We love learning and staying up to date on best practices in the industry. Lori and I attended the Elder Planning Issues Conference (EPIC) March 9 and 11, 2021. Below are some of the take-aways, in point form.
” The entire eldercare system is fragmented, underfunded and unsupported.” Andre Picard health journalist
What’s Wrong with Eldercare:
- Population is aging with no preparation for the grey tsunami.
- Hospitals discharge the elderly faster with little or no community support.
- Inadequate provincial funding for community-based care
- Families are forced to become the caregivers.
- Older persons are the victims of an inadequate government response.
- Most vulnerable, those with no family or no funding for private care
Canadians Are Not Preparing to Fund Long Term Care:
- Less than 1% of Canadians have long-term care insurance.
- CLHIA found that 74% of Canadians have not included provisions for long-term care in their retirement plans.
- Over 75% of Canadians fear that they will run out of money and drift into poverty.
The following are some notes from the Elder Planning Issues Conference March 2021.
Collective Delusional Thinking:
- Get old and get taken care of by government.
- I paid my taxes, now I can get the benefits including LTC (long term care).
The Growing Demand for LTC Services:
- By 2040, the senior’s population in Canada will be 8,000,000.
- 65% of the elderly will require long term care and/or homecare.
- Service requirement in $Billions is forecast for the LTC/homecare markets.
Dementia Overwhelms Service Delivery:
- 750,000 Canadians have cognitive impairment including dementia.
- 70,000 are under age 65.
- Cost to care for dementia was $15B in 2008 and $253B in 2038.
The Gap for Long Term Care Beds:
- Canada will need 199,000 new long term care beds by 2035.
- This represents a doubling of current capacity.
- Canada requires $64B in capital spending & $130B in operating expenses between 2021 & 2035 for care facilities.
Healthcare Forecast for LTC Costs:
- Fewer family members to be available to care for seniors.
- Forecast inflationary costs for LTC services with increased demand.
- 50 to 75% over 10 years
- Increased competition for staff & providers, beds
- More capacity taken up by dementia patients.
Lack of Price Transparency in Eldercare Marketplace:
- No published rates
- Inefficient marketplace
- Sellers have more bargaining power than buyers.
- Unreported elder fraud in marketplace
- Vendors double staffing
- Nurses with fraudulent hours
- Case study- 1 nurse reported 20 hours per week but spent 2 hours per week.
No Digital Infrastructure:
- Canada health infoway has spent $2.5B on digital infrastructure.
- The infrastructure is not built or available to support elder care.
Preventing Elder Fraud – real life case:
- Father age 82 developed dementia
- Became paranoid of his 2 “bad” children & became isolated.
- Caregiver couple living in his home.
- Caregiver got his Debit card.
- Stole between $1M to $1.5M in cash.
- Got call from social worker when father was almost homeless.
- Arranged for nursing home admission.
- Public guardian took over supervision of assets.
- Spent $12K on his funeral.
- Inherited $800
Early Signs of Elder Fraud & Financial Abuse:
- $1 trillion in personal wealth transferred to next gen between 2016 & 2026.
- ⅔’s of elder fraud is a family affair.
- Clues to elder fraud:
- Requesting an early inheritance
- Creating co-dependence (abuser as the caregiver to create dependence)
- Older persons are isolated from family & friends.
- Forced capacity assessment to prove capacity (the defence- money was gift)
- Using scams to target seniors.
- Misuse of debit cards and forged signatures
Elder Abuse Revealed by The Military:
- The Canadian military has drawn the curtain back on horrific allegations of elder abuse in five Ontario long-term care homes with reports of residents being bullied, drugged, improperly fed and being left for days in soiled bedding.
Funding Options For LTC:
- Pensions
- Assets
- Reverse mortgage (drift into poverty)
- LTC insurance
- Community annuity (peer to peer community funding solution)
Families Want Home Care:
- 70% of COVID deaths are from long term care centers.
- Families now want home care as an option.
- But home care is very costly.
The Real Costs of Homecare
- 85-year-old male with strokes and paralysis is bed confined.
- 24-hour care is required
- LHIN (provinces Local Health Integration Network) funds 2 hours per day of care
- Private care is needed 22 hours per day.
- $28 per hour x 22 hours per day = $616 per day
- $616 per day x 30 days per month = $18,480 per month
- $18,480 per month x 12 months per year = $221,760 per year
Irene Is Diagnosed with Dementia:
- Diagnosis in 2003, chose to stay at home, died in 2020.
- Cost to the family over $1,000,000 – most spent on homecare.
Think Again:
- We need to re-think eldercare, non-system of care, monopoly healthcare, issue of competence, funding sources.
ReThinking Planning:
- Financial planning, care planning, health planning, risk management
ReThink Planning – LONGEVITY Planning
- Combine financial, life & health planning into one service.
- Focus on more than savings.
- Focus on how to make life meaningful/purposeful.
- Longevity calculator for health planning
Caregiver Support:
- The social-networking platform Huddol www.huddol.com lets carers and professionals exchange social support and advice.
Bill C-7, MAID and Dementia:
- With dementia- natural death is not foreseeable
- If loss of capacity is imminent, the waiting period is determined by MD/NP.
- Another MD/NP provides a written opinion that person meets the criteria.
- Final consent can be waived in certain circumstances.
- RCM provides medical advice for these clients & families.
- RCM to provide risk mitigation strategies.
- Source: Dementia Advocacy Canada
Summary:
- Canada and groups need to ReThink eldercare & long-term care.
- PlanWell by RCM uses modern tontine – a tontine is an investment (annuity) plan for raising capital, devised in the 17th century and relatively widespread in the 18th and 19th centuries. It enables subscribers to share the risk of living a long life by combining features of a group annuity with a kind of mortality lottery.
- Modern tontine pooling provides effective pooling for long term care (LTC)
- CareWell assists in arranging for LTC services.
- CareWell provides transparent pricing in a competitive homecare market.
- For more information please request
- For more info: RCM Health Consultancy
