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Book Review: Naked in the Nursing Home: The Woman’s Guide to Paying for Long-Term Care without Going Broke by Harold L. Lustig

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Every once in a while I read a book that motivates me to action. The new one by financial advisor and eldercare expert Harold L. Lustig did just that. In his curiously titled Naked in the Nursing Home: The Woman’s Guide to Paying for Long-Term Care without Going Broke, Lustig introduces a topic to which, admittedly, I hadn’t previously given much thought. But now I definitely will.

Here’s why. Our odds of needing long-term care are greater than one in two at age 65, much higher than other risks we routinely insure, such as automobiles and houses. And long-term care is not just a topic for older people. In fact, over 40 percent of people who need such care are under age 65. Lustig points out that Michael J. Fox was only 30 when he noticed a twitch in his finger that was later diagnosed as Parkinson’s. Christopher Reeve was 43 when he had his tragic riding accident that left him a quadriplegic.

For women, in particular, long-term care is a nightmare, because wives and daughters not only bear most of the caregiving burden for their aging loved ones, but they are far more likely than men to end up in a nursing home.

If getting injured or ill enough to require long-term care doesn’t scare you, the cost of paying for it will. I checked the estimated annual cost of long-term care for my state, New York, and it ranges from about $45,000 to $119,000 a year, depending on the type of care I’d require or desire. If, like me, you’re one of the proverbial “99 percent,” it’s doubtful that you can afford that price tag. And unless you have a wealthy partner or a gaggle of wealthy and generous adult children, chances are your loved ones can’t either.

But don’t despair just yet. Lustig has helped many people avoid what he calls a “family financial crisis” brought on by long-term care. The key is to plan for it so you can pay for it — without jeopardizing your assets, such as your home, or your children’s financial futures.

What about insurance, you ask? Like tropical storm Irene’s victims in upstate New York, who thought their homeowners insurance covered flood damage (and discovered, too late, that it didn’t in most cases), you may be under the impression that long-term care is covered by your health insurance or by Medicare — the free healthcare Americans get after age 65. Wrong!

What about Medicaid, you ask, the government-funded insurance for low-income Americans? Well, Lustig likens Medicaid to a minefield. To get Medicaid to pay for long-term care, you have to qualify financially, and if you happen make one of the 15 classic Medicaid mistakes he warns readers to avoid, you will lose your eligibility. His advice? Consult a qualified elder law attorney who is experienced in Medicaid and current on all its most recent tricks and traps, who can assess your finances and help lead you through the Medicaid maze.

Okay, so are there other alternatives? Yes! If you’re a veteran or the spouse or surviving spouse of a veteran who served in an armed conflict, you could be in luck. That option is called Aid & Attendance, and it’s an excellent, free long-term care benefit funded by the Veterans Administration. Lustig calls it the best-kept secret in long-term care.

If that option isn’t available, there are a number of great long-term care insurance options. The good news is that LTC insurance is cheaper the younger you buy it. If you’re under 60 and you’re healthy, you may feel like running, not walking, to your local insurance agent after you read Lustig’s book.

LTC insurance has its own “gotchas,” but if you’re serious about wanting to protect yourself and your family against future financial ruin, in the event that you get injured or are diagnosed with a serious medical condition, LTC insurance offers the best protection and peace of mind. The section devoted to LTC insurance provides an overview of four classes of LTC insurance, discusses how it will affect your taxes, and includes frequently asked questions.

Lustig then presents case studies of three hypothetical families to demonstrate how they might use all of this information to maximize their options. He also has a chapter on the warning signs of elder financial abuse and how to prevent it, and gives us tips for finding trustworthy professionals who can help, such as geriatric care managers, financial advisors, and elder law attorneys.

In the back of the book, Lustig includes pages of valuable resources for patients, seniors, and their caregivers and loved ones, as well as a glossary of perplexing terms found in insurance, medical, or legal documents.

For boomer women worried about caring for spouses, elderly parents, and eventually, themselves, this comprehensive resource offers guidance and information they won’t find anywhere else. Don’t sit around worrying about outliving your assets in some run-down long-term care facility. Read this book so you’ll be motivated to do some smart planning instead.

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About Patricia Gale

Patricia Gale has written and ghostwritten hundreds of blogs and articles that have appeared on sites such as Psychology Today, Forbes, and Huffington Post, and in countless national newspapers and magazines. Her "beat" is health, business, career, self-help, parenting, and relationships.