Plan for Long Term Care Before You Need It

By Rose Mary Zapor, Esq.

Lakewood Legal Center


 Long Term Care refers to a wide-range of medical, personal and social services for individuals who are unable to provide for their own needs for an extended period of time. This need for care from others may be caused by age, accident, illness, dementia, stroke, depression or frailty.

Long Term Care Planning, on the other hand, is the process of preparing for and funding long term care.

Personal needs may include assistance with activities of daily living to help move about, dress, bathe, eat, maintain hygiene, toilet, or help with incidental daily living activities like household cleaning, meal preparation, shopping, paying bills, visiting the doctor, and taking medications. In other cases, long-term care may consist of providing supervision to avoid injury or wandering, companionship, or support and respite for a caregiver.

How Expensive Can Long Term Care be?

Long term care costs can be substantial. US median rates for nursing homes are close to $210/day, while assisted living median rates hover around $115/day. The average hourly cost of home care is $20.

Informal Caregiving, provided by family and friends, can carry significant costs as well. These costs are almost entirely shouldered by the child(ren) of the aging parent. For more on this, see “Caring for a Loved One at Home Can Be Challenging.”

Long Term Care Can Be the Greatest Crisis Seniors Will Face

Unfortunately, there is an abysmal lack of planning for long term care in our country. A survey, conducted by the John Hancock Insurance Company, reveals most seniors acknowledge the need for planning but very few actually make preparations for long term care. The study found over 50 percent of the respondents worry about paying for long term care but almost 70 percent of respondents said they had done little to no planning for their long term care needs.

All gaining individuals, regardless of current health, should have a plan in place. Long term care can be the greatest crisis an older person faces. With the need for care, the aged lose their grasp on the three most important lifestyle concerns of the elderly;

  • Remaining independent
  • Having enough money
  • Maintaining good health

All of this can disappear with the need for long term care. The costs of care can wipe out a lifetime of savings and destroy equity in a home and poor care planning can lead the elderly into serious withdrawal and sadness.

Here is a brief outline of ways to create a long-term care plan:

Prepare General Planning Documents and Instructions for Decision Making

These documents and instructions might include requests pertaining to care preferences, wishes pertaining to end-of-life scenarios, wants concerning preferred medical treatments, a list of health care providers, desires for disposition of property and instructions to a potential care advocate or representative. These documents and instructions can be formalized into legal documents by an elder law attorney.

Determining a Care Advocate in Advance

A Care Advocate or Personal Care Representative will represent the interests of a loved one receiving or preparing to receive long term care. This care advocate plays an important role in making caregiving decisions, arranging funding for services, and coordinating care. This person could also be given responsibility by power of attorney or guardianship. A care advocate could be a spouse or child, a caregiver, a friend, a trusted adviser, or even a certified care manager.

Planning for End-Of-Life

End-of-life planning can include preplanning a funeral and burial, preplanning final arrangements, expressing wishes for a place to die, and giving information and instructions for advanced planning documents. We recommend using a Funeral Pre-Planning Advisor to assist in these matters.

Preparing Legal Documents and End-Of-Life Arrangements

These items might include estate planning documents, advanced directives, wills, trusts, and various powers of attorney. We recommend using an elder-law attorney or an estate planner to assist in these matters.

Providing Financial Information for Future Care Costs

This planning would provide the family with a list of assets, income, a savings plan, and insurance plans. Particular funding strategies for long-term care services and asset preservation can also be discussed and planned for. This might include Medicaid or Veterans Benefits.

Make Your Wishes Known

This final step is important. No plan has meaning unless those who will be involved in making the decisions are aware of it. We encourage you to provide copies of the long term care plan to all that may be involved, even if the involvement may seem inconsequential. These directions will allow the family, caregiver and possibly the care advocate to make informed decisions based on the wishes and instructions made in the plan. This will save these individuals a great deal of time, heartache, stress and money as they implement the care plan.


Environmental Funerals

Environmentally-friendly burials are gaining in popularity and becoming a viable option without interfering with traditions.

There are so many little, almost imperceptible steps society has taken to lessen our impact on the earth. Recycling has become the norm, hybrid cars aren't the joke they once were, and eating organic and locally produced foods is something most people attempt to include in their lives. (Whether or not we succeed isn't always the case, but at least we try.) So it's only natural for these values to carry over into the choices we make for our final disposition. Because if you had the choice between being buried in a more natural state, as opposed to being loaded with chemicals, which would you choose?

The green burial movement has been active for some time now, and people are interested in green burial and green funerals for a variety of reasons:

·         Green funerals and green burials can be a final eco-friendly act, one last effort to lessen our impact on the earth and reduce our carbon footprint.

·         Green burial can be seen as the traditional way of being buried -- a return to the way people were buried before the industrialization and commercialization of funerals.

·         For people observing religious traditions -- specifically Jewish or Muslim funerals -- green burial can be a way to honor those customs.

·         Consult with a knowledgeable funeral director to learn if they provide or are experienced in green funerals.

Important Facts To Know About Green Burials

Green burial, also called a natural burial, is an environmentally friendly burial that aims to have as little impact on the earth as possible.

How To Choose A Green Funeral Home

Green funeral homes make environmentally friendly goods available to their customers, offer non-toxic body preparation options, and work with green cemeteries or natural burial grounds.

A Guide To Buying Green Burial Products

If you're planning a green burial, you'll need to purchase burial products that are environmentally friendly -- this generally means you'll want a green casket and a green headstone.

 Natural Materials Used To Make Green Caskets

Green caskets are made from natural materials that will easily decompose when buried and will have as little impact on the earth as possible, such as bamboo, pine, recycled cardboard, hemp or other natural materials.

If you're planning a green burial you'll want to mark the grave with natural elements, rather than a commercial headstone.

The Three Different Types Of Green CemeteriesTraditional, Home, and Green

In addition to traditional cemeteries, there are a number of other options for where you can be buried, such as at a “green” or “eco-friendly” cemetery.

Pre-Planning A Home Funeral Service

Home funerals take place at a family home, rather than a cemetery chapel, religious place of worship, or a funeral home.  In the Denver Metro Area, the burial will then take place at a cemetery.

How To Have A Home Burial

If you live in a rural area you may be allowed to bury a body on your own property. For many families, home burial is a more intimate, economical, environmentally friendly, and personal method of burial.   Home Burial is not allowed in the Denver Metro Area.

Also called a natural funeral, a “green” funeral is an environmentally friendly funeral that aims to have as little impact on the earth as possible.

Finding A Green Cemetery

Many conventional cemeteries are now offering green burial options.  There is a fairly new cemetery in Denver called Seven Stones that specializes in such burials.

Purchasing A Green Casket

Green caskets are commonly made from materials such as bamboo, cork, teak, willow, rattan, banana leaf, seagrass, and recycled cardboard, as well as hemp, organic wool and felt, and organic cotton.