Why Long-Term Care Planning is Even More Important During a Pandemic (Part 2 of a 3-part Series)

Suzanne is a family caregiver for her 75-year-old mother who has dementia and for her two young children. She is most concerned about her mother, who has a weakened immune system, and her infant son, being only 2 months old. With no vaccine at the moment, the best thing caregivers similar to Suzanne can do is take precautions by staying home, washing hands, and wiping things down.

As the instances of coronavirus increase in our area, experts say that family caregivers, similar to Suzanne, are in a uniquely difficult situation. Those who are at home are challenged with isolation from activities that the caregiver and patient count on. At the same time, caregivers aren’t getting any opportunities for much-needed respite, making this a particularly difficult time for everyone.

Being at home with loved ones with dementia or other debilitating diseases 24/7 during a pandemic makes us seriously think about what will happen when their condition worsens and the time comes when we can no longer care for our loved one at home. The challenges we are facing with our loved ones are only going to get more difficult than they are now, making planning for long-term care in advance essential.

In part one of this series, I discussed why estate planning is of vital importance during this global pandemic. In part two, I will explore elder law and planning for long-term care, and in part 3, I will focus on retirement and financial planning.

Planning Ahead for Long-Term Care is of Critical Importance Now

As Alzheimer’s disease or other cognitive impairment progresses, individuals living with degenerative diseases typically require a more advanced level of care, known as long-term care, because their needs exceed what the person’s family can reasonably provide. This type of care can range from in-home assistance to skilled care in a residential facility. Even if your loved one is in the early stages of dementia, the best time to think about long-term care is before you need it.

People with Alzheimer’s disease or other cognitive impairment and their loved ones should begin planning for long-term care as soon as possible. Planning ahead for long-term care expenses is one of the most important steps you can take, as nursing home care can be very expensive ($12,000-$14,000 a month in the DC area).

With long-term care services being so costly, how can anyone afford them without going broke or depleting their assets? Medicare will pay for a small amount of skilled home health after a hospitalization, but most home care and homemaker services are paid out of pocket. Medicare will also pay for short-term rehabilitation that takes place in a nursing care or rehab center following a three-day hospital inpatient stay. But Medicare does not pay for long-term care!

Medicaid, on the other hand, is the single largest payor of long-term care costs because so many people can’t afford to cover the costs themselves. However, Medicaid has different income and functionality requirements, making it extremely difficult to qualify, so the help of an experienced elder law attorney, such as myself, is absolutely essential.

If you or your loved one is over 65 or suffering from any sort of serious health condition, it is wise to plan for the future now. Whether you or your loved one is years away from needing nursing home care, is already in a nursing facility, or is somewhere in between, the best time to do Medicaid Asset Protection planning is the present, not when you are about to run out of money.

In the Absence of Social Interaction, How Can Caregivers Manage?

As you can see, it’s important to plan now for long-term care for your loved ones, should they need it in the future. But, what can caregivers do now, during this pandemic, to manage their challenging roles?

As you may be experiencing, the restrictions of the coronavirus pandemic bring more confusion to the already disoriented person with Alzheimer’s disease or dementia and can cause a great deal of stress for the caregiver. Here are some things you can do:

  • Changes in routine: Caregivers may struggle with explaining the sudden changes in routine. Experts suggest that you shouldn’t unnecessarily alarm the affected person. Refrain from watching a lot of the television coverage, as it can cause undue anxiety and stress for yourself and your loved one.
  • Overcoming isolation and boredom: Interacting with others can help the affected individual retain a sense of belonging, assist in providing normal routine, and ultimately promote a better quality of life. This makes the greatest challenge, perhaps, the isolation from activities the caregiver and patient count on. The caregiver should strive to keep a routine and structure as much as possible and have activities on hand that the person with Alzheimer’s enjoys, such as puzzles, word games, and favorite movies. You might try looking at photo albums or even creating some. All are ways to engage and curb boredom.

Additionally, the caregiver might come up with a few easy exercise routines; let the patient assist with cooking or sorting recipe collection; or try simple gardening. Coloring and painting can also help pass the time, as well as listening to music, which might spur a little impromptu dancing, which is enjoyable and a great form of exercise.

  • Practice proper diet and nutrition with special attention to frequent hydration. Because an Alzheimer’s patient’s immune system might already be compromised, make sure they drink enough liquids throughout the day to maintain their overall health.
  • Use available technology: There are also a number of apps that can keep caregivers and their loved ones engaged. Here are just a few examples: “My Reef 3D,” an interactive aquarium and that allows users to “feed” the fish; “Talking Tom Cat 2,” that allows you to talk to the main cat character and the cat will say it back; and “Timeless,” which helps Alzheimer’s patients remember events, stay engaged with others and assists in recognizing other through facial recognition technology. Besides apps, Alzheimer’s patients and their caregivers can visit with friends and loved ones over FaceTime, Skype, Zoom etc.
  • Find connections through prayer and spirituality: Spirituality can also have a positive outcome during this time. Caregivers and their loved ones can find connections through prayer and meditations and by listening to favored spiritual music. Many websites and YouTube channels offer soothing background music that bring a sense of peace and calm amid all the distractions.
  • Stop the spread of the virus: Caregivers should adhere to the usual precautions against the spread of the virus, such as frequent handwashing and covering the mouth for coughs and sneezes. When it comes to face masks, the federal Centers for Disease Control recommends wearing one if you are sick or if you are caring for someone who is sick.

Also follow cleaning protocols, such as disinfecting frequently touched surfaces, such as doorknobs, light switches, counters, phones, toilets, faucets, and sinks. Caregivers should follow the instructions on the disinfectant and use proper ventilation while cleaning. Don’t let these cleaners be handled by your loved one with dementia. Tissues, wipes and hand sanitizers should be always on hand and placed throughout the home in various locations.

  • Suspend non-essential doctor’s appointments or take advantage of telemedicine: It’s also suggested that doctor’s appointments and other outside therapies be suspended during this time unless the caregiver and/or the affected individual needs immediate attention. However, be sure to pay attention to any flu-like or respiratory health symptoms in both themselves and their loved one, and contact a physician immediately if these arise. Should any other medical condition arise, contact the primary care physician immediately and follow the recommended course of action. Medications can be filled and/or refilled at pharmacies, many of which are offering free delivery.

Get Your Long-Term Care Planning in Place During this Time of Uncertainty

Most Americans feel uncertain about many things right now, but one thing you should be certain about it planning in advance for long-term care. Planning for long-term care will provide some much-needed peace of mind during a time when we can certainly use some!

Here at the Farr Law Firm, we have strategies to help everyone plan for themselves and their loved ones. With advance planning, each person can retain the income and assets it has taken a lifetime to accumulate and the peace of mind that they are prepared, should something happen to them or their loved one. If you or your loved ones have not done Incapacity Planning or Estate Planning, or if a loved one needs nursing home care or even if your loved one is already in a nursing home, please contact us as soon as possible to make an appointment for an initial consultation For those who feel safer in their homes, we offer videoconference or phone appointments in lieu of in-person meetings (but we are still open for in-person meetings):

Elder Care Fairfax: 703-691-1888
Elder Care Fredericksburg: 540-479-1435
Elder Care Rockville: 301-519-8041
Elder Care DC: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.