We are not prepared for the coming dementia crisis

[CHDeac]

But is private health insurance (even before Obamacare cratered it) materially better in that particular area? I think it is just a shitty situation to be in no matter what insurance you have. I think care from family members in a dementia setting is going to dictate "success" more than any type of insurance can provide. It is not a situation where increased money = increased acute care = better results. It sucks no matter how much money is involved.

There is a market for long therm care insurance. Its pricey but can be a huge relief to families dealing with this. I don't work in the LTC space but have spent time reviewing iit and its worth a look, especially as you get older.

 

[ITK]

My cat and I work with dementia patients. It's more sad for the people around them. Most of them have no idea what is going on. Except this one guy they told me had dementia. He was 93 and had been married for like 71 years or something. Definitely was not all there and then I ran up to the time they told me to get out of there so I was all "We have to get out of here because they told me your wife on her way and she is allergic to cats". He said "Of course she did, my wife says lots of things". So he really couldn't remember much except his wife was full of shit.

 

[ConnorEl]

There is a market for long therm care insurance. Its pricey but can be a huge relief to families dealing with this. I don't work in the LTC space but have spent time reviewing iit and its worth a look, especially as you get older.

The vast majority of folks needing long-term care do not have this.


IMO, it (for everyone) needs to be wrapped into our next move forward on health care reform.

 

[CantStandYa]

How many beds does the Cleveland Clinic have for assisted living for Alzheimer's patients?

Apples and oranges. You said "facilities that accept Medicaid" in your previous post, which is pretty much every medical facility in the country. If you were specifically referring to assisted living facilities, that's a whole other story. My bad.

 

[thatguy2016]

Apples and oranges. You said "facilities that accept Medicaid" in your previous post, which is pretty much every medical facility in the country. If you were specifically referring to assisted living facilities, that's a whole other story. My bad.

yeah..."assisting a loved one with dementia" was a pretty good context clue

 

[ConnorEl]

Bigger clue was the context—my post #15 to which thatguy was responding.


Anyhow, yes, most people have insurance that covers much better (often still not well) for acute care than for long-term or custodial care. Medicaid is the largest payer for the latter.

 

[2&2 Slider To Leyritz]

Ignoring (mostly) the inaccurate swipe at the ACA, no—“private” health insurance isn’t “better” at meeting the needs of folks requiring long-term or custodial care.

Biggest payer for this is Medicaid (because you are poor in the first place or spent all your money on care and became poor). Sure, families generally do the best they can. But often families can’t provide any, enough or adequate care.

If only there was a mechanism where everyone contributed to a pool of resources that would be there for each of us when we need it.

The vast majority of folks needing long-term care do not have this.


IMO, it (for everyone) needs to be wrapped into our next move forward on health care reform.

Bigger clue was the context—my post #15 to which thatguy was responding.


Anyhow, yes, most people have insurance that covers much better (often still not well) for acute care than for long-term or custodial care. Medicaid is the largest payer for the latter.

So we already have a pool of resources that is there for everyone if/when they need it - Medicaid, and Medicaid already covers and is the largest payer for custodial care. If Medicaid is not performing up to expected standards, then we need Medicaid reform, not healthcare reform.

 

[JuiceCrewAllStar]

one idea I heard for Medicaid/Medicare reform is to expand the risk pool

 

[ConnorEl]

So we already have a pool of resources that is there for everyone if/when they need it - Medicaid, and Medicaid already covers and is the largest payer for custodial care. If Medicaid is not performing up to expected standards, then we need Medicaid reform, not healthcare reform.

Lol


No.

 

[ImTheCaptain]

the Tunnels can barely handle the trumpshill dementia as it is. this country is fucked

 

[Strickland33]

If sd3 and catarube are any indication, then dementia sufferers are getting younger, too

 

[2&2 Slider To Leyritz]

Lol


No.

Explain. Every single working citizen pays into Medicaid. Everyone with means then spends down their own assets to level the playing field first before leaning on the system, and then Medicaid kicks in for them. If you could design a perfect system from scratch, that would theoretically be it. Now, if the care provided by Medicaid is substandard then reform Medicaid, but you literally could not design a better theoretical system.

 

[thatguy2016]

Explain. Every single working citizen pays into Medicaid. Everyone with means then spends down their own assets to level the playing field first before leaning on the system, and then Medicaid kicks in for them. If you could design a perfect system from scratch, that would theoretically be it. Now, if the care provided by Medicaid is substandard then reform Medicaid, but you literally could not design a better theoretical system.

you think that's a perfect system?

so you and your wife retire at age 65 with $2 million in assets

the next day, you are diagnosed with dementia while your wife is perfectly healthy; you could easily live 10+ years with your worsening condition and your wife could easily live 25 or more

how is this going to work out for you?

 

[ConnorEl]

Sure you can.

Everyone pays into a system that exists to ensure that your needs for care, when you need it, are met.

Everyone should participate in a system that provides for long-term care, residential hospice care, etc. as it’s needed.


That would be a better system.

 

[2&2 Slider To Leyritz]

you think that's a perfect system?

so you and your wife retire at age 65 with $2 million in assets

the next day, you are diagnosed with dementia while your wife is perfectly healthy; you could easily live 10+ years with your worsening condition and your wife could easily live 25 or more

how is this going to work out for you?

We spend down our $2 million on our healthcare. I'm not sure why that $2 million would or should have any higher priority than our healthcare. Or why someone else should be paying for my healthcare when I have $2 million. If you think someone else should be paying for my healthcare while my wife buys a beach house, then I don't know what to tell you.

 

[2&2 Slider To Leyritz]

Sure you can.

Everyone pays into a system that exists to ensure that your needs for care, when you need it, are met.

Everyone should participate in a system that provides for long-term care, residential hospice care, etc. as it’s needed.


That would be a better system.

Again, that is what Medicaid is supposed to do. As its needed is the key. If someone can afford their own care, then the system is not needed to pay for it.

 

[ImTheCaptain]

that's not what medicaid is supposed to do

 

[Deacon923]

my company is in the business of dementia care. it is extremely demanding work and it's really difficult to find people who are willing to provide the front line care, especially at the high standard my company provides. It's also extremely expensive for the resident/family. Easily $6,000/month as a baseline, and often much more. Meanwhile the trendline for active workers per retiree is going in the wrong direction: https://www.pgpf.org/chart-archive/0004_worker-benefit-ratio. Citizens who live a long time with dementia use up huge amounts of resources, both their families resources and Medicare, and there are less people to pay for it and less people to actually do the work of care.

By the way... guess who provides a large amount of the labor to care for your elders? First generation immigrants. Maybe they're "taking our jobs"... but does anyone think that all the middle aged white guys who used to work in manufacturing, or who are going to get displaced by robot cars and trucks in a few years, are going to line up to change adult diapers and spoon feed granny?

 

[ConnorEl]

Of course, most folks in our great nation do not reach retirement with a 2 million dollar nest egg.

And folks that do have more of a tendency to be in the minority of folks who have purchased long-term care insurance.

Of course most of them (or their families) discover the policy doesn’t cover their needs as well as they thought it would. But it still helps, sometimes a lot.

And it’s perfectly possible to create a system that more broadly meets our individual and collective needs without first requiring that we become impoverished.

 

[thatguy2016]

We spend down our $2 million on our healthcare. I'm not sure why that $2 million would or should have any higher priority than our healthcare. Or why someone else should be paying for my healthcare when I have $2 million. If you think someone else should be paying for my healthcare while my wife buys a beach house, then I don't know what to tell you.

yeah, I'm not worried about your widow's beach house; I'm more worried about her being 82, broke, and diagnosed with dementia, looking at living for another 8-10 years

Good article here about the insurance industry's poor forecasting of LTC risks in the 80's and 90's