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Moving Story About How Long-Term Care Insurance Works

March 14, 2014 by Honey Leveen Leave a Comment

What follows is a true story about a friend and colleague. An extraordinary health event occurred. My friend’s long-term care insurance (LTCi) kicked in, exactly as planned. LTCi has provided dignity for my friend and her family, plus choices and options that would otherwise not be possible.

My Story: Talking the Talk and Walking the Walk

by Allan Shoff

This is the story of my wife, Karen Shoff, and the role long-term care insurance has played in our lives.

Karen is the love of my life. We’ve been married for 33 years. She was active, passionate and accomplished in her varied life endeavors. Our rich family life was a huge source of satisfaction to Karen. We have two grown children, 12 grandchildren and one great grandchild. Our daughter, son-in-law, and five of our grandchildren have now moved back from Israel to help with Karen’s care.

In 2009, Karen had some tingling in her left arm. We went to Cedars Sinai Hospital’s emergency room where they did several examinations, including a brain scan. There were problems with the machine’s calibration—and with the technician giving the brain scan. Karen got eight times the recommended radiation dosage. Within a short time, she began to experience memory loss. We were part of a class-action lawsuit and received a fairly paltry settlement, which only paid for about eight months of Karen’s care.

Over the past four years, Karen has continued to lose function. She no longer speaks to people or interacts with anyone at a personal level. She has some pain, but more discomfort and fear of falling. Music therapy has been helpful to her, but over the past few weeks, she has become more and more withdrawn, spending virtually the whole day with her eyes closed, and communicating very little with anyone.

Many readers of this newsletter know of Karen. Karen was one of the most passionate, knowledgeable, reputable, accomplished long-term care insurance specialists in the country. She was a visionary and a true leader. She was a featured speaker at NAHU’s 2001 National Convention and a long-time member of the Million Dollar Round Table. She was always seeking ways to give back to the insurance profession and the world. She did whatever she could to foster interest in long-term care insurance education and responsible financial planning.

Karen has her undergraduate degree from Cornell, a master’s from Smith College School for social work, and a master’s from the Leonard Davis School of Gerontology at USC. The early part of her career was spent as a social worker at a nursing home.

Karen’s experience as a nursing home social worker made a huge impression on her. In addition, her own experience with her father compelled her to write her widely acclaimed book, “There’s No Place Like [A Nursing] Home”. You can learn about this book and buy a copy at www.longtermcarela.com or email me at shoffandshoff@earthlink.net. Many advisors have found the book to be a powerful tool in their practice.

The book intimately tells the story of our experience caring for my father-in-law at home. At age 97, my father-in-law suffered a massive stroke. His doctors told us they did not expect him to survive more than a week. Against all odds and advice, but with the wholehearted support of our family, we flew Karen’s father from New York to our home in Santa Monica, CA, and provided him with 24-hour care for the last 11 months of his life. Due to the excellent care Karen arranged for her father at home, he exceeded all expectations and regained his speech. Although he would not re-gain other skills, he found pleasure reminiscing and participating in other facets of family life. Karen publicly expressed, as often as she could, how precious to us all his last few months were.

Thank goodness Karen talked the talk and walked the walk by placing ample long-term care insurance on herself.

Karen has been using caregivers since August 2011. At present, she has 24-hour care with three regular caregivers. One is a nurse who spends about 15 hours a day here, plus two additional part-time caregivers. In addition, our daughter, son-in-law and grandchildren all help in various ways. I do what I can, but the whole situation is very trying for me.

Karen owns two CNA LTCI policies, each with lifetime benefit periods and 5% annual compound growth increases. These policies cover about 85-90% of Karen’s care expenses. Without her LTCI, the necessary, dignified, loving level of care Karen receives would be entirely impossible.

I Predict A Bleak Future For Many Who Refuse To Face Reality Early Enough

March 6, 2014 by Honey Leveen Leave a Comment

This blog falls into the “Denial is not just a river in Egypt” category.

Thanks to Dr. Robert Roush of The Huffington Center for Aging for giving me the link to www.longlivetexans.com/index.php/site/facts-figures. All quotes in this blog come from this link.

“In Texas, 340,000 individuals are now living with Alzheimer’s disease (AD) and that number is projected to increase to 470,000 by 2025.”

“Nationally, Texas ranks third in the number of AD cases and second in the number of AD deaths.”

Currently, the link shows, the incidence of AD for those ages 85 and higher, is 50%.

“Moreover, Texas ranks second nationally in the amount of uncompensated care provided by caregivers. By year end (2012), the direct and indirect costs of AD and other dementias are projected to exceed $200 billion, nationally.”

It’s unpaid long-term care that can kill. Much, if not most care in the US is provided by family and friends, on an unpaid basis and often at huge physical, emotional, and financial sacrifice to people and families. Unpaid care is not calculated in the Gross Domestic Product. I can find studies proving that unpaid caregivers die before the people they’re caring for with increased frequency. Unpaid caregivers also lose their health with greater frequency than the general population does.

“The incidence of AD is rapidly increasing. This will have significant economic and human ramifications on our society. While other causes of death have been declining in recent years, deaths due to AD have been rising. Between 2000 and 2008, deaths due to heart disease, stroke, and prostate cancer declined by 13 percent, 20 percent, and 8 percent, respectively, whereas deaths attributable to AD increased by 66 percent.^10″

A chart you can click on from www.longlivetexans.com/index.php/site/facts-figures is called, “Projected Changes Between 2000 and 2025 in Alzheimer’s Prevalence by State”. It indicates that between 2000 and 2025, the prevalence of AD in TX may increase by as much as 81%.

According to the American Association for Long-Term Care Insurance (AALTCI) 2012-2013 Sourcebook, Alzheimer’s Disease is the leading cause of long-term care insurance (LTCi) claims at ages 65 and higher. In addition, the AALTCI also says Alzheimer’s LTCi claims are by far the longest duration and most expensive claims paid by LTCi.

Why would anyone not want to have a level-headed conversation about the need for responsible, affordable long-term care planning way in advance of a health decline, when LTCi premiums are still reasonable? Beats me.

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.

Request a Free, No-Obligation LTCi Quote

Moving Story About How Long-Term Care Insurance Works

I Predict A Bleak Future For Many Who Refuse To Face Reality Early Enough

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

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