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FINANCIAL PLANNING FOR LONG TERM CARE

Bringing the pieces together

W O R K B O O K

M a r i e t t a H a l l , C F P®This long-term care planning workbook is meant as a guide to help you think

about and organize your resources. It is not meant to substitute for financial, legal, tax or medical advice from a professional. It is a preparatory document for your

meetings with those professionals. Fill out as much as you can and then make an appointment with a Certified Financial Planner Professional® to create your plan.

Stop by our booth for information to download the fullFinancial Planning For Long Term Care Workbook

FINANCIAL PLANNING FOR LONG TERM CARE - WORKBOOK | Marietta Hall, CFP® | [email protected] 2

My Core

Values

Family MeetingCritical Information you might need for:

in case of incapacity or death.

Family who know my values, finances & wishes:

Friends who know my values, finances & wishes

Attorney You Should Call:

Name

Phone

Financial Advisor You Should Call:

Name

Phone

Name

Phone

Name

Phone

Name

Phone

Name

Phone

Name

Phone

Name

Phone

Name

Phone

Name

Phone

CPA You Should Call:

Name

Phone

Name

Phone

Name

Phone

Clergy and Spiritual Advisors You Should Call:

Physician You Should Call:

Name

Phone

Other Professionals You Should Call:

Name

Profession

Phone


Preferred Caregiver Plan

Caregivers Preference Rank (1st, 2nd, 3rd) Comments

Spouse

Children

Relatives

Friends

Professionals

Best Place For You Reasons, People, Other Thoughts

Where would you prefer to live if you need care?

States rated with the best quality of life or less costly care that friends or relatives should consider:

What is your plan if? Others I care for and my wishes

Primary Caregiver premature death? Children:

Extremely long illness life - 20 years or more? Ward:

Spouse:

Both spouses entering care?

Parents:

Name:


Checklist of Critical Documents

Documents Where are the originalsDate Last Reviewed Notes

Property Titles

Durable Power of Attorney

Springing Power of Attorney

Last Will and Testament

Health Care Power of Attorney

Advanced Health Care Directive

Trust Documents

Important People Name Notes

Personal Representative

Executor

Co-Executor

Contingent Executor

POA

Contingent Named POA

Trustee

Contingent Trustee

Other

Name:


Financial Resources Inventory

Current Income Sources Record Exact Titling Balance/Benefit Date

Pensions

Social Security Income (If Over 63)

Social Security Disability Income (If Under 63)

Military Benefits

Disability Insurance (short-term and Long-term)

Rental income

Asset Sales Agreements

Income Annuities

Accounts Receivable

Buy/Sell Business Agreements

Alimony and Child Support

Child Support

LTC monthly benefits once qualified

Other

TOTAL $ $

Survivor Income Sources

Survivor Benefits of any of the income listed above

Life Insurance Benefits

TOTAL $ $

Assets

Long Term Care Hybrid Sum of Insurance

Tax Deferred retirement accounts

Deferred Annuities

Roth retirement accounts

Cash & liquid investments (cash within 20 days)

Cash Value of Life Insurance

Home Equity

Rental and business property

Land and Other Real Estate

Pre-paid burial expenses

Other Assets – less liquid: businesses, collectibles

TOTAL $ $

Liabilities

Mortgage

Child Support

Alimony

Purchase Agreements

Other Debt

TOTAL $ $

Special Circumstances for planning:

Are you AK Native or American Indian? o Yes o No

Are you a veteran? o Yes o No

Name:


Longevity Projection 20-Year View 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Vascular Dementia (Stroke or Heart)

ALS- Lou Gehrig’s Disease

Alzheimer’s Disease diagnosis of mild or better at 90+

Alzheimer’s Disease diagnosis of severe any age

Alzheimer’s Disease diagnosis of very severe any age

Lewis Body Syndrome

Alzheimer’s Disease diagnosis of mild or better at 80


Alzheimer’s Disease diagnosis of moderately severe any age


Alzheimer’s Disease diagnosis of moderate any age


Alzheimer’s Disease diagnosis of mild or better at < 65 (<1% of cases)

Multiple Sclerosis (RR, SP, PP, and RP)

Parkinson’s

Dementia Longevity Analysis

Early Stage - Go Go years where you may need assistance with 1 or more ADLs and illness might be managed and cost of care is lower.

Mid Stage - Slow Go years where you may need a care provider for 1-2 ADLs and care costs could progressively rise.

Late Stage - No Go high cost years where you need a care provider for 2 or more ADLs and end of care costs.

KEY

Activities of Daily Living or ADLs is a term used by healthcare professionals to refer to the basic self-care tasks an individual does on a day-to-day basis. These activities are fundamental in caring for oneself and maintaining independence. An individual’s ability or inability to perform ADLs is often used by health professionals as a way of measuring an individual’s functional status, especially that of older adults or those with disabilities.

Basic ADLs are self-care activities routinely performed which include, but are not limited to:

1. Eating: Self-feeding

2. Bathing: Showering and/or bathing

3. Dressing: Dressing, which includes selecting appropriate attire and putting it on

4. Toileting: Toileting, which includes getting on/off toilet and cleaning oneself

5. Transferring: Functional mobility, which includes the ability to walk and transfer in and out of a chair or bed. Essentially, it’s the ability to move from one place to another as a person goes through their daily routines.

6. Maintaining Continence: Exercises complete self control over urination and defecation.

One way to look at basic ADLs is to think of them as the activities a person does when they get up in the morning preparing to leave the house and those they do regularly day in and day out.

Source: www.seniorliving.org/caregiving/activities-of-daily-living/

What are Activities of Daily Living (ADLs)?


Worksheet For Care Funding

EARLY Stage Est. 1-8 Hours of Care Cost Per Unit Estimated Units Source of Funding

Spouse $

Other Family/Friends $

Home Health Care $

Adult Day Care $

Respite $

Moving Costs To Supported Housing $

Funds To Travel While You Can Enjoy It $

MID Stage Est. 8-16 Hours of Care Cost Per Unit Estimated Units Source of Funding

Spouse $


Home Health Care $

Adult Day Care $

Assisted Living $

Continual Care Community $

Respite Time For Primary Caregiver To Get Away $

Home Improvements In Preparation To Age In Place

$

LATE Stage 24 Hours of Supervised Care Cost Per Unit Estimated Units Source of Funding

Spouse $


Home Health Care $

Assisted Living $

Nursing Home $

Moving Costs $

Respite Time For Primary Caregiver To Get Away $

Home Improvements To Age In Place $

Name:


Location

Semi Private Room Minimum

LTC Semi-Private Room Median Cost

Semi-Private Room Max

Avg annual Cost of Assist. Living

Avg Daily Adult Day Care Cost

Quality of Life Ranking

Social Environment

USA Avg $19,345 $85,775 $515,380 45000.00 $70 AK $178,850 $292,000 $515,380 72000.00 $168 19 27AL $54,750 $73,000 $107,675 36684.00 $26 35 1AR $47,450 $62,050 $79,570 36156.00 $80 7 21AZ $57,305 $76,650 $116,800 42000.00 $82 39 34CA $41,245 $97,367 $228,125 51300.00 $77 50 47CT $65,700 $91,958 $130,305 55200.00 $80 10 20CO $105,850 $150,198 $197,830 46200.00 $69 38 39DC $109,500 $118,443 $129,575 79200.00 N/ADE $107,675 $127,750 $141,255 72180.00 $73 24 30FL $73,000 $94,900 $172,463 37200.00 $65 33 45GA $48,728 $74,668 $110,778 33600.00 $60 32 38HI $23,334 $137,240 $585 51000.00 $70 36 37IA $58,400 $68,894 $155,490 44832.00 $63 9 10ID $65,335 $88,695 $124,100 37800.00 $101 20 12IL $47,450 $68,255 $381,425 44640.00 $72 47 35IN $47,450 $80,300 $116,070 48300.00 $85 48 43KS $54,750 $66,613 $118,625 51000.00 $75 16 16KT $55,663 $80,731 $104,025 41340.00 $68 27 22LA $43,070 $62,050 $82,490 39516.00 $63 42 31MA $102,200 $140,525 $177,755 67188.00 $65 25 42MD $77,015 $109,500 $152,205 49800.00 $78 31 26ME $71,175 $109,683 $134,685 58680.00 $108 12 8MI $47,450 $95,630 $164,250 42000.00 $78 29 23MN $48,665 $98,094 $144,358 43020.00 $83 2 4MO $42,705 $58,948 $102,200 32400.00 $80 15 18MS $63,145 $77,928 $102,200 39984.00 $45 6 17MT $70,536 $86,505 $108,770 43800.00 $119 13 2NC $43,800 $82,125 $127,020 39000.00 $53 34 25ND $89,009 $127,630 $155,673 36216.00 $98 1 3NE $40,150 $76,011 $127,933 45420.00 $74 14 13NH $41,063 $115,888 $143,080 58260.00 $72 4 7NJ $78,475 $120,450 $164,250 69732.00 $90 49 49

NM $19,648 $76,194 $178,485 48000.00 $101 8 11NV $47,147 $87,600 $144,299 40800.00 $75 43 50NY $86,140 $132,907 $394,565 47856.00 $80 37 48OH $59,495 $81,578 $117,530 50136.00 $57 40 29OK $45,625 $53,655 $109,500 36396.00 $60 17 9OR $47,450 $105,408 $182,500 48840.00 $89 18 15PA $41,063 $111,325 $165,126 41400.00 $62 44 41RI $76,650 $101,835 $124,100 61860.00 $75 23 36SC $56,575 $77,015 $130,670 34380.00 $55 30 33SD $62,415 $75,599 $105,485 42840.00 $68 5 14TN $63,510 $73,318 $111,325 43140.00 $65 28 32TX $19,345 $54,750 $109,500 42000.00 $35 46 46UT $24,273 $67,525 $91,250 37800.00 $62 22 6VA $67,525 $85,775 $149,650 54096.00 $68 41 44VT $95,995 $105,120 $132,130 49524.00 $132 26 28WA $60,225 $102,930 $175,200 55920.00 $65 21 24WI $41,990 $94,900 $135,404 48000.00 $65 3 5WV $75,190 $116,435 $143,810 45000.00 $62 45 40WY $67,525 $84,939 $108,770 40980.00 $85 11 19

LTC Financial Planning Resources

LTC Data Excerpted from:

• Nursing Home Data Excerpted from 2017 Cost of Care, Genworth Financial

• Quality of Life and Social Ranking Data from US News and World Report 2017 Best State’s Ranking

• Adult Day Care and Assisted Living cost by state from payingforseniorcare.com

• State of AK by Region from payingforseniorcare.com, Pioneer Home Pricing from Juneau office

N U R S I N G H O M E S


Cost Comparison By General Region

Type of Care Avg. Cost In AKCost to fund 5 yrs

In-home Care $26 per hour, 24 hours daily $1,138,800.00

Adult Day-Care $3,360 5 Days A Week $201,600.00

Assisted Living $197 Daily $360,000.00

Nursing Care $800 Daily $1,460,000.00

Fairbanks Adult Day Care: $200 Daily Assisted Living: $222 Daily Nursing Care: $800 Daily Home Health: $27 Per Hour

Rest of State Adult Day Care: $142 Daily Assisted Living: $201 Daily Nursing Care: $11,651 Daily Home Health: $30 Per Hour

Anchorage Adult Day Care: $86 Daily Assisted Living: $197 Daily Nursing Care: $727 Daily Home Health: $26 Per Hour

Juneau

Anchorage

Palmer

Fairbanks

Sitka

Ketchikan

Pioneer Homes in Alaska - Levels of Care

Level 1 - $2,588 monthlyLevel 2 - $4,692 monthlyLevel 3 - $6,795 monthly

Same rates all regions.

South CentralAnchoragePalmerInteriorFairbanks

South EastJuneauKetchikanSitka

Pioneer Homes Locations by Region

Wait list is 1-2 years once you are in top 20 names.


Domain 1 Basic Monetary Skills Question: “Please identify these coins and currency”

1. Naming coins/currency � Identify specific coins and currency2. Coin/currency relationships � Identify relative worth of coins/currency3. Counting coins/currency � Accurately count coins and currency

Conclusion: o Capable o Marginally Capable o Incapable

Domain 2 Financial Conceptual Knowledge

Question: “What is money?” Define a variety of financial concepts

1. Define term “money”2. Define ways people obtain money3. Define the term “loan”

o Capable o Marginally Capable o Incapable

Domain 3 Cash Transactions Question: “Please give me the exact amount of money needed to buy this box of tissues”

1. Identify item cost � Identify cost of single item from price tag2. one item grocery purchase � One item transaction; verify change3. Addition of sales tax � Explain additional charge regarding purchase


Domain 6 Financial JudgmentQuestion: “How could you be sure the price for the car is fair? ” 1. Detect telephone fraud risk � Detect and explain risk2. Determine appropriate value � Explain how to determine worth of automobile3. Advertising automobile � Indicate how to advertise automobile4. Receiving payment � Explain how to obtain appropriate payment


Domain 4 Checkbook ManagementQuestion: “What is a check?”

1. Understand checkbook � Define check2. Use checkbook � Simulated transaction; pay by check3. Use checkbook register � Simulated register entry and balancing


Domain 7 Bill PaymentQuestion: “If you had a question about this bill, what would you do?” 1. Understand bills � Explain meaning and purpose of bills2. Identify bill amount � Identify money owed on bill3. Questioning amount of bills � Explain how to question amount of bill4. Unpaid bills � Explain consequence of unpaid bills


Domain 5 Bank Statement ManagementQuestion: “What are some of the ways John Doe spent money during this month?” 1. Identify bank statement � Explain purpose of bank statement2. Identify bank statement balance � Calculate bank statement balance3. Identify deposit � Identify monthly checkbook deposit


Domain 8 Knowledge of Personal Assets and Estate ArrangementsQuestion: “Do you have a will or a living trust?” 1. Income � Identify source of income2. Assets and will/trust � Identify valuables and will/trust


How do I know when to step in?

Diminished Financial Capacity - 8 Domains


o Mail is piling up, unpaid bills

o Excitement about winning lottery or a prize

o Taking out a lot of money and will not disclose why

o New companion, advisor or POA and they are breaking previously established financial patterns

o Elder is fearful, distressed or depressed and this is out of character for them; such as cannot afford medication or groceries and did not previously have these financial problems

o Missing checks from the checking account or do not remember writing checks

o Unusual checks written from the account, not their signature

o New individual is accompanying elder into the bank

o Elder is withdrawing substantially more money than they usually did per month

o Elder complains they cannot get a hold of the person handling their investments or money or they will not give them an accounting for spending when they ask

o Charges inconsistent with elder’s lifestyle and this is out of character

o Abrupt changes in financial documents like wills or deeds

o Elder has been a victim of financial exploitation in the past

Office of Elder Fraud & Assistance

Additional Advocacy Groups

Red Flags of Fraud

Contact Information Address: 900 W. 5th Ave., Ste 525 Anchorage, AK 99501 Phone: (907)334-5989 Fax: (907) 375-7788

Division of Public Health Health Facilities Licensing & Certification4501 Business Park Blvd, Ste 24, Bldg LAnchorage, AK 99503(907) 334-2483, Fax (907) 334-2682After-Hours Complaint Hotline 1-888-387-9387

Persons 60 and OverOffice of the Long Term Care Ombudsman3745 Community Park Loop, Suite 200Anchorage, AK 99508(907) 334-44801-800-730-6393

Persons Under 60Disability Law Center of Alaska3330 Arctic Blvd., Suite 103Anchorage, AK 99503(907) 565-1002, Fax (907) 565-10001-800-478-1234

Medicaid Fraud Control Unit310 K Street, Suite 300Anchorage, AK 99501(907) 269-6279

Contacts: Beth Goldstein – Supervisor Mike Carbone – Investigator Email: [email protected] website: doa.alaska.gov/opa/oefa/

Resources

Alzheimer’s Resource of Alaska1750 Abbott Road Achorage, AK 99507(907) 561-3313, Fax (907) 561-33151-800-478-1080www.alzalaska.org