By Karen L. Jerome, MD
Read Part 1: The Journey of a Caregiving
They’ve finally accepted having an aide in the apartment. So, how do we pay for it? Fortunately, my parents are planners and invested in Long Term Care (LTC) insurance a number of years ago. Now, how do we go about collecting on that investment?
First, there’s the waiting period. In my mom’s case, the plan required 100 days of in-home care before LTC would pay anything. (In my dad’s, a different policy, home care would be covered immediately. But, he doesn’t qualify for coverage yet because he can perform his Activities of Daily Living (ADLs) independently.) While we waited out the 100 days, mom had to undergo a virtual evaluation to make sure she did qualify. No in-person evaluation was even offered.
I had to bring my laptop to their apartment and join a Teams meeting with the review nurse. (I’m not sure how two 90-something-year-olds with no computer literacy were supposed to manage this if I hadn’t been there.)
I answered most of the questions as my mom sat completely uncomprehendingly next to me. Then we got to her part of the evaluation.
Mom was able to state her name and date of birth. And that was pretty much all she could do. When asked about the season she answered “winter” when it was still summer. The month was “November,” though actually early September. The day was “Saturday,” really Tuesday. She was in “New York,” rather than Maryland and had apparently completely lost the 25 years that she’d lived in New Jersey after the New York years and before the past 5 in Maryland. She declined to participate in the other exercises such as spelling “world” backwards. Thankfully, the nurse didn’t ask her to draw a clock. The next part of the exam was to assess her ability to ambulate independently, dress herself, etc…
On that day, Mom couldn’t even stand up from her chair without assistance, and that gave the nurse enough information about her mobility. The evaluation was over. Several weeks later we received the news that she had been approved for the LTC benefits.
I don’t believe that the evaluation was particularly upsetting to my mom, but it certainly took a toll on me and Dad, who was sitting nearby and witnessed it. We know how diminished and disabled she is, but to see her answer or fail to answer those questions was devastating. There’s no pretending that her dementia isn’t severe. At least, we’re able to get a little financial assistance now, though.
I’m trying not to think about all the money she’s paid in premiums and hoping, now that we’ve just passed the 100-day mark, their long-ago investment pays off.
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