For many residents of North Carolina long term care should be at the top of their watch list. This is especially true if they are within 10 to 15 years of the normal retirement age of 65. The subject of long-term care can be difficult to discuss. In fact, I find that many financial advisors shy away from discussing it because their clients seem to avoid it like the plague. For most of the people I meet with, I find the opposite to be the case. Especially when I begin the conversation with, “whether you take action now or in the future, I believe firmly that this is the most important planning discussion you will ever have.” By keeping the conversation positive and putting careful thought into approaching viable solutions for them, they usually leave my office feeling good about what we have accomplished together.
In my seminars and webinars, I often open the conversation with the following question: “Who here wants to stay in their home in the event they can no longer care for themselves?” You can imagine the positive response. When people are asked about what long term care means to them, they usually say, “being in a nursing home.” This doesn’t make for the start of a positive discussion. I find the better approach is to focus on what is involved in maintaining their current way of life even if they become unable to care for themselves.
I recently met with a couple in their late 60’s. The husband told me a story about a friend of his who was a very prominent cardiac physician in his community who, as a result of a stroke, became unable to manage his regular daily activities. Things that you and I take for granted such as, taking a bath, getting dressed, and walking from place to place, had become virtually impossible for him without assistance. Being a rather large individual, it was difficult for his wife to offer assistance. As a result, they faced the dilemma of hiring a home care nurse at $21 per hour for 8 to 10 hours per day. In spite of their considerable financial accumulations, they found themselves watching their cash rapidly dissipating after a few short years. It was at that point in the story that my friend told me that fortunately the friend had purchase a long term care insurance policy several years earlier. The fascinating thing about the conversation was that my friend talked about all the great times that he and the “doc” and his other buddies continue to have together. He spoke about a recent trip to the coast of North Carolina for a fraternity buddy reunion.
He described it as a week of fishing, cajoling, cooking homemade meals, reminiscing about college days and of course the obligatory nightly “round-table” discussions complete with cold beer, cigars and poker. It’s not the kind of picture you would expect when it includes someone, who three years earlier, became the recipient of round-the-clock care-giving.
It is important that I don’t leave out the one thing that causes more hardships to aging family members than the loss of our daily activities and that is cognitive impairment, more particularly Alzheimer’s Disease. It is estimated that there as many as 5.5 million Americans with Alzheimer’s disease. The number of people with it will increase significantly if current population trends continue in the absence of effective treatment or prevention. 10% of people over age 65 now suffer with some form of cognitive impairment and that number grows to 50% of those over age 85. This is happing because as we all age the risk of Alzheimer’s increases and overall the U.S. population is aging. A person in their 80’s might live with Alzheimer’s might for as little as 3 -4 years while others might live 10 or more years if diagnosed before age 65. Alzheimer’s is a slow disease that progresses in stages beginning with little to no symptoms, then progresses to mid-stage of mild cognitive impairment in which memory begins to fade or judgment becomes impaired. Then in the final stage of Alzheimer’s, dementia can brings about the loss of thinking, memory, and reasoning skill often times to the point where it seriously affects a person’s ability to carry out their daily activities..
“You may have to leave home, without it”
One thing I have learned in my years as a long term insurance specialist, it is a mistake for me to assume someone is too young, too unhealthy, too rich, or too poor to purchase long term care protection. I grew up in North Carolina and one thing I know for sure, North Carolinians can be fiercely independent. We like our way of life. Home is not just about where we live, it is what we are about; children, grandchildren, friends and family gathering around a warm fire with a cup-o-Joe and hot apple pie on a cold winter day or sitting on the porch enjoying the cool breeze of early May with Aunt Carolyn’s “sweet tea”. The thought of having to leave that behind for a bed at an assisted living facility or nursing home is usually the last thing to cross our minds. So, it is enabling people to stay in their homes longer that I dedicate my time in getting folks to sit down for “a spell” and discuss things. Now, before I am accused of being partial to the “Old North State”, it’s not just people in North Carolina long term care issues have an effect on. In fact, Florida ranks as one of the states where long term care planning has become among the most popular topics in retirement publications. Indeed, regardless of where we live, I believe we owe it to our loved ones to discuss their care-receiving wishes while they still have that choice available to them.
I am often asked, “how does long term care insurance provide for costs associated with home care assistance?”. The answer has many facets, but suffice it to say, that a properly-designed policy, in addition to its facility benefit, should contain provisions that enable the recipient to pay, both qualified home care professions as well as friends and family, for in-home assistance with those everyday activities of daily living I mentioned earlier. Many older policies did not offer payment for home care services. Today’s policies offer cash payment options which allow for payment of transportation services, medical supplies, rehabilitation support and more. Those with Alzheimer’s disease or other forms of cognitive impairment can sometimes require more attention than those with the loss of physical abilities. Over time, caregivers can become tired, frustrated and depressed. The emotional, physical and logistical toll can become overwhelming. That is the point when many families are finally forced to seek profession assistance. If adequate financial resources are not available, then a nursing home may become the “last resort”, as a first option. It is a difficult decision to put mom in a nursing home. But for some, it is their last and only option. In the days ahead, please consider your loved ones and what being able to stay in their home would mean to them. A properly designed long term care plan could just be the solution that allows them to “never leave home, because they aren’t without it”.
