“If I ever get really bad, just shoot me!” He would say this all the time….while in his 60’s and living on the lake, and when back in town closer to family and medical care in his 70’s. He was talking about the possibility of needing care one day. His definition of ‘really bad’ kept changing, and, of course, he didn’t mean it – the ‘just shoot me’ part – but it was as close to a discussion with his family as was going to happen with him.
It’s difficult and downright scary to think about needing care, and we often dismiss the notion with, ‘my kids will take care of me’, ‘I have plenty of money’, ’ I don’t think I’ll need care, my grandparents were healthy into their 90’s’,’the government will have to come up with a plan’, or…..just shoot me!’ It’s a way of protecting ourselves from reality, but when we get past the denial, the problem still exists.
So what exactly is reality?
Bill and Marilyn called a northern Wisconsin lake cottage their home. They came to see me several years ago after hearing me speak at a long term care planning workshop. As the conversation progressed, it was apparent that Bill, although he appeared healthy and was very gracious, was having unmistakable problems with his memory. Marilyn knew he would be totally relying on her in the not-too-distant future, and that terrified her. She had been in remission with MS for years, and it had always been their plan that he would take care of her – now what?
The risky part of planning on family to take care of you is that they are just as vulnerable to needing care as you are. Frequently, caregiving falls onto the laps of adult children, who are most often employed, have children of their own, and live in a different town. Most caregivers experience physical and emotional exhaustion, sleeplessness, financial loss, deteriorating health, anger and guilt, but they say depression is their most common emotion. Many of us are lucky to have family who will step in to care for us – but is this what we would want for them?
A family friend and retired doctor ‘had plenty of money’. Along with his golf partners, he confidently rejected the suggestion of needing a long term care plan. Gene and Diane spent winters in Arizona, summers on the lake in Minnesota. At the age of 62, Diane suffered a massive stroke and required care on a daily basis. In Arizona, the cost was close to $6000 a month. When back in Minnesota, Gene decided to take on the caregiving himself to keep the costs down. ‘Do you know what this is doing to my retirement account? And I have no life!’ he lamented.
On a recent flight, I joined in conversation with a woman whose 55-year-old husband, a cardiac surgeon, fell from a ladder several years ago and sustained a brain injury so severe he will need total care for as long as he lives. Connie, a nurse, had to go back to work when their savings was nearly gone. “We thought we had our plans in place”, she said. “I never wanted to go back to work at all, but now I’m going to have to work for the rest of my life.” We all may be just a heartbeat away from a life changing event.
The reality is that more than half of us will need care at some point in our lives – help with bathing, eating, dressing, or supervision when dementia sets in. Life altering conditions such as stroke, Parkinson’s, MS, or disabling injuries from accidents can occur at any age – we just never know when. Today, over 40% of those getting care are between the ages of 18 and 64. Long term care is one of the biggest unfunded liabilities most Americans face today, and it could ultimately be the biggest threat to our savings and our lifestyle.
So how do we plan? We can rely on family or savings, but we’re aware now that this does not always work well. Many think their health insurance or Medicare will pay for their long term care. For the most part, neither will. VA funding for care is limited, its facilities in short supply. Medicaid is a government program that will pay for our care after our savings is gone, but it generally only pays for care in the Nursing Home, and recent law changes have made eligibility for this money much more difficult. In addition, despite continued cuts in services, state and federal government leaders on both sides of the aisle concede the Medicaid program as we know it today is unsustainable.
Those who think the government will come up with a long term care plan on a grand scale for everyone will have to get in line behind those looking for remedies for Social Security, Medicare, and the acute health care crisis. And we all know how well and how quickly Congress moves on such matters. The Medicare Prescription Drug program alone will cost almost double its initial projections, and another big ticket expense that would generate unprecedented taxation for future generations would be a tough sell.
If we qualify, we can consider long term care insurance. Not the ‘Nursing Home Insurance’ policies of the past, today’s policies are consumer driven. They not only help protect income and assets, they give you care on your own terms – in a facility, in a community setting, or at home. They pay for skilled and unskilled care, meal preparation, home modifications, specialized transportation, and more. Some policies will even refund your money if you don’t need the care. Premiums are now tax deductible to businesses and for many individuals, and additional government incentive programs will be rolled out this spring.
When you are considering a contract that can be worth hundreds of thousands of dollars to you and your family, make sure you seek the advice of a specialist in this market, someone with experience and credentials who has access to the major long term care insurance carriers, someone who can help you compare policy features and costs, making sure you get the plan you need and can afford, a plan that will be as adaptable in tomorrow’s care world as it is in today’s. A long term care insurance specialist can help you chose a company with solid financial ratings, a proven track record for paying claims, and a commitment to continued product development and strength of this industry. For many, long term care insurance remains one of the simplest and most cost effective ways to combat the future impact of a long term care event.
Our parents didn’t have too many choices for planning, nor did they expect to live so long. Most of them had modest savings but pensions that gave them income for life. Pensions will be rare for the generations that follow. And today, as retirees and Baby Boomers deal with their aging parents needing care, many have a greater awareness of the role long term care insurance can play in protecting their 401k’s and their lifestyles. My personal and professional experience has made me a believer in the insurance. It’s not perfect, and it’s not for everyone, but for those who qualify, and for those who want to protect their independence, protect their savings, protect their spouse, and protect their children – it’s priceless.
As he was being brought by wheelchair into the nursing home just weeks before he died and after years of care at home, he looked up over his shoulder at my husband and said it just one more time, ‘Now, Son, if I ever get really bad…..just shoot me !”
Patricia Francisco, LTCP is a Long Term Care Insurance Consultant in Duluth, MN. You can contact her at (218) 722-0508