Archives for February 2014

The Relationship Between Money And A Dignified, Peaceful Death.

February 27, 2014 by Honey Leveen Leave a Comment

Along with my prior blog about choosing the right healthcare proxy, my dear friend also consented to share the following, intimate account of her father’s passing, as a service to readers of this blog.

I am conveying her story because it is the perfect example of the difference having ample money to pay for long-term care makes.

Money creates options

With money, comes access to higher quality long-term care. If you don’t have many millions of dollars saved, you must rely on long-term care insurance if you wish to access high quality long-term care.

As you read this story, imagine how different D’s father’s end of life would have been if he had not had ample money to pay for the independent living community plus the 12-hour a day home health care her father needed. Most families do not have the wealth to do this.

D’s father required rather extensive care for about seven years at a total cost of nearly one million dollars. This would obviously be a financial catastrophe for the typical American family, in addition to causing physical and emotional sacrifices for most families. Fortunately, all three siblings agreed to spend as much wealth as necessary on their father’s care. This is not always the case. As you read D’s story, you will see that because her father had superb care from others, D did not have to provide daily hands-on care for her father. However, D was actively involved in checking on her father’s care – which contributed significantly to its high quality. She also provided essential emotional support to her father on a daily basis.

This combination of no financial stress plus D’s daily presence by phone or in person over a 7-year period undoubtedly extended his life and significantly added to its quality.

LTCi ownership is about making sure you have access, dignity, options, and choices if you need long-term care, at minimal financial, physical, and psychological sacrifice to those you love most.

D’s story:

Dad moved into independent living with an aide. He had end-stage macular degeneration & hearing impairment. Having an aide enabled him to have a better quality of life, interacting with others. He made new friends, lost others, but powered on. Managing Dad’s care was my full-time job during his final years.

I took Dad for his check-ups, especially his pulmonologist, a wonderful caring man. Dad had been on oxygen constantly, for the last 3 years as his lungs were failing. I was unhappy about Dad’s color, so I took him for a check-up. I received the news that the end was near and it was going to be bad. The doctor was right. Witnessing my father’s death was gut wrenching. I was determined to make Dad as comfortable as possible.

Dad’s last week was spent gasping for air, completely overheated, sweating profusely. When I called, he had kept hanging up the phone on me. I did not realize how close the end was because of this.

Dad’s 97th birthday came, he woke and asked if he was 97 yet. Then he said “Good!” and went back to sleep. Close family and friends spent his birthday sitting with him, talking to him, holding his hand.

Periodically, I would ask him if wanted to be held, he would nod yes. So I would get in bed with him and hold him. At one point, he started patting my tush and I reminded him that I was his daughter. He replied, “ I diapered that tushie, it’s mine,” laughed, and fell back to sleep.

Hospice had been called, but they were a bit late in arriving. By then, his whole body had quieted down, no more gasping for air like a fish out of water and profuse sweating. The RN said he was ready to go, based on his posture, appearance, and his not waking anymore. The purpose of Hospice was to give liquid Morphium to ease my father’s suffering.

Two days after Dad’s 97th birthday, on the last night of Passover, he died. He had fun, joy, laughter delighted in his family and grandchildren. He was always the best dressed man in the room. I can also say he was not always a joy. He could be oh so cranky, with the best of them, but witty. We had a standing date every Wednesday and he sang me good-night every night, in that croaky voice that couldn’t carry a tune with a bucket.

Choosing a Healthcare Proxy and Long-Term Care Planning

February 21, 2014 by Honey Leveen Leave a Comment

Planning for long-term care and choosing a healthcare proxy (HCP) must both be done as far in advance as possible, with as much honesty as humanly possible.

Be very sure that the people you choose as your HCP will carry out your wishes.

Both are done because people wish to have the highest possible caliber of care, dignity and options, even if they have limited, or no capacity to make decisions.

Choosing the right HCP also ties in to long-term care insurance (LTCi) purchase because both are done out of the utmost consideration and love of others.

Both actions are done to ensure the least amount of stress and discord for surviving family and friends.

The following is a true story, shared by a very close friend:

“Because my father did not want my sister to feel left out, he named her as his second health care proxy (HCP). That was a bad decision and the wrong reason to grant a HCP.

My Dad lived a long and very productive life, retiring at 87. As he approached 90, some medical issues that he had since his late 20’s became much worse. But each was survivable.

With Dad’s consent, my siblings and I decided that there would be no surgeries or heroic measures taken to keep him alive.

Despite his failing health, Dad was astute and very capable of managing and understanding his business affairs. He ably directed his wishes. He appointed our brother Power of Attorney. As Dad was filling out the HCP form with his attorney, he said to me, ‘You are number 1. You will make my medical decisions with and for me, as you have been doing for years. I have to give your sister something, or she will feel totally left out, so I am making her #2. I do not want her husband involved in the decisions.’ Dad also had a Do Not Resuscitate (DNR) order, much to my sister’s surprise.

For years, I took care of all of Dad’s medical care. My sister only visited from time to time, when Dad was hospitalized, or to spell me for a day or two. She had a family, lived out of town and was busy with her life. The key thing Dad didn’t want was to die in a hospital with tubes sticking out of him, strangers around him, alone. He was very clear about this.

My sister chose to ignore our father’s DNR, along with his wishes.

My sister was visiting. Sitting in Dad’s living room, She heard Dad’s agonizing gasps but chose to overlook them. She did not call me. When I got there, she said to me cheerily, ‘What’s up?’

I dropped my things on the floor and immediately went to Dad; I knew this was it. That sound, that sound, that unmistakable sound was horrifying. I believe my father was in pain. Unnecessary pain. I do not understand how anyone could sit in a room obliviously over-hearing painful gasps. She did look in on him from time to time, but she was out of touch with reality. She continued texting, making calls, laughing, etc.

Once I got there and she acknowledged the severity of the situation, she said, ‘I am #2 HCP and my husband says Dad should be in the hospital with an IV drip for his dehydration and someone should work on a small bedsore that had appeared in the last few days and he should be intubated.’

My father’s lungs had ceased to function. Her behavior was nuts. I replied, ‘Your husband is not the one with the HCP and you cannot delegate. You can refuse your responsibilities or do what Dad wants. This is the end. The RN has given you the facts. I can have the MD call you directly to tell you the same thing.’ My sister insisted on calling her husband. Our brother had to assertively remove our sister from Dad’s apartment.”

A very difficult situation was made much harder just by the bad choice of a HCP.

Make sure your wishes are known. My attorney has a copy of my last wishes to back up my HCP, just in case some stranger butts in to change your decisions.

My advice is make sure that those you select as HCP are chosen for the right reasons. They should be reliable, in the loop on medical status, doctors, meds. They must be capable of making decisions without consulting a spouse or someone else for every move, and they must be able to defend your wishes and act in your best interests, first and foremost.

Sign that I’m Getting Old: I See Actual Evidence of Income Inequality

February 6, 2014 by Honey Leveen Leave a Comment

In my prior blog, www./2014/income-inequality-is-here, I gave irrefutable proof that income inequality is here. Due to the human tendency to deny facts that are unpleasant, it is often difficult for even smart, educated people to acknowledge this.

The email below comes from an informed prospective client who works in the long-term care industry. Every day she sees families in crisis, largely because their loved one does not own long-term care insurance (LTCi). She believes LTCi is the only solution for middle-class people who want to secure their dignity and options, should the probable need for long-term care arise. She sought my help upon the strong recommendation of her friend. We had a good rapport, and I showed her reasonable LTCi premiums. At the point of placing her LTCi application, she froze in fear, like a deer in headlights :

“Honey – Just wanted to touch base with you. I want to be respectful of your time. My week became crazy at work. Things went haywire with individuals quitting and getting laid off. I am going to hold up on my long term care insurance. I will pay the increase when I get the insurance. I may be getting laid off. I will know some time in Feb. I do not want to take on added expense until I know something. Thank you kindness and patience with me. ~ Tracy“

When I began selling LTCi 23 years ago, I did not get many objections like the one above. True enough, there was horrid, incorrect, sometimes scathing media coverage of LTCi in those days. This is not as true nowadays. People were also convinced Medicare would pay for their long-term care or that their kids would care for them. Thankfully, both of these myths have been largely dispelled.

Now we have income inequality replacing the obstacles described above and throwing a wrench into what I believe would be an otherwise thriving LTCi industry.

This is sad to me. With the presence of income inequality, there is a stronger than ever need for LTCi ownership.

Income Inequality Is Here

February 5, 2014 by Honey Leveen Leave a Comment

For years, the press has done faulty reporting on long-term care insurance (LTCi) and the public has been in deep denial of the need for it. Now we have a new enemy of responsible long-term care planning: income inequality.

A story in the February 3, 2104 New York Times titled, “The Middle Class is Steadily Eroding. Just ask the Business World” caught my eye. It also confirms my observations.

The article says there is no doubt our middle class is eroding, in a pretty dramatic way.

“In 2012, the top 5 percent of earners were responsible for 38 percent of domestic consumption, up from 28 percent in 1995. About 90 percent of the overall increase in inflation-adjusted income was generated by the top 20 percent of households in terms of income.”

“Investors have taken notice of the shrinking middle. Shares of Sears and J. C. Penney have fallen more than 50 percent since the end of 2009, even as upper-end stores like Nordstrom and bargain-basement chains like Dollar Tree and Family Dollar Stores have more than doubled in value over the same period.”

“Foot traffic at midtier, casual dining properties like Red Lobster and Olive Garden has dropped in every quarter but one since 2005, according to John Glass, a restaurant industry analyst at Morgan Stanley.”

“With diners paying an average tab of $16.50 a person at Olive Garden, Mr. Glass said, “The customers are middle class. They’re not rich. They’re not poor.” With income growth stagnant and prices for necessities like health care and education on the rise, he said, “They are cutting back.” On the other hand, at the Capital Grille, an upscale Darden chain where the average check per person is about $71, spending is up by an average of 5 percent annually over the last three years.”

Click here for another blog I did about income inequality.

Where am I going with this? Why am I reporting on this in a long-term care insurance blog?

Rationally, when finances are tight, insurance is actually more necessary than ever. Yet soaring income inequality evokes fear. When fear strikes, people panic. Business logic is inhibited.

I commonly see people who are suffering the effects of income inequality continue to spend money. It’s usually on “stuff”. A good many people can still afford long-term care insurance (LTCi) because we can get LTCi premiums to be very reasonable. But seeing their costs go up, their incomes remain flat and their jobs in possible jeopardy impedes people from doing the only sane, considerate, dignified thing, which is to buy reasonably priced long-term care insurance.

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Archives for February 2014

The Relationship Between Money And A Dignified, Peaceful Death.

Money creates options

D’s story:

Choosing a Healthcare Proxy and Long-Term Care Planning

Sign that I’m Getting Old: I See Actual Evidence of Income Inequality

Income Inequality Is Here

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