How To Use Your LTCI

CARE MANAGER'S CORNER - Author : Eileen Dunn, MS, CMC, CLTC, Geriatric Care Manager


I met with a couple needing assistance with home care.

The husband had stage 4 pancreatic cancer and required treatment 5 days per week. The one-story home was set up well, to accommodate his needs. He was alert and oriented to person, place and time but was physically very weak and was on a continuous flow of oxygen. He required one-to-one assistance with transfers and getting to a standing position. Once standing, he was able to ambulate slowly with stand-by supervision for fall precaution and to be sure the tubing from the oxygen was not a trip hazard.

The wife’s morning routine involved getting up at 6 am. to get herself ready and then get breakfast for the two of them. After breakfast, she assisted him with his morning hygiene and getting dressed so they could be out the door to go to treatment by 8:30 a.m. Although the treatment wasn’t until 10:00 a.m. and the treatment center was not far from where they live, she explained that by the time she got him into the car, parked and assisted him into the treatment center it took well over an hour. After treatment, she had to get him back into the car and often had some errands to run such as stopping at the grocery store, picking up medication, etc. By the time she got home, got him back into the house and settled, it was usually 3 or 4 in the afternoon and time to start dinner. And then there was the evening routine of medication, cleaning some of his equipment and evening hygiene. It was not until she got him settled in for the night that she could even sit for a few minutes to go through the mail, pay bills, or tend to other routine household duties. She was exhausted.

As usual, one of the first questions I asked was, “Do you have long-term care insurance?”. She said they did, but she didn’t think it would help much, maybe a couple of hours in the morning to help get him ready for treatment. I explained that her that the insurance would not only pay for someone to help get her husband ready for treatment but also to assist her getting him to and from treatment. His plan of care clearly indicated the need for assistance with transfers and that included getting into and out of a car. She was shocked. She thought “home care” meant just in the home!

I often find myself having to teach clients how to use their insurance. The care plan I put together included a home health aide from 7 am to 7 pm Monday thru Friday and from 8 am to 5 pm on Saturday and Sunday. The home health aide assisted with the morning hygiene while the wife got breakfast. She assisted the wife to and from treatment and sometimes they would even all go out to lunch after. It was so much easier now that she had the help. Some days the wife would bring her husband home with the aide and then she would go out and run errands and get a pedicure, her favorite “distraction”. On Sunday morning, they resumed going to church and then to their favorite restaurant for Sunday brunch.

He died four months later and I had lunch with his wife a few weeks ago. She said that even though he paid almost $40,000 in premiums over the last 13 years, was on claim for only four months and the policy paid out almost $30,000, she said it was the best thing they ever did. She realized that they did not receive in benefits what they had paid in premiums but the peace of mind and stress relief it gave her was priceless. She said without the assistance provided by their long-term care insurance, they wouldn’t have enjoyed their last months together the way they did.


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