Claims and Intermittent Cognitive Impairment for Long Term Care Insurance Claims

Help With Long Term Care Claims

We had a client who was on claim recently for the physical part of care – she needed help with dressing and bathing. But she also had intermittent episodes of dementia. She would be fine and then suddenly she didn’t know where she was or who the people were that were sitting there with her.

The family wanted to get this documented for several reasons. Here is the problem: it is intermittent. When family take their loved one to the Doc to get a cognitive screen done, it is possible for that person to pass the pencil-and-paper test and yet a half hour later have a memory-loss episode severe enough that they can’t be left unattended. There are a couple of different ways to handle this.

  • If you know there is a predictable pattern to the memory-loss episodes, then make plans to get your family member to the doctor when you know it is most likely to happen. For instance, if you suspicion your Mom has Sundowner’s (memory loss that is more severe late in the day), then make sure the doctor’s appointment is at the end of a long day that has been filled with activities. Our brains don’t work as well when they are on overload anyway and with a senior with Sundowners, this is only more pronounced. So be aware of when the memory-loss tends to occur and plan a strategy to give you best chance of having it in evidence when you are at the doctor’s office for assessment.
  • The other way is to get a full neurological work-up. Often times brain scans will show evidence of white matter deterioration or other brain changes that can substantiate a diagnosis of dementia when it is highly intermittent. In fair warning, the brain’s working is still a good deal unknown. Even a full neurological workup may not show the full extent of memory loss when it is triggered by particular events like over-exertion, exposure to certain chemicals or other such triggers. Nevertheless, if the intermittent impairment isn’t showing on one of the normal pencil-and-paper standardized mental tests, a shift to a full neurological workup can sometimes provide the doc with the evidence needed to diagnose.


Part 1- Long Term Care,  The Basics


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Handing Down the Kingdom

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