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Take control of your personal care decisions

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Take control of your personal care decisions: the value of long-term care insurance.
OMA Insurance
9/1/2012
We often take our mobility and mental ability for granted, so it’s easy to see why many people are caught unprepared when assistance with routine daily activities is required as a result of an injury, illness or cognitive impairment. Long-term care insurance can provide you with the freedom to obtain extended care services without compromising your personal finances, relationships with family and friends, or your ability to make choices about the care you’ll receive.

​In times of good health, it's only natural to take for granted those routine tasks that we perform on a regular basis, such as bathing, getting dressed, and even the simple act of climbing into bed at the end of a long day.

But there are a number of medical issues that can make it impossible to manage these tasks without help — and not all are tied to the effects of aging. As a physician, you've likely seen patients both young and old who require assistance with routine daily activities as a result of an injury, illness or cognitive impairment.

We often tend to take our mobility and mental ability for granted, so it's easy to see why many people are caught unprepared when extended care is needed. Without a plan in place to secure the necessary support, you're needlessly putting yourself in a position that can compromise your relationships, your finances, and your ability to make choices about the care you'll receive.

Fairness To Family And Friends

Of course, you would want to help a loved one in need — and hope that they would do the same for you in return. However, is it realistic to expect family or friends to care for you for a long or indefinite period of time? Even the most giving person has limitations on his or her time and stamina.

Physical demands aside, emotions are perhaps the biggest factor to consider when the relationship between the caregiver and recipient is a personal one. For both parties, resentment, shame and guilt are often experienced. Could you, in good conscience, place such a heavy responsibility on someone's shoulders? Would you (or they) feel comfortable with having to help with intimate personal needs, like bathing or continence?

Shortfalls In Government Support

In Ontario, the provincial government helps residents access subsidized long-term care services. Applications are co-ordinated by Community Care Access Centres (CCACs) and funded by the Ministry of Health and Long-Term Care. While the merits of the system are many, there are three key issues to bear in mind:

1. The CCAC — Not You — Makes Key Decisions About Your Care

A Community Care Access Centre case manager makes the decision whether you are eligible to receive the services, and whether these services will be provided at your home or in a facility. If you are approved for in-facility care, the CCAC assigns beds based on availability, which could mean that you may not end up in the facility of your choice.

2. Wait Times Are Lengthy

There are over 20,000 people at any given time waiting for a long-term care bed in Ontario. For direct transfer from hospital to long-term care, the average wait time is 50 days. For people waiting at home, the wait time is almost six months.

3. It's Not Free

Although the Ministry of Health and Long-Term Care pays for the personal care and nursing care you receive, you are responsible for a "co-payment" to cover accommodation costs, which are standard across Ontario. A long-term stay in a private room costs $2,166.58 per month.

High Costs Of Private Care

CCAC resources are limited, and go to those with the greatest need first. Given wait times, level of care required and personal preferences, it is very likely that you will have to supplement government services with out-of-pocket private care, which adds up quickly. As an example, the average cost of a single room in a non-subsidized retirement home in Ontario is $2,930 per month, with private nursing care averaging $54.76 per hour.

Many people prefer to remain at home for as long as they can, but need the help and/or supervision of an in-home personal support worker. According to Greg Lindsay, President at Selectacare, a private care provider in Ontario, "Our hourly rate for a live-out, in-home support worker is $21.45, which is about standard for this province. If 24/7 care is needed, this amounts to roughly $14,415 per month — or just under $190,000 annually."

Better Access, More Choice

Long-Term Care Insurance (LTCI) helps you pay for the costs of long-term care services. The coverage available to you through the OMA endorsed Insurance Program pays a monthly income benefit when care is required.

Unlike some LTCI products, which only reimburse you for eligible expenses up to a pre-determined maximum per day, the income benefit can be used in whatever way best meets your needs. You do not need to prove the expense meets an eligibility requirement.

You have the power to decide whe­ther care is given at home, in the community (such as an adult day care), or in a long-term care facility. You also decide what type of caregiver is right for you, and how much of his or her time is required. Taking steps now to plan for the potential use of extended care services gives you better access to the help you need — and more freedom to choose where and how these services are provided.

To learn more about the advantages of Long-Term Care Insurance and other solutions available to OMA members, contact a non-commissioned OMA Insurance Advisor at 1.800.758.1641 or info@omainsurance.com. Additional information is also available at www.omainsurance.com.

Customize Your Long-Term Care Coverage By Selecting One Of The Following:

  • Weekly benefit amount: 
    Starting at $150 per week, up to a maximum of $2,000.
  • Income benefit period:
    Choice of 100 weeks, 150 weeks, 250 weeks, or an unlimited period.
  • Waiting period:
    Choice of 30-day period or 90-day period.

Underwritten by Sun Life Assurance Company of Canada