Having A Long-term Road Map Can Prevent Family Elder Care Crisis

Brandon Miller and Joanne Jordan, Certified Financial Planners in San Francisco published a very practical article in the San Francisco Bay Times about planning ahead in order to be prepared when a family member is faced with a disabling illness in old age.

I've excerpted some highlights here. Readers of this blog can read the complete article at the following link.
 http://www.sfbaytimes.com/?sec=article&article_id=17605
 

As the boomers and their parents age, more and more family members are managing eldercare responsibilities. The emotional, physical and financial demands of caring for aging parents can be extensive. What’s more, the healthcare needs of aging parents can become overwhelmingly expensive — and may include costs that affect their family members in ways that aren’t immediately apparent.  

• Having a long-term road map and a savings plan in place can help you care for your parents in the way they desire while enabling you to continue working towards your financial goals. This can be helpful in making informed short-term decisions, especially when there are unexpected expenses and emotions involved.     

• Talk about finances now. It’s essential that you are familiar with their financial strategy and resources.  

• Create a contact list for medical emergencies and know how to your access your parents’ bank accounts and other financial resources on short notice.    

• Know the location of important financial and legal documents and lockbox keys.

• Identify current healthcare costs and needs.   

• Build a support network. Talk with siblings or other family members, neighbors and industry professionals to determine who can help you care for your aging parents — and in what capacity and at what cost.   

• Anticipate future l i festyle changes and challenges. This includes determining whether your home would need to be modified to provide additional space or comforts, such as wheelchair access.

• Understanding these costs ahead of time can help you identify what you and your parents can afford and will give you time to consider the pros and cons of each option. 

•  Know your rights at work. The Federal Family and Medical Leave Act of 1993 (FMLA) allows covered employees up to 12 weeks of unpaid leave to provide care for a family member with a serious health condition.

A Profound Elder Abuse Case Study from the American Society on Aging

When Elder Abuse, Neglect, and Financial Exploitation Hit Home is a poignant case study published in the Fall 2012 issue of the American Society on Aging’s quarterly journal, Generations.

Jeannie Jennings Beidler advocated relentlessly for an intervention to stop the elder abuse that was happening to her grandparents. She begins the blog by reminding us that older adults are most commonly at risk of being abused by a family member. This heartbreaking reality is exemplified in her story that starts with her learning that her grandparents were being financially exploited and neglected by her unemployed, alcoholic uncle living with her grandparents. Ms. Beidler made several attempts to bring attention to her grandparents’ poor living conditions and was able to get them hospitalized, only to see them released again into a hostile, unsanitary environment.

Following months of advocating for an intervention and numerous attempts to navigate the many complex systems involved with her grandparents’ case, an intervention happened and her grandparents eventually found residence in a nursing home.

Ms. Beidler says, “My grandfather passed away four months after the intervention and my grandmother joined him eleven months later. Though a tragic story, I find great peace in knowing that they were well cared for and happy during their final months of life. This was my life’s most challenging and demanding period, but it was also the most meaningful. I will forever cherish my memories of my grandparents.”

Robin Roberts, the NYC Elder Abuse Center’s Multidisciplinary Team Coordinator, views this case as an example of how victimized older adults can fall through the cracks of a fragmented response system reacting to abuse in an unsystematic fashion without accountability. A systematic approach, such as that offered by multidisciplinary teams (MDTs), would have increased the likelihood of agency collaboration and accountability and brought about a swifter intervention for Ms. Beidler’s grandparents.

During MDT meetings, all of the systems, organizations and professionals needing to be involved in a case work together over time to develop and implement a comprehensive plan for elder abuse victims and their families. In addition to helping victims, the process of working together creates accountability and helps foster trust among agencies.

The NYC Elder Abuse Center addresses cases like those of Ms. Beidler’s grandparents through MDTs and case consultation services.  We would love to hear how other communities are furthering this work. How can we improve our elder justice system to guarantee the safety of those most vulnerable to abuse and ensure justice for its victims? Please post your responses here! We look forward to hearing from you.

http://nyceac.com/elder-justice-dispatch-a-profound-elder-abuse-case-study-from-the-american-society-on-aging/?goback=.gde_1905451_member_242094663

The Myth of Medicaid Planning: It's Not Used to Avoid Purchasing Long-term Care Insurance

For the nearly two decades that I have followed and advocated for the sale of private long-term care insurance there has been a widespread belief that a substantial number of older Americans who could afford to purchase this coverage, chose instead to protect assets using a strategy known as “Medicaid planning”.

When sales forecasts for private market LTC insurance failed to live up to expectations, Medicaid planning was the favorite scapegoat of many frustrated carriers and brokers.  It sparked a successful lobbying campaign by the industry to clamp down on Medicaid planning that resulted in the passage of a federal law in 2005 making it more difficult to use this strategy.  Instead of the significant boost in sales of LTC insurance as the “experts” predicted, sales declined steadily following passage of the law.  

Despite growing evidence to the contrary, many in the industry continued to insist that healthy elders, in cahoots with shady lawyers and greedy children, continued to hide their assets in order to qualify for Medicaid long-term care benefits.  

Now, as the private long-term care insurance market is struggling more than ever, ("Don't look now, but the long-term care insurance business is hurting - badly. And that could make it more difficult, or more expensive, for you to get a policy." http://www.cnbc.com/id/100669104) it turns out that this image—sort of the greedy geezer equivalent of Cadillac-driving welfare queens—is largely an urban myth.

Newly published research documents what I and others, have been saying for a long time: Most frail seniors and younger people with disabilities who receive Medicaid benefits were poor long before they ended up on the program. They did not hide their assets because, in large part, they didn’t have any to start with.

The key story is that those who did spend down started with far fewer assets and income than those who did not. They were disproportionately minorities, unmarried, and poorly educated. Among those who became Medicaid eligible by 2008, the median value of their total assets a decade earlier (including housing but excluding IRAs) was only $33,000—just one-fourth of the total wealth of those who did not spend down.

As I've said in this blog for a long time. More Americans need to purchase long-term care insurance. But folks who choose to use Medicaid planning have never been good prospects for private coverage. 

They are simply too poor and too sick to qualify. 

You're comments are welcome and will be posted as long as you don't hide behind anonymity.

I can always be reached via e-mail at bob@elderlifeplanning.com 

Is Caring For Aging Parents Unfair to Women?

Is Caring For Aging Parents Unfair to Women? by Carolyn Rosenblatt
http://www.forbes.com/sites/carolynrosenblatt/2013/05/09/is-caring-for-aging-parents-unfair-to-women/

It is estimated that over 60 million families are caring for an aging or disabled person at home.  At least 80-90% of caregivers are women.  There is no question that most of the burden falls on women for the physical and financial impacts of caregiving.  As parents live longer, more women are feeling the crunch.

The average caregiver today is a midlife woman and she already earns less on average than her male counterparts.  Fewer than half of workers manage to keep their jobs during the period of caregiving.  If a midlife woman is saving for retirement and has to quit, she will lose out on the benefits of working until retirement age. That will adversely affect her own future as she ages.

More than a third of those surveyed reported that their work situation was affected by caregiving, either because they had to quit altogether, retire early, reduce work hours or take a leave of absence.  Another 37 percent of those studied weren’t employed, which enabled them to function as caregivers, as much as full time.

Women who have young children at home, the “sandwich generation”, are particularly hard hit by caregiving for aging parents. In the report, 69 percent of workers looking after aging parents had to leave work early, arrive late, or miss days because of caregiving responsibilities.

 Is there anything that women can do about this situation?

There is no likely relief in sight from low wages , given our political situation and our lawmakers.  Low wage caregiver jobs will probably continue to be filled mostly by women.  Women in this field who work as long as they can will likely need caregiving from their own families in their futures.

There are sometimes specific things they can do to help themselves when assuming the caregiver role.  This is particularly true if they have siblings. And it’s important to do these things early, before caregiving becomes a crushing burden of everyday life for them.

Women need to advocate for themselves among their siblings. Some siblings are simply unwilling to pitch in, and think that sisters and daughters should care for mom and dad for free “because it’s family”.  Where adequate resources exist, women caring for aging loved ones need to ask for help from siblings. They also need to educate their siblings about the personal financial impact on them of doing the caregiver job.  It’s not free when you’re losing money doing it, say nothing of the tasks involved.

They need to insist that everyone contribute when possible, rather than accept the role thrust on them without speaking up at all.

Women can ask for caregiver contracts.  These agreements, drawn up by an elder law attorney, can allow for compensation of the caregiver sibling in some way, whether by direct payments every month, or by a larger share of any inheritance the siblings can reasonably expect from the parents needing care.

Women need to be specific in  requesting division of labor in caregiving.  For example, women can ask their siblings to manage the parents’ bills, shop for a parent’s needed items and see that they are delivered, keep the medications straight and see that prescriptions are filled timely and other like chores that can be done “off site”.  The primary caregiver sibling needs to think this through and make lists of chores a sibling can be assigned to ease her own caregiving burden.

In some families, no one will help but the primary caregiver, despite requests and specifics.  In some families, the parent has few resources to contribute and the primary caregiver doesn’t want mom or dad to go to a nursing home.  She chooses to care for the aging parent, regardless of the difficulty and financial impact.  For those of you in this role, it is an upright thing to do. You are not likely to regret your efforts and your sacrifice.

In my work at AgingParents.com, I speak to caregivers nearly every day.  I can say that whatever it takes, the best people among us are the ones who do the job of attending to aging parents’ needs as best they can. Even when it is unfair, they do not abandon their parents. My heart goes out to you. I know how hard it can get. Hats off to every one of you! And I hope you will also acknowledge yourself for doing the right thing.

How to Use a Life Insurance Policy to Pay for Long Term Care

A Guest Post By Anne-Marie Botek

http://www.agingcare.com/Articles/use-a-life-insurance-policy-to-pay-for-long-term-care-157309.htm

An active life insurance policy is a no-no for individuals who are seeking to spend-down their assets to qualify for Medicaid.

Considered an, "unqualified asset," any life insurance policy with more than $2,000 in value must be dealt with properly before an elder can receive financial assistance from Medicaid. (Learn more about Medicaid and long term care expensesSome seniors end up abandoning their policies, or letting them lapse, by ceasing to pay their monthly premiums. Others surrender their plans in order to receive a pre-determined, "cash surrender value," a lump sum of money that varies in value based on how many payments the policy holder has made and what the overall worth of their policy is.
There is, however, a third option that most people fail to consider when facing a Medicaid spend down: converting a life insurance policy into a Long Term Care Benefit Plan.
What is a long-term care benefit plan?
Anyone in possession of an in-force life insurance policy has the ability to transform that policy into a pre-funded financial account that will disburse a monthly benefit stipend to help pay for that individual's long term care needs. Unlike life insurance, a long term care benefit plan account is a Medicaid qualified asset. (Learn how life insurance can affect Medicaid eligibility)
The conversion process transfers ownership of a life insurance policy from the original holder, to an entity that acts as the benefits administrator. Because the original owner no longer holds the policy, it won't count against them in the Medicaid spend down process.
The benefits administrator assumes all responsibility for paying the monthly premiums on the policy to the insurance company, and agrees to pay the previous policy holder a series of monthly payments based on the value of their policy. These payments can then be used to pay for a person's home care, nursing home, hospice care and assisted living costs.
If this process sounds unfamiliar, don't worry, you're not alone. Most people don't know that the long term care benefit conversion option exists.
"For the last 100 years, anyone who's owned a life insurance policy has had the right to do this," says Chris Orestis, co-founder and CEO of Life Care Funding, a company specializing in life insurance policy conversions. "The problem is that most people are unaware that this option exists."

New Data Reveals Bewildering System, Staggering Cost Differences

Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences

When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD,
or chronic obstructive pulmonary disease, she faces an official price tag of $99,690.

Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment,
according to a massive federal database of national health care costs made public on Wednesday.

Americans have long become accustomed to bewilderment and anxiety when confronting health care bills. The new database underscores why,
revealing the perplexing assortment of prices for medical care, with the details of bills seemingly untethered to any graspable principle.

Even within the same metropolitan area, hospitals charge prices that differ by staggering degrees for the same procedures. People without health
insurance pay vastly higher costs for care when less expensive options are often available nearby. Virtually everyone who seeks health care winds
up paying inflated prices in one form or another as these stark disparities in price sow inefficiencies throughout the market.

While this basic picture has emerged as the consensus reality among health care experts, their evidence has been primarily anecdotal.
Hospitals have protected their price lists -- documents known as charge masters -- as closely guarded secrets.
 
Prices are secret no more.

The database released on Wednesday by the federal Centers for Medicare and Medicaid Services lays out for the first time and in voluminous detail how much
the vast majority of American hospitals charge for the 100 most common inpatient procedures billed to Medicare. The database -- which covers claims filed
within fiscal year 2011 -- spans 163,065 individual charges recorded at 3,337 hospitals located in 306 metropolitan areas.

The Obama administration shared the data in advance with The Huffington Post, The New York Times and The Washington Post. What emerges through a
preliminary analysis is a snapshot of an incoherent system in which prices for critical medical services vary seemingly at random -- from state to state,
region to region and hospital to hospital.

 http://www.huffingtonpost.com/2013/05/08/hospital-prices-cost-differences_n_3232678.html

2013 Marks 10 Year Anniversary of the Genworth Cost of Care Survey

2013 marks the 10 year anniversary of the Genworth Cost of Care survey.  While the survey has gone through its fair share of makeovers over the last decade, the mission of the survey has remained constant – helping families evaluate options to address the increasing costs of long term care.  Genworth has always taken pride in having the most comprehensive study, collecting rates for four major long term care provider types – Nursing Homes, Assisted Living Facilities, Home Health Agencies, and Adult Day Care Centers.   The Genworth Cost of Care survey gathers the largest volume of data with nearly 15,000 completed surveys covering all 50 states and the District of Columbia, in 437 regions nationwide.

Given this being the 10 year anniversary, here is a look into
how long term care costs have evolved over the years:

Provider Type (all figures reflect pricing for private pay/out of pocket costs)	2013 National Median	2013 Nation Averages	2004 Nation Averages	2004-2013 Growth	2004-2013 Compound Annual Growth Rate**	Five-Year Compound Annual Growth (2008-2013)
Nursing Home - Private Room (1 person)	$230.00 Daily	$243.90 Daily	$179.00 Daily	36.26%	3.50%	4.45%
Nursing Home - Semi-Private Room (2 people)	$206.59 Daily	$218.83 Daily	$158.00 Daily	38.50%	3.69%	4.22%
Assisted Living Facilities	$3,450.00 Monthly	$3,518.79 Monthly	$2,400.00 Monthly	46.62%	4.34%	4.23%
Home Health Aide (non-Medicare certified agencies)	$19.44 Hourly	$19.60 Hourly	$18.24 Hourly	7.46%	0.80%	1.00%
Homemaker/Companion (non-Medicare certified agencies)	$18.25 Hourly	$18.66 Hourly	$16.53 Hourly	12.89%	1.36%	0.84%
Adult Day Care*	$65.00 Daily	$66.86 Daily	n/a	n/a	n/a	1.61%

https://caregiving.genworth.com/caregiving-resources-articles/-/carelib/blogs/139961/Genworth-2013-Cost-of-Care-Survey?cid=em_extrg_050913_coc2

Consumer Reports Investigative Report on Financial Exploitation of Elders

Consumer Reports has published an investigative report on financial exploitation of older people that underlines how widespread such abuse is.

"Financial exploitation of elders is broadly defined as the illegal or improper use of the funds, property, or assets of people 60 and older. In one national study, 5.2 percent of older Americans said they'd been victimized by family members, and 6.5 percent said they'd been exploited by others. A seminal national study by the MetLife Mature Market Institute found that the cost of such abuses is at least $2.9 billion a year. Yet many experts told us that because these crimes often go unreported, those estimates are most likely the tip of the iceberg."

"We found there are numerous avenues on the national and local level, with both government and not-for-profit organizations."

"One of the best preventive measures is vigilance. To catch elder abuse requires your willingness to visit your elderly loved one both at regular and irregular times. See the bottom of our article Protecting Mom & Dad's money for resources and additional advice."

http://news.consumerreports.org/money/2013/01/financial-elder-abuse-by-relatives-there-is-help.html

Stone Phillips New Documentary 'Moving Grace,' About Caring for His Aging Parents

"You have to be able to consider not only your aging parents, but also your own life. It’s not easy to become a caregiver for an aging parent. You have to take into consideration what works for the caregiver as well as the aging parent."

By Kristen Hare,  Mon, 05.06.13

Since 1965, Vic and Grace Phillips made their home in Ballwin. There, they raised three children, including son and broadcast journalist, Stone Phillips.

Today, the Phillips live in a retirement community in North Carolina, and the years, conversations and choices it took to get them there are documented in “Moving with Grace,” a new documentary filmed and produced by Phillips.

Phillips: It was a few years. I would say we spent the better part of a year really discussing that we needed to move them closer to one of us.

Discussions about moving them to North Carolina mirrored the process of moving them out of their house. My father saw the wisdom, the necessity of moving, even though he didn’t look forward to it and he hated to leave his friends and his community in St. Louis. Mom was very resistant, would fluctuate back and forth. And especially as her dementia increased, she would forget the discussions that we had.

Caring for aging parents is something most baby boomers now have to face. What was it about your personal experience that made you want to document and share it with others?

Phillips: That’s precisely why I wanted to do it. As I talk with friends about what was happening with my family and my parents, everyone had a similar story, everyone was interested and I was interested in their stories. This is one of those time of life issues.

With our aging parents, we are taking over management of their lives. It’s become an almost universal story and challenge. 

The policy issues I don’t really get into that much in this documentary. This is a very personal story. I think what I came away with is these are family decisions that have to be made.

You have to be able to consider not only your aging parents, but also your own life. It’s not easy to become a caregiver for an aging parent. You have to take into consideration what works for the caregiver as well as the aging parent.

It’s hard to begin to take control over an aging parent’s life, it’s emotionally difficlut, it’s a role reversal -- there is a kind of unsettling, uncomfortable feeling about it.

I came away feeling  that it’s really important to communicate and to talk to my mom, particularly and let her know that even though we were making this decision that she didn’t want to do, that we still cared about hearing how she felt, what she wanted to say about it, hearing her feelings. So even though we weren’t honoring her wishes, we were honoring her feelings. I think that really helped.

How are both your father and mother doing now?

Phillips: They’re doing well. They moved to North Carolina when they were still living independently, even though my mother’s dementia was increasing. Now they’ve moved into assisted living, they need the additional care.

The outcomes of these things are unpredictable, but I think if you can talk about it, continue to talk about it and just support one another as much as you can, you have a better chance of a better outcome.
 
To Read the full transcript of this brief excerpt follow this link: https://www.stlbeacon.org/#!/content/30692/take_5_stone_phillips_050213

Alzheimer's Disease Now the Most Expensive Illness in the U.S

Alzheimer's Disease Now the Most Expensive Illness in the U.S
Likely to Increase 40 percent in 12 Years

By David Brimm, Community Contributor, Chicago Tribune
April 24, 2013

The number of Americans with dementia is estimated to be between four and five million, which when you factor in Alzheimer's, has become the most expensive malady in the U.S., costing families and society $157 billion to $215 billion a year, according to a new Rand study. Cancer and heart disease are the bigger killers, but their attending costs are lower than that of Alzheimer's and other types of dementia due to not only drugs or other medical treatments, but the care that's needed just to get cognitively impaired people through daily life.

The Alzheimer’s Association reports the number of people 65 and older with Alzheimer’s disease is estimated to increase 40 percent to 7.1 million by 2025. Without medical advancements, that number is projected to rise to 13.8 million people by 2050 and could reach as high as 16 million.

Dementia incidence increases dramatically from age 65 to age 85, with many studies reporting a doubling every 5 years. Community studies indicate that the rates of dementia increase from 30% for persons aged 85 through 89 years to 50% for persons aged 90-94 years, to 74% for those 95 years or older. Other studies indicate that beyond the age of 90 the rate of new diagnosis of dementia levels off.

http://www.chicagotribune.com/news/local/suburbs/downers_grove_darien_westmont_woodridge/community/chi-ugc-article-westmont-eldercare-expert-warns-that-dementia-2013-04-24,0,7849799.story

Will California’s Eldercare Reform Help or Hurt?:

Will California’s Eldercare Reform Help or Hurt?: Older Californians Appears to be Suffering From Too Much, Not Too Little Coverage

 The heart of the problem is the fragmented nature of care for this fragile population.
California Health Report , News Analysis, Daniel Weintraub, Posted: Apr 20, 2013

Amid all the recent worry about people lacking health insurance, one vulnerable group of Californians appears to be suffering from too much, not too little coverage.

Low-income older adults who are dually eligible for both Medicare and Medi-Cal (California’s name for Medicaid). That might sound like a good thing. But the lack of coordination between the federal program for seniors and the state-federal program for the poor may be hurting their health. 

Now the California is among a number of states trying to fix the problem by combining all of the services available to these people under one administrative roof. That will include not only their health care but social services too, such as in-home workers who bathe and feed patients who can’t take care of themselves but don’t need to be in a nursing home.



Gov. Jerry Brown says the changes will be a boon to more than a million elderly and infirm Californians – including many formerly middle class people who spent down their savings until their funds were low enough to qualify for Medi-Cal, which now pays their nursing home bills. Brown estimates that the reforms could shave a half-billion dollars from the California’s budget for health programs.

 If the managed care plans that will be taking charge of people’s needs are not up to the task, their health could suffer. And the health plans themselves might be saddled with unmanageable costs if the rates and rules for the program are not set just right, ultimately causing turmoil and confusion for the very people the changes are designed to help.

The heart of the problem is the fragmented nature of care for this fragile population.

Medicare pays for doctor visits, prescription drugs and short-term hospitalizations, but does so using the traditional “fee-for-service” method. Patients are responsible for managing their own care, finding and choosing doctors and medication, and the federal government pays the tab. The program also offers the Medicare Advantage managed-care option, but that does not cover long-term care and other services included in Medi-Cal.

If an older person is poor, they are also covered by Medi-Cal. The state-run program (financed by federal and state dollars) picks up any deductibles and co-payments charged by Medicare and pays for long-term care, including nursing homes that Medicare does not cover.

But that means that a patient moving from a nursing home to a hospital or back to their own home will often be switching among doctors and caregivers, increasing the potential for confusion, errors or lapses in care. Social services, which many of these patients also need, are managed independently, usually by the counties.

Uncoordinated Care at its Worst

Jane Ogle, deputy director of the state’s Department of Health Care Services, says focus groups with seniors in advance of the governor’s proposal turned up accounts of uncoordinated care at its worst. She said one person had 26 different doctors. Another was on 52 medications.

The complete article is available at http://newamericamedia.org/2013/04/will-californias-eldercare-reform-help-or-hurt.php

Planning For the Eldercare Boom

Planning for the eldercare boom
by Angil Tarach-Ritchey

 April 22, 2013

For the last two years, ten thousand Baby Boomers have been turning 65 years old each and every day. This will continue for the next 17 years. If you work in eldercare or you're a Baby Boomer that is not new to you, but how serious are you taking the fact that our current healthcare and private care system cannot support this growing population?

Geriatric care providers and healthcare professionals see where our current system is failing seniors, and family caregivers, but what are we doing to improve it, change it, or create a new system? As it stands today, if you are a senior in the U.S. and you need assistance with bathing, meals, housekeeping, transportation or errands there are no real financial resources to speak of unless you are a veteran or have already purchased a long-term care insurance policy. Seniors for the most part are paying out-of-pocket for assistance and/or care. While there are limited state or county programs some qualify for, it's not generally enough to provide the assistance that many seniors or their families are seeking. It's not uncommon to find those programs closed to new applicants or to be put on a waiting list a mile long.

We have seen recently that the cost of a private nursing home room is up to $84,000,-(Editor's note: The cost is twice that in states like NY, MA, CT CA and many others. 8 hours of care at home is $200 daily in these states. If needed 5 days per week that's $1000 per week. MOST home care is not covered by Medicare)

Tarich points out that aging adults are expected to pay out of pocket, until theyexhaust all savings and assets to qualify for Medicaid. "Could you pay that much per year for care?"  She asks. "If you can, how many years would you be able to handle that cost? I venture to guess that the majority of us could not pay this price much more than a year or two, if at all."

That same semi-private bed in a skilled facility will average over $210,000 a year over the next two decades. Considering your own age and how far into the future you may need care. Even if you are a dedicated long-term care employee, you have to ask if YOU will you be able to cover your care? Medicare and Social Security are floundering to continue into the future, and Medicaid cannot possibly handle these costs. Will you count on a son or daughter you expect will be healthy, financially well off enough to be able to care for you, or do you just want to go into the future by the seat of your pants just hoping you'll be cared for in some way? What if you don't have children? What if they become sick or are not stable enough to help you? Do you really want to burden them or have them forgo their own lives and happiness to care for you?


http://www.mcknights.com/planning-for-the-eldercare-boom/article/289698/#