Jim Reynolds' message for the companies writing and the producers selling long-term care insurance (LTCI) is simple: You're doing a good job; keep at it.
Reynolds is chief executive of Caring Companion Home Care L.L.C., Concord, Mass., and a member of a family that has been in the home care business in several different U.S. markets since 1992.
The family now has operations in Florida, Kansas and Missouri as well as Massachusetts, and he is familiar with the stories of hundreds of home care clients.
His own company now focuses exclusively on families that can scrape up the money to pay cash for private-duty nursing care and other home-based services.
When asked during an interview about how many of the families can use LTCI coverage to pay for the care, he thinks a bit, then says the percentage might be "10% to 10%." Then he thinks a bit more and says, "Closer to 10 percent.... It's not near as high as it ought to be."
The National Association for Home Care & Hospice, Washington, estimates that 7.6 million Americans received formal home health care and related services with a total value of about $58 billion in 2007. Millions more frail and disabled Americans, including elderly Americans, received homemaker services.
The services provided in homes ranged from a little help with shopping and doing the laundry to help with operating complicated medical machinery.
In many cases, a little money spent on home health and homemaker services can help an older person save money and maximize quality of life by staying in their own homes, Reynolds says.
Home care may be the country's secret weapon in the battle to provide support services for the aging boomers, because expanding the supply of home care may be as simple as sending a would-be aide to a 90-day certification course and is not nearly as complicated or costly as creating a nursing home bed, Reynolds says.
Reynolds' firm can do everything for a client from providing simple homemaker services to sending in nurses. It can attach GPS devices to clients suffering from dementia and post reports on the Web.
One thing the firm doesn't do is accepting clients who will be paying for Medicare or Medicaid.
Medicare will pay for skilled nursing services at home for some patients.
Medicaid may pay for some home-based services for some patients in some parts of the country.
Reynolds once served occasional government program enrollees in an effort to be helpful. He soon got out of that business, after he discovered that government plans often paid him rates that were lower than the cost of caring for the patients.
Taking those accounts "is a going-out-of-business strategy," Reynolds says.
Reynolds has read the same stories everyone else has read about families having trouble getting LTCI carriers to pay benefits, but, in his experience, the families that have private LTCI are glad they do.
Some insurers want him to customize his bills for them or to update their caseworkers, but benefits usually seem to flow to the families smoothly after a few months, as far as he can tell, Reynolds reports.
"Most people don't have private long-term care insurance," Reynolds says. "Nearly everybody buys life insurance."
But people are much more likely to need long-term care later in life than they are to die during their working years, Reynolds says.
"They should be thinking about long-term care insurance because they are likely to need it," Reynolds says. "It is a real life saver."
Reynolds also would like to see consumers and LTCI producers know more about how long-term care is provided.
"People tend not to think about what their middle-aged years might be like," Reynolds says.
But in many cases, he says, adult sons and daughters will be looking after parents for 12 years or more -- about as many years as they spent bringing up their own children.