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What is Chronic Care?

                Before we can understand the risk of Chronic Care, we first need to understand Broken-Leg-Chronic-Carewhat is Chronic Care?  The word Chronic come from the Greek word Khronos meaning time, when an illness is Chronic it means its “Long-Term” and is not necessarily getting any better. Chronic Care is a status of someone who needs continual care because they not getting any better. For example someone who is wheel-chair bound because of a broken leg is not Chronic,  in all likelihood the leg heal and they will walk again.  Contrast this to an individual who has a spinal injury and is in a wheel chair, this condition is chronic because it is long-term.  

 

                When someone has an injury or illness that will or can recover from it is usually covered under health insurance as skilled-nursing care[1].  Most health insurance policies cover skilled nursing care, including Medicare and Medigap policies, what they don’t cover is chronic care. When you have a chronic issue, the individual care is most often provided by family members or just tolerated to the best of one’s ability.                Often times a person will begin coverage under skilled nursing care, if the condition does not improve, they will be termed as chronic and it will no longer be covered.                                            The problem is when chronic care becomes unmanageable, then the economic, emotional and physical hardship become a reality. Imagine the activities we do every day to just exist, it is really easy to take them for granted.  There are six daily activates that determine the level of chronic care, these are known as ADL (Activities of Daily Living). These activities are as follows:

1. Bathing: The ability to wash oneself in a bathtub or shower, including the mobility of getting in or out of the shower or bathtub. This also includes the ability to give yourself a sponge bath.

2. Eating: The ability to get food from the plate into ones mouth without assistance.

3. Dressing: The ability to get clothes from the closet and drawer and dress yourself without any assistance.

4. Transference (Mobility): The ability to walk without the assistance of a mechanical device and moving from the bed to the chair without assistance.

5. Toileting: The act of going to and from the bathroom, getting on and off the toilet and performing the necessary hygiene associated with going to the toilet without assistance.

6. Continence: The ability to control to control the bladder or bowel function voluntarily and maintain a reasonable level of personal hygiene.

                Failure to do two out of the six of these activities is what triggers most long-term care insurance policies. Imagine the time and energy it would take daily to assist someone with these activities, then you will understand the potential financial risk.  Unless a family member is willing to dedicate their constant presence to help out on a daily basis, you will be forced to hire someone for these daily needs. There are Home Health care companies that will send people to the home to help provide these daily activities, they also require a minimal time commitments, usually 2-3 hours. Their rates on the low end could 15.00 per hour up to 40.000 an hour.  Even with minimal outside assistance you can easily spend $50/day or much more.  The more severe the need the more expensive the cost, entire life savings could be wiped out in a couple of years.  Chronic Care is a huge risk for everybody, so it is important to examine the options.         



[1] Skilled nursing is a term that refers to a patient's need for care or treatment that can only be done by licensed nurses. ... Examples of skilled nursing needs include complex wound dressings, rehabilitation, tube feedings or rapidly changing health status.