Aging Life Care Managers and Reverse Mortgages: A resource you may not have considered
By Nancy E. Avitabile and Gretchen Napier, previously published in the March/April 2018 issue of Reverse Mortgage magazine
An Aging Life Care Manager (ALCM) is contacted by a couple residing in the suburbs outside New York City and asked to visit and evaluate their health and financial needs. The husband is 94 years old and has a degenerative cognitive condition. His spouse has provided social support. Part-time private home health aides handle the personal care. The couple has Long Term Care Insurance that will cover the cost of home health care for several years, but it is limited and does not cover their living expenses.
The ALCM assesses the clients’ long-term care needs, the husband’s disease trajectory, the wife’s ability to continue to provide support. The ALCM examines the remaining LTC insurance benefits, as well as the couple’s New York State Medicaid eligibility. Even with the Long Term Care Insurance and retirement savings, the ALCM is concerned the cost of their needs may exceed their resources. The couple wants to remain in their home, and the ALCM wants to make sure they can afford to. So, the ALCM considers other funding streams and contacts a local reverse mortgage loan originator. The couple’s adult children become very involved; they work in finance and understand the pros and cons of reverse mortgage. The ALCM, the family and the reverse mortgage loan originator work as a team to get the couple a HECM. The combination of the balance of long-term care benefits, savings and the reverse mortgage provide the family with a new level of comfort and security.
What is Aging Life Care?
Aging Life Care™, also known as geriatric care management, is a client-focused approach to caring for older adults or others facing ongoing health challenges. The Aging Life Care Manager (ALCM) provides guidance to older adults and their families. With a broad focus on care needs, finances and social supports, ALCMs create a sustainable long-term plan that ensures quality care through the lifespan.
The ALCM assists clients in attaining their maximum functional potential. The individual’s independence is encouraged, while safety and security concerns are also addressed. ALCMs address a broad range of issues and have extensive knowledge about the costs, quality and availability of resources in their communities. An ALCM could be retained to assist with hiring home care providers, to consult on the pros and cons of assisted living, to help trigger a long-term care claim or to provide ongoing medical coordination of care.
Many ACLMs are members of the Aging Life Care Association™ (ALCA), which requires adherence to Standards of Practice and Code of Ethics and thus provides clients with a level of trust. While the ALCM may be hired by an adult child or attorney, the focus is objective and always in the best interest of the older adult or person in need.
ALCMs begin every relationship with a comprehensive assessment of the client’s situation that includes their family dynamics, social support, legal paperwork, mental and physical health, home safety, life satisfaction and finances. Finances and cost of care are a concern of almost every client regardless of the size of their bank accounts. As illustrated in the opening example, part of the financial resource assessment includes identifying available assets/income, state or city entitlements, benefits or coverage and options that may be available but have not yet been considered, such as reverse mortgages.
Collaborating with other professionals
Aging Life Care Professionals are most effective when serving as the quarterback of a highly skilled team of specialized professionals. ALCMs survey the entire field, keeping an eye on the big picture, and making sure the specialists are in the right positions to successfully implement the agreed upon plan. To coordinate a care plan, an ACLM may involve:
- Physicians (from geriatricians and internal medicine doctors, to specialists of all types);
- Senior move managers (www.nasmm.org) & organizers (www.napo.net);
- Daily money managers (secure.aadmm.com);
- Elder law attorneys (www.naela.org);
- Long-term care insurance professionals;
- Home care (Skilled nursing and therapists, as well as nursing aides and companions);
- Retirement communities (Assisted Living, 50+ apartments, nursing homes, etc.) and
- Reverse mortgage loan originators.
Helping loan originators serve the client
There is mutual value to ongoing relationships between ACLMs and reverse mortgage loan originators.
When a reverse mortgage professional works with an ALCM, she or he does not have to know all the ins and outs of age-related issues. The reverse mortgage professional may want to bring in an ALCM early in the process to help assess the client’s needs. If the reverse mortgage professional is unsure about the safety of the client staying at home, an ALCM could conduct a home visit to evaluate both the home environment and the client in the home environment. An Aging Life Care Manager would be able to identify any additional funding sources for which the client may be eligible.
There are distinct warning signs that can alert a loan originator that an ALCM can be helpful. If the client seems unsure about details of their situation or behaves in an unpredictable or erratic manner, an ALCM would be able to help assess whether or not the client was competent to make major financial decisions. If a client is having difficulty gathering all the necessary paperwork, an ALCM could locate the papers and take care of the details. If complicated family dynamics are impeding progress, an ALCM could be a helpful, unbiased third-party as an intermediary and/or advocate for the elderly client.
Once the reverse mortgage process is completed, an ALCM can be useful in prioritizing the best use of resources through a well thought out care plan. And conversely, if the client does not qualify for a reverse mortgage, an ALCM can help find other financial resources or a better living situation. In short, Aging Life Care Managers make you look good!