuring familiarity about where to go and what to do. It has really helped slow her dementia decline.

Secondly, we ourselves are aging. How can we be sure we will remain healthy enough, strong enough, mentally capable enough, to take care of someone very elderly who needs 24/7 care? The answer is, we can't. A lot can change in 5 or 10 or 15 or even 20 yrs. My MIL's doctor thinks she has a very good chance of living to 100 or more; she may in fact outlive us as she has better morbidity AND mortality factors.

I simply cannot, in good conscience, promise anyone I will be capable in 2025 or later, of taking care of them properly. My DH certainly can't either; he had a stroke at age 50 and every day he lives beyond 72 fully compos mentis will be a tremendous gift from the gods. He's already showing signs of slight cognitive decline at age 62.

When I was a teenager I took care of my father who had Parkinson's. In those days they couldn't do much for it. He became bedridden very quickly. My aunt took over his care, but I learned to be very aware of what it takes to care for someone who is bedridden. It is one of the hardest jobs ever!

Over a year's time we investigated 8 nearby facilities for MIL and compared them. We revisited the ones we thought were a good "fit". We selected one, then met to get the specifics. We ran the numbers ourselves, then ran them again by her financial advisors.

Then we brought MIL for three visits over the next couple of months so she wasn't going in "cold". It was still emotionally hard for her to leave our home, but in less than a month she was telling her friends and family how much she loved it at the facility.

It took time, effort, and money - but she is better cared for and happier than she could ever be on her own or with us. That's the reality of it, and it was the best thing we could have done for her and for us.

I'm NOT saying that facility care is for every senior. But in our case, it was the answer, and she fortunately has the money to pay for it.

I hope everyone is able to find the solution that works best for them and their loved ones. This is such a difficult issue, and it takes a lot of work to be properly educated on the "ins and outs", which change constantly!

I see that all of you don't agree on the need for Long Term Care Insurance, but we have it and I'm most grateful for it. The cost since inception was recovered the first year we used it for DH; we are now into year three.

Some of the older policies are better than the new ones. Ours pays a lot more than the newer ones. The company was always trying to get us to change the policy with lower cost promises, etc., but we didn't go for it and kept the original policy intact. When we first started using it the Ins. person started out saying this wouldn't pay and that wouldn't pay, but then said, "Oh, wait! you have an old XYZ policy. Forget what I said - everything is covered."

If the Ins. Co. didn't contact any of her children to warn that she had cancelled the policy that would be illegal. If you haven't already, I think you should pursue getting it reinstated... quickly

>>If the Ins. Co. didn't contact any of her children to warn that she had cancelled the policy that would be illegal.>>

Not in the state where I live. If the mother didn't designate anyone else to be notified in case of unpaid premiums, the insurer has no obligation to contact anyone else.

I believe those policies are quite expensive, perhaps Mom couldn't afford it any longer? I never met an elderly person yet who said they want to go into a nursing home, they all say they want to stay in their homes. My parents were no different. But often, there just isn't any other option. My sister took Mom in when she could not take care of herself any longer. It was extremely difficult, much as we love our parents, taking care of the elderly is not easy. The perception of the sweet and kindly little old lady is not always the case. Sometimes they can be difficult and demanding. Its understandable, they don't feel well but it makes it extremely difficult for their care givers. I would never expect my kids to do this for me. Eventually it got to the point where she needed full time nursing home care. And yes, her estate was affected. Mom refused to do anything to protect her assets, insisting that her parents would not want her to go on medicaid so she felt she would spend all her assets on the nursing home if she went into one. The money is all gone and we've started the Medicaid application process, which is quite involved. She'll be on medicaid after all, although she doesn't realize it, at least that is some small comfort. I don't plan on making the same mistakes with my estate.

"Mom refused to do anything to protect her assets, insisting that her parents would not want her to go on medicaid so she felt she would spend all her assets on the nursing home if she went into one."

That's the way it's supposed to work. The person's assets are supposed to pay for their expenses.

I agree that your assets are for use to take care of you not to give an inheritance. I feel sorry for families that feel that everyone should pitch in to cover the cost. In my mind it is better to use the assets until they are gone rather than beggar family members, which I have seen. Medicaid should be for when all of YOUR finances are gone and not to give family members money.

Never expected Mom to give me anything. She could have gotten a policy for long term care which would have helped protect her assets for a time. That way, she might not have to go on Medicaid at all. The Medicaid application process is a nightmare, because Mom never kept organized records and receipts, and we have to somehow locate 5 yrs of these documents. She has none of her important documents, tax records, birth certificate, etc and cannot remember where they are. Mom insisted on living in her own home as long as she could, but never wanted to do the necessary repairs and maintenance so we did all the work, and believe me there was a lot of it. Any time she needed a plumber or other repair person that would cost her money, she became hysterical and refused to pay for it,. Little repairs turned into big repairs because they were neglected. So we did it all, basically remodeled the whole house all while working full time and trying to keep up with our own home. We never asked Mom to pay for our work, or asked her for anything at all, so please don't imply we were after an inheritance. We did the work because she wanted to stay there and would not hire others to do it. My father is still in his house and also calls upon us to do the work there too. I am willing to help out where I can, but working full time jobs and taking care of 3 houses is exhausting and parents should not expect this from their kids if the parents can afford to pay a contractor for some of the work. This is why I am not always in agreement on the elderly staying in their homes when they can no longer take care of it. We don't want to depend on our kids for these things, which is why we will sell the house when we can no longer take care of it and are looking into long term policies now. We also are getting all our documents in one location so it will be there if needed.

It was your comment "I don't plan on making the same mistakes with my estate." It sounds like you wish to have an estate to pass on but want others to pay for you if you need long term care. I agree about having parents pay for costs for their house if they can afford it. If you are affording it, time to tell your parents that you have to cut off your bank account. Hard to do if you have been covering the charges for years but you need to start thinking of your and any children's future.

Why would you interpret that comment as to say I want others to pay for my own long term care? That thought never entered my mind. I meant that I will pay for my own policy and take care of my own expenses and home repairs. I learned firsthand how difficult it is to take care of another 2 houses, my own home, raise 3 kids and work full time. I don't want to burden my kids like that. Yes, I would like to pass my estate on to my children if I can. If I can help that by getting a long term policy for myself I will do it. I've never taken a dime from my parents or the government or anyone else. And I certainly will never ask my kids to contribute to my support. My parents did (and Dad does) have the funds to pay for the work on their homes but they became extremely frugal in their late years and don't want to pay for anything. They know my husband and I are handy and can do most any home repair so in their minds, why pay if they can have us do it for free. I am not talking about just cutting the grass, replacing a faucet, etc. I am talking about replacing 1/2 of the roof, tearing out rotten siding, moldy sheetrock, gutting and remodeling a bathroom, numerous plumbing issues, etc. Yes, I should have been firm with Mom and insisted she get some of these repairs done professionally but she became so hysterical over it that I gave in. If you have never dealt with a parent or loved one in the early stages of dementia you will not understand. You cannot reason with them as you would a normal person.

My husband has Alzheimer's so yes I know about not reasoning. Suggestions for you. Do not wait for your parents to need guardians but get a power of attorney now. With that you can use their money for the repairs. Keep all receipts for this. Purchase your long term care now do not wait until your late 40's or 50's and have it automatically deducted from your bank account so you will not forget to pay or decide it cost's to much like the OP found out.

Most of all harden your backbone as the dementia will only get worse. You can give the option of either pay for fixing things or nursing home. If you have siblings make it clear that it is necessary that things be fixed or living conditions will become worse and the state may make the decisions for your parents.