Archive for August, 2014

Taking the Car Keys and Other Indignities

August 25, 2014

We start out as infants totally dependent upon adults for our very survival. As time goes by, we gradually become more independent. We learn how to walk, tie our own shoe laces, interact socially, and then in what seems like the blink of an eye, we learn to drive a car. I remember the first time my son picked me up at the Denver Airport after I returned from a business trip. “Where is Mom? How did you get here?” I asked.

As we move into adulthood we make our own decisions (mostly) about careers, who to marry, where to live, how to raise our children, how to spend our money, and everything else. Then we watch as our parents become older. Soon we start worrying about their health. Are they eating well? Are they telling us what they tell their doctor? Are they telling their doctor(s) what they need to? Are they really OK living in that big house by themselves and so far away?

Time for a reality check from the parents’ point of view: “We (the parents) are capable autonomous, adults.” “We know what’s best for us.” “The children are…well…kids.” “What do they know?”

So it begins. The adult children mean well. They only want their parents to be safe and healthy and happy. But for the parents, every “suggestion” is seen as an attempt to tell them what to do…to take away another piece of their independence.

Here comes a biggy: “Dad, you really shouldn’t be driving anymore. It has become dangerous. You almost ran into someone the other day.” Dad: “But if I stop driving, I will have to depend upon others to get me where I want to go. I will lose my independence.”

Then come the adult children’s concerns about their parents medications, and then their finances (“Mom, you must stop giving so much of your money to charity. You will need it to live on.”). At some point the adult children “know” that it is time for Mom and Dad to move…to a smaller home, to an assisted living facility, or to “move in with us.”. All advice given with the best of intentions.

For the adult children: Please understand the psychological impact on your parents every time you ask them to give up yet another chunk of their independence. They know all too well the changes taking place…at some level they understand that due to their reduced physical and perhaps mental abilities, that you are becoming the parent and they are becoming the children…and they do not like it. Please continue to do whatever is needed to keep your parents safe and healthy and maybe even a little happy. But do what you have to with sensitivity and respect and the wisdom they have helped you to achieve.

For Mom and Dad: Your adult children love you. They only want what is best for you. Please don’t judge them too harshly. You raised them to be their own people. Now they are trying their best to help you. They may see things that you are not yet ready to deal with.

For my readers: I would welcome your thoughts on this difficult subject. Share your experiences with me if you are comfortable doing so. I did not tell you how to take the car keys away because I do not know how to. Fortunately, my own and my wife’s parents stopped driving before anyone was hurt.

Disclaimer: This eNewsletter and all links to other sources should not be construed as tax or legal advice because they are neither. Raymond Smith, The Long Term Care Specialist, does not give legal or tax advice. Consult your attorney or tax advisor for these matters. The views expressed are my own.

© Raymond Smith, The Long Term Care Specialist, 2014

Money Doesn’t Buy Long Term Care Insurance…Your Good Health Does

August 25, 2014

Regardless of how much you are willing to pay for long term care insurance, no company will sell it to you unless you qualify medically. The following is a sampling of uninsurable health conditions taken from one carrier’s actual underwriting guide:

Using Adult Day Care within the past 6 months, AIDS, a history of alcoholism with any current alcohol use, ALS (Lou Gehrig’s Disease), Alzheimer’s, in an Assisted Living Facility within the past 6 months, Chron’s Disease with complications or multiple flares, COPD (Chronic Obstructive Pulmonary Disease) combined with tobacco use within 12 months, dementia, diabetes (if poorly controlled, or with tobacco use, or if injecting more than 50 units of insulin per day),

Dialysis, disabled (If collecting private disability insurance or Social Security disability benefits. Collecting Social Security retirements benefits is OK.), Down’s Syndrome, electric scooter use, epilepsy (if poorly controlled), hemophilia, high blood pressure if more than 170/94 or if noncompliant with treatment, HIV positive, using Home Health Care within the past 6 months, immune deficiency, mental retardation, multiple myeloma, multiple sclerosis,

Muscular dystrophy, in a Nursing Home within the past 6 months, organ transplant, osteoporosis with a T score of -4.0 or worse, oxygen use, Parkinson’s, physical therapy within 3 months, polycystic kidney disease, pulmonary hypertension, quad cane use, rheumatoid arthritis (severe), schizophrenia, shingles (within 6 months), surgery requiring general anesthesia either scheduled or planned (but not yet completed), systemic lupus, walker use, workers’ compensation (currently receiving). There are many, many more disqualifying conditions (as well as combinations of conditions). I only listed some.

Build: The height and weight tables vary slightly from insurance company to insurance company. Most now use a single chart for both men and women. Pay attention to the minimum as well as maximum allowable weights for a given height. Here are a few examples from another insurance company.
5’0″ and 92-203 lbs is OK. 5’4″ and 105-231 lbs is OK. 5’6″ and 112-246 lbs is OK. 5’10” and 126-277 lbs is OK. 6’0″ and 133-293 lbs is OK. Other companies may be a little more or less stringent.

What about cancer? Internal cancer is often insurable if there has been no lymph node involvement or metastasis, and a low stage/grade number, and at least two years since last treatment.

The take-away from all this doom and gloom? If you have the good fortune of not having been diagnosed with a disqualifying medical or psychological condition, you should apply for long term care insurance while you still can. If you already have a policy, keep it! You cannot be cancelled because of a change in health.

Think about it: we are all potentially one doctor visit away from a diagnoses that will make us uninsurable. The reality of life is that we will all become uninsurable at some point. The only question is: When?

Disclaimer: This eNewsletter and all links to other sources should not be construed as tax or legal advice because they are neither. Raymond Smith, The Long Term Care Specialist, does not give legal or tax advice. Consult your attorney or tax advisor for these matters.

© Raymond Smith, The Long Term Care Specialist, 2014