The Daily Nightly from NBC Nightly News with Brian Williams

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The Daily Nightly began on May 31, 2005. As Brian wrote in his first post it aims to provide a narrative of the broadcast day and a window into the editorial process at NBC Nightly News. Brian weighs in every weekday and NBC News correspondents and producers post regularly.

Brian Williams became the seventh anchor and managing editor in the history of NBC Nightly News on December 2, 2004. Read his full biography.

Advice on caring for your parents

NBC Nightly News approached me to participate in their evening broadcast, as part of their series on caring for one's parents. The topic is very timely, given the graying of America. It will be even more pressing for the children of Boomers, as we will be the largest number of individuals 65 and older even seen in this country. Many times, when one gets well beyond the age of 75, there is a need for additional assistance. This need is often recognized by adult children prior to the individual recognizing the need.

As an adult child of an aged individual, the following tips may be helpful:

1) While your parents are healthy, talk about preferences for advanced directives, durable power of attorney for health affairs, and other end-of-life care issues. As part of this conversation, talk with your parents regarding their wishes should they develop a prolonged illness with associated frailty, or a disability; do they wish to live with you or another sibling? Would they prefer to live in an assisted living facility? Are the finances in place to allow transition into assisted living, or to provide in-home care? What are the preferences regarding nursing home placement?

2) If you have not had the opportunity to have a conversation such as that above, and you are facing a health care crisis with your parent(s), consider having a family conference with the primary health care provider, your parents, and any other siblings and extended family who may be involved in providing support. This can be a very efficient means of coming to consensus regarding care.

3) Be aware that you are not alone. Lots of people face challenges in assisting with the care of their elderly, failing parents. Organizations such as the Alzheimer's Association, the Areawide Aging Agencies, churches, etc., can often provide support and resources that are not readily available within the immediate family.

4) Realize caregiving can take its toll on the caregiver, and take advantage of offered help. Caregiver fatigue can endanger the health of the individual being cared for and the caregiver.

5) Recognize that it is not easy providing care from a distance. It is particularly challenging when parents wish to maintain their independence, and yet it appears that they are not capable of such. As long as they have decision making capacity, their choices must be honored. When they recognize that they need help, the transition to other settings is much more efficient. The challenge is that, unfortunately, sometimes this recognition takes the development of a crisis.

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My mom gets nearly 3000 a month for income between pensionand social security and va aid and attendance. She is now in a nursing home and has been in one for over a month. I want to get her out of this one and get her into a good one. I will private pay until her medicaid kicks in which I have applied for. How do I go about this.

The Federal government provides favorable tax treatment for qualified long term care insurance. Among the provisions are those that allow certain employers to provide the insurance as a tax-free fringe benefit, a deduction for self-employed individuals for a significant portion of premiums paid, and exclusion from income for many of the benefits received under qualified long term care insurance policies. Many states have also provided tax incentives for purchasing long term care insurance.

As long term care insurance becomes a more popular benefit in the work place, it is important for people to become savvy about this kind of insurance. As to whether you should buy a policy at work or on your own, compare the policy benefits and rate being offered by your employer with what is available from an independent broker. If the employer plan allows everyone to qualify without any medical questions, the rates could be higher because the insurance company has taken on the significant risk of not knowing whether there is someone being covered who could quickly go on claim—so they have to charge more. Even if the rank and file has to go through medical underwriting, the executives may have gotten the easy underwriting. The bottom line is to do some shopping on this important issue. One other pointer on employer provided coverage is that often times the contract is between the employer and the insurance company and at the end of the contract term, the insurance company may raise the rates. In contrast, if you buy an individual policy the rates can only go up if the insurance commissioner in the state approves a rate increase on all similarly situated policyholders in the state.

When are we going to see a segment about the elderly that had planned for retirement?

We keep seeing the elderly need to have their children support them in their "golden years." Did these people not think about what issues could lie ahead?

My husband and I are putting as much into our nest egg, so our children DON'T have to dish out their savings when we get older.

Some of these senior citizens should have done some long term planning years ago, instead of putting the burden on their children now.

In an ideal world, there would be one definitive telephone number and website to refer to for all caregiving needs. Either referral resource would have "live" counselors available who would be able to make suggestions to services that address specific issue available through: aging/ government/community/senior and religious institutions. They would also refer to general, privately-owned choices of professionals, who offer the expertise and solutions the caregiver needs, but doesn't know how and where to locate.

In the not-so-ideal world we live and age in, services are fragmented and business competition is fierce to get their financial share from your caregiver needs. Caregivers complain of wasted time and money, frustration, and anger locating trusty, reliable solutions, services and products.

I know this all to well, as a Certified Senior Advisor, and ex-creator of 50-plus Expos,senior news columns and a senior help hotline. Over 20 years, hundreds of upset, perplexed caregivers have contacted me for answers to their urgent questions. But I do not have all the answers at my fingertips.

(Today, I have also publish a monthly internet news magazine for baby boomers to seniors, www.MatureResources.org, which has many eldercare and caregiving articles and resources.)

I, too, have recently become a sudden caregiver like so many before me. My husband was diagnosed with an aggressive non-Hodgkins lymphoma last April - and my world turned emotionally, financially and physically upside-down. For all my experience helping others, I became a robot searching for medical help. I slept in a make-shift chair/bed in his hospital room for many of his 120 nights in the hospital. He was treated by a brigade of medical marvels - the nurses, medical specialists and the wonderful doctor who created his intense chemotherapy protocol.

And,his medical bills have surpassed $1,000,000 - most of which is or will be paid by his HMO.

Fortunately, his illness is in remission and both of us are back to, hopefully, making a living. Our lives are turning around to "near normal"; yet we will always have the scars of illness, fright, and "innocence lost" as part ofour DNA.

I truly feel for millions of caregivers like me - and hope some day we all will receive the "giving" part of "caregiving" offered directly from public and private agencies. The caregiving/caregiver journey must be devoid of road blocks which stall our progress helping our loved ones.

I understand you may need our help with some of your seniors in search of help with veterans benefits, assisted livng, medicare, medicaid and other subjects in this matter. We would be happy to help them. Please see our site:)

www.veterans-express.com
info@veterans-express.com

I saw your story about long-term care insurance. Please consider that it is very complex and expensive coverage and that most seniors don't end up in nursing homes, or if they do, they're not there for long. FEAR OF NURSING HOMES helps some high-pressure unscrupulous insurance salespeople make a bundle. An alternate product to explore is home care insurance which can help pay for services to keep you in your own home.
Make sure you are dealing with reputable insurance representatives when considering these products. It's good to have a KNOWLEDGEABLE friend or family member present when discussing these options and if your sense you are being pressured, show the salesperson the door!

It is sinful to have our "older" generation have to spend all of their hard earned savings on long term care. These people have helped to put America where it is and stand to lose everything because of Mother Nature taking her toll on their bodies.
Instead of WASTING billions of dollars "assisting" in the Middle East where the sectarian problems have been going on for hundreds of years with no solutions, why don't we take care of our own first! After all, doesn't Charity Begin at Home?

Area Agencies on Aging (AAA) provides services under the National Family Caregiver Support Program. This program is NATION WIDE. They provide services to caregivers caring for a person 60+. Although each AAA may provide different services for your area it is worth looking into. Many services may provide respite (relief care, meals, transportation, ect. Contact the Administration on Aging (AOA),your local State Department of Human Services Aging Division or call the eldercare locator at 1-800-677-1116 to find the agency close to you.

Caring for aging parent as well as making plans for our own future and well being should be a major concern for most people. My mother had the wherewithal, fifteen years ago to purchase long term care insurance for my father and her. It ended up being a blessing for them both as well as me and my siblings. It was one thing that we didn’t have to be stress over and worry about.
I was able to retire early and move in order to help care for them. It wasn’t an option for them to come and live with me. They needed more care than I was capable of giving them. When I arrived both my parents were in rehab because of health issues. My father had congestive heart failure and emphysema and my mother was suffering from Alzheimer’s disease and had recently fallen and fractured her hip.
I was able to move them into a wonderful assisted living facility. The long term care insurance paid much of their monthly rent. They still were receiving their social security, as well as a pension so they were still able to still save money. As you well know, long term care insurance doesn’t last forever. Both my parents had purchased a four year policy paying out $100 a day.
My father passed away two months after moving into the assisted living facility. As for my mother, she was moved to an Alzheimer’s facility where the care was exactly what she needed. She continued to save a bit of money as the long term care insurance was still paying her monthly rent. Obviously, my mother wasn’t concerned at this point about how things were getting paid. The onus was on the family but my parents were intuitive enough to make a wise decision many, many year ago. Sadly, my mother passed away last month.
It seems that there have been many perspectives from many individuals. Choosing long term care insurance must be right for you. All I can tell you is that I never had to tap into my parents investments and they were still able to grow over this period of time. Down the road, if my parents lived past their four-year long term policy then we would use the money from their investments.
As a single person, a mother who had Alzheimer’s, as well as an aunt with Alzheimer’s, I have taken out a long term care policy on myself. It is costing me about $1000 a year. At the age of 80, I will have paid $30,000. If I were to go into an assisted living facility at that point, it isn’t even a question; it would cost me much more than the $30,000 that I will have paid out.
In closing, one thing that has irritated me during this process is that when filing income taxes for my parents, the money they received from long term care insurance is and was taxable. They did a prudent act by purchasing long term care insurance, not relying on the federal government to pay for their care through Medicare . . . and they get taxed on the payment. That is ludicrous!

I would like to see the stories reflected from those caregivers who are poor and the care reciepients are poor too. The caregiver is making sacrafices to provide care and they do not want to place their loved one in a nursing home. This is a growing number as well. Many of these care recipients are living on fixed incomes, and while they may receive some assistance from a home and community based service, life is still very hard for them.

This is an interesting topic because my mother bought a plan through GE. I have one complaint about that plan. My mother wasn't told that when she hired someone to care for her that she was to take taxes out of that money and report that money to the IRS. She also had to come up with money out of her limited income to pay for the state taxes through EDD for her care person. Nothing was ever told to her until I fired one of her employees and she filed for unemployment and they contacted my elderly mother in which made her very upset. She has health issues and those problems sure didn't help much. It has turned into a snowball effect and is still going. I think there needs to be some changes in the long-term care plans before more are sold. Elderly people become very upset and it could cause them the have a stroke or heart attack after surprises like what happened to my mother. I don't totally agree with long-term plans.

My Mother will soon be 88 yrs. old. About 12 years ago, I noticed her memory failing. At the time we lived 1000 miles apart. She would call and tell me bazarre stories that I could hardly believe true. But when she was stranded/confined in the house for 3 days during a blizzard without heat, my husband and I encouraged her to move close to us. She lived in her own mobile home for about 6 years, but chose to give up driving immediately after moving. I am thankful for HER wise choices. Although she has senile dementia and failing eye sight the ole thinker still comes through. At first I found myself being short and curt with her when she would repeat the same questions over and over or rearrange (and misplace) items. I found a book titled DANCING ON QUICKSAND. I have loaned my copy and do not recall the author's name, but it truely changed my responses to Mom. It was a tremendous encouragement that I was not the only one having these experiences. It helped me change my attitude and behavior which made a great change in my Mom. We wanted her to live with us when she became unsafe to live alone, but she chose to live in an ALF. She had purchased two Nursing Home polices that have been a godsend in helping her live in a great facility. She likes having "friends her age" even though she can not remember their names. The activities are more stimulating for her physically and mentally than we could possibly do at home. I see her nearly every evening. I go different times during the day. I communicate with the staff and the managers of the ALF. She is not only my Mother, she is my friend. Even though she does not always remember who I am or how we are related, she remembers that I love her and I am there for her. Our children learn by example...we need to keep teaching. Thank you for this encouraging segment on your program.

We found a significant issue with long-term care insurance was the rate of inflation for payments. The broadcast interview of an advisor cited payments initiated at an early age being lower ( around $1100 a year) which would be about $50,000 over 40 years. We briefly had LTC insurance but dropped it after three years because the annual rate was going up at about 9% a year. My projection of the cost for 20 years, with inflation, was over $200,000. To me, this is a major consideration. I can exceed this amount by contributing to a Roth IRA which would be available for LTC if needed. If I should pass quickly, as did my father, the money goes to my heirs rather than the insurance company. For me, the rate of inflation for LTC payments over ten to thirty years is a major problem.

LONG TERM CARE:

My education is in Finance and I have an undergraduate degree and a master's in Finance. I'm always disturbed when misleading financial information is displayed as news. On tonight's news show you showed an interview with a person pointing out how "simple" the decision to buy long term care insurance should be. His example was that if you paid $1,250 per year for 40 years you would only pay $50,000 for Long Term Care coverage (per him -less than one year's nursing home cost). In my estimation, if you invested that money over a 40 year window you should be able to count on an 8% to 11% return on investment in a decent mutual fund. In other words, a diciplined investor would have between $350,000 and $800,000 to pay nursing care after that same 40 year period. What's nice for the diciplined investor is that he/she can control options available and if he/she dies instead of going to a nursing home, the estate can pass on to heirs any remaining funds. I believe that less than 50% of the population ever enters a nursing home (but I didn't take time to confirm this).

I'm not suggesting that anyone take the risk of the market vs. insurance. I'm mearly pointing out that this is not a simple decision and shouldn't be presented as though it is. By the way, GE owns NBC and GE is one of the largest sellers of long term care. Shouldn't that have been pointed out.

Sincerely,

Ed Goldberg
Atlanta, GA

As someone who has dedicated the last 25 years of my life to the Long Term Care Insurance industry, I am thrilled to see this issue come to the forefront. It still amazes me to see how many people still think that the government is going to pay for their care. Unfortunately, by the time they find out how wrong they are, it's way too late.
All the signs are there - tax breaks for LTC premiums, tougher restrictions on Medicaid, a federal LTC program for federal employees, the "Own Your Future" campaign that is federally sponsored. The message is clear from Washington: Make your own plans for long-term care because we can't afford to take care of you.
To those who think it is too expensive I offer this: the premium for my husband and me is $165 per month - or $1980 per year. We are in our 50's. After paying premiums for 30 years, we will have paid a total of $59,400. After 30 years, our benefit will be about $412 per day. If either of us receives 144 days of care (or about 5 months) we will have recouped our entire investment... and if we need more care than that (which is very likely) we'll be way ahead of the game. It just makes so much sense to me. Kudos to MSNBC for bringing this issue to the forefront.

I'm glad you are addressing this serious problem. I have urged my adult children to buy long term health insurance before they hit their middle forties so that the premiums will be low. As I understand it, the premiums will not increase once you sign up. My late husband and I tried to buy long term insurance when we were in our fifties and we were both denied because of pre-existing conditions (his diabetes and my arthritis). As it turned out, his rehab hospital care cost me $24,000 a month after his Medicare ran out -- he fell and broke his neck, rendering him quadraplegic on a ventilator, and lived this way for 11 months. He was only 65 when he died. As a result, my retirement funds were greatly diminished and I'm having to work part time. This isn't the retirement I'd planned!

My mother passed away in December 2006, having paid at total of about 35k in long term insurance of which she received nothing. There are so may restrictions to who qualifies and who doesn't. At one point she was in a nursing facility for over 90 days and we fought with the insurance company to pay for her care after the 90 days. They paid it, only to have her pay it back as the paperwork the nursing facility had to fill out wasn't enough for the insurance company to qualify my mother. She lived to be 88 and told everyone she knew not to bother with the long term insurance...sell your home, move into assisted living, and die. She had quite a sense of humor, but I tend to agree. She was a wonderful, wise woman.

Are you aware that there is some of us out here who are not eligible for long term health care insurance? I have spina bifida oculta and walk with crutches and because of this, no ins. company will insure me, even though I'm willing to pay the premiums. However, someone with diabetes or etc. can get this coverage. I call this discrimination. What are we suppose to do?

I specialize in Long Term Care insurance and I have over 1000 Long Term Care (LTC) policyholders. I have helped my clients with their 100+ LTC claims so far. The folks on this post reporting problems getting claims paid are probably dealing with older (1970-92) policies purchased when the problem was little understood and the policy benefits were restrictive. Back then, we moved in with our kids or went to a nursing home. Today, the plans are comprehensive, usually come with a care coordinator to assist the family to find the help they need, can pay for equipment, home modification, housekeepers, and assisted living facilities. I have never had a complaint from a client who used their policy. As one policy holder said, "Your program made my wife’s last days infinitely more comfortable, and for that I am eternally grateful." That is the true reason for LTC insurance; protecting your options and dignity as well as the care-giving spouse or family member.
If you are having a problem with a company and have contacted your agent and then their company president with no relief, go to your local federal Area Council on Aging for information and referral: 800.677.1116 or www.eldercare.gov You can speak with a state counselor on medical insurance who can help you with advice about Medicare, Medicaid and LTC policies. Most of these offices will also have free or less expensive services and referrals to help the care-givers either keep a person home easier or find appropriate placement. There is no replacement for having the money to pay for the care, however, and if a person buys good LTC insurance and uses their full daily benefits for 3-4 months anytime in their life, all the premiums they have paid are usually recuperated in that period. Get Long Term Care insurance as young as possible. Get 5% inflation on it. Don't buy it at all if it will be a hardship to pay for it. Medicaid is there for the poverty stricken. Reverse mortgages can help keep you home, but LTCi will be able to pay more per month and help you find the help you require, too. AALTCI.org and http://ltcfp.info/public/ltcfp/infoLTC.html are good general sites for unbiased information on LTC insurance.

Of all the comments on here mentioning LTC insurance I'd say it's 20+:2 good to bad...and I suspect the odds will only get better as the messages continue to come in. While the horror stories of the products that didn't do what they should've done break my heart, I think it a dangerous and inaccurate move to try to dissuade others from looking into these products based on a few bad products or companies in the past. The harsh reality is this: unless someone plans to spend down to the eligibility levels required for medicaid (impoverishment for all practical purposes)there are two things that will fund extended care and they are your money (dollar for dollar) or the leveraging of your money through some form of long-term care insurance (spending pennies to protect your dollars). You can either pay for care by tapping into or exhausting your retirement portfolio or you can protect it with insurance and use it as intended...for retirement. While I completely agree with the idea that each and every person has the right to and should make their own, informed decisions, I would like to point out a few things worth mentioning in defense of the industry.
First of all it has changed tremendously in recent years. The companies truly interested in providing this product have risen to the top (often picking up all of the old business from the companies that were not in it for the long haul) and have used the mistakes of the the failures to build innovative and very importantly financially strong products that will be there when the policyholders need them most. The major carriers that have remained in the game are, in my opinion and for the most part, in it for the long run. They have seen the errors commited in the past and they have corrected these errors and made the changes necessary to avoid making them again in the future.
Very few things work perfectly the first time, and LTC insurance is no exception. Fortunately though, the companies that got in to make a quick buck failed and the strong and commited ones that have stayed in the game know that to remain strong their products must perform. Not only well, but well enough to disprove the naysayers jaded by flaws in the old and obselete products and well enough to provide an increasingly growing need whose only likely alternatives are limited options and impoverishment (ie medicaid)or something ranging from the invasion of principal of one's retirement portfolio to complete exhaustion of income and assetts (ie self-funding).
Long-term care insurance is by no means the solution for everyone who will some day require extended care, but it is an option that can and will prove a tremendous gift to many, many people and in my opinion should be explored at least as an option and not be counted out based on the mistakes of companies that are no longer in the business.

People who are interested in Long Term Care insurance need to research the companies. Go with the bigger, stronger companies that have been doing it for a while. It is an everchanging industry but companies like Unum, stay with the times as far as keeping up with regulations and paying claims quickly. Also you people who are in the work setting need to ask thier employers about group policies. They are more affordable than individuals and you can add dependants, spouses, and parents on the policies for a higher premium. In response to the gentleman who is a boomer, with no kids, and wants to know who will take care of him...i say get LTC insurance now while your premium will be low. The cost will not increase (depending on what company you use) and you will be protected when its your turn.

The most important thing elder parents can do is estate planning in advance. After 10 years of taking care of Mom, paying out of my pocket her Real Estate Taxes and other major expenses, I'm now in the fight of my life with my brothers over her estate.. which she left to me but her Attorney made an error on a legal description and now the Quit Claim Deed is vhaving to be probated almost three years after I sold the property and moved, there by opening the door for contecting the deed...

I loved my Mom and kept her home until she died. I think you need to address the need to preplan for the future of their descendents. So that the one's who were there are not stripped of their freedom and dignity once again after the loss of the parent they were there to care for..

After caring for an elderly mother at home for several years, it was necessary to put her in a facility. We chose the same facility where my mother-in-law had been for approximately a year. After handling their finances, I realized the need to get Long Term Care for myself. In reading people's comments on the expense, if you pay even $2500/year in premiums, that is a drop in the bucket compared to the expense. Most good facilities are between $3500/5000 per month - that's $60,000 in one year.

My wife and I have been caring for my mother for over 10 years now. She fell and injured her spinnal cord and became a wheel chair bound person. At first it was hard fighting the hospital(s), doctor(s) and such. The main big fight was the Social Service people, in every instance that my mother had to be in the hospital the Social Service hindered her care (at the ER for over 8 hours). My wife and I have Power of Attorney over all of my mothers financial and health matters. She is now 90 tears old and is healthly (thank god)and still has her memory. I myself look at this (taking care of her) as a way to pay her back for caring and loving me when I was young. We do not regret a day of the last 10 years.

Alzheimer’s Association is offering a caregiver's course. Hosted by The Hearth at Gardenside in Branford, CT and is FREE and open to all family caregivers. This is a four part training program for the Alzheimer’s caregiver. It is one day a week from 6-8 pm beginning on March 14th with an overview. Then the course continuing on April 11th with approaches to care, communication techniques, behavioral challenges & family dynamics. May 9th-Creating a safe environment, stress reduction for the caregiver and community resources, all with positive approaches. June 13th Legal issues facing seniors and their families, long term care costs and health care decision making and advanced directives.
If anyone is interested they can register at 1-866-3MEMORY or 1-866-363-6679.

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