Mom's (89) dementia (mid-stage Alz) is getting to the point where she needs a lot more structure and supervision than she is getting. She is still fine with the ADLs so far but problem-solving, calendar management, cooking for herself, and driving are tanking fast. Here's my concern: What would you advise me before I contact the LTC insurance company to best convey to them that we need help? I know they are quick to deny coverage for any reason (it's their j.o.b. I suppose.) Mom's social skills are intact and to anyone not spending an amount of time with her, she seems extremely high functioning. She was denied access to benefits about 1 year ago, making me nervous and dreading our next attempt. Also, she barely recognizes/admits she has a problem, making it difficult to "steer" her towards any help.
I am looking for concrete help on what to say... and NOT say... to the LTC insurer. I tend to babble and don't want to shoot myself in the foot from the beginning ;-) TIA for your help!
I'd sit down and write a list of all the activities of daily life *ADLs* she needs help with and go from there. Her doctor should be able to back up the claim that she needs help with these ADLs and that should satisfy the insurance company, I would hope.
Best of luck!
Below is a link of articles and others questions and answers on this topic that might be helpful from this forum.
My aunt and uncle both had LTC. Theirs paid differently because they chose different benefits knowing my aunt would most likely have Alzheimer’s. Her mother and grandmother did. Once activated, it continued to pay until her death. (Parkinson) She didn’t go into LTC but it paid her daughter a specific amount for several years. Uncles is just for a couple of years. I remember cousin had a hard time getting it activated for her mom and she was on hospice.
Policies are different and each individuals health issues are different.
Here is the link.
https://www.agingcare.com/search?term=Long+term+insurance
Read up on ADLs vs IADLs.
Read the policy and ascertain the criteria for "kicking in".
If you speak to them on the phone, write yourself a note that says "only answer what they ask you". No elaboration.
Can she cook a meal for herself? If there are any "buts" or "ifs", the answer is "no".
https://www.agingcare.com/questions/need-help-with-long-term-care-insurance-claim-such-a-maze-of-information-472590.htm