Another Harmful Article on long-term care (LTC)

Checking my Google alerts for long-term care (LTC) mentions, I found this useful and correct piece by Terry Savage, someone I greatly respect because she researches thoroughly (“Long-term care combined with life insurance solves problems,” Chicago Sun Times, January 24, 2011).

Then I came across this harmful piece by Anne Teregesen of the Wall Street Journal (“The latest long-term-care snafu,” Wall Street Journal, Personal Finance, January 22, 2011.) Here’s what I had to say to her:

Dear Ms Teregesen,

While you got your info correct in this recent article, it is a pity that you chose to place all the emphasis in this piece on old policies without mentioning that policies placed from the 90’s on don’t have these restrictions and work like a charm. Furthermore, the number of these old-old policies is small – a point you also failed to mention. Rather than “spook” consumers away and give them one more reason to procrastinate and not have a conversation about responsible LTC planning, I wonder why you could not have at least mentioned that the statistics are that over 95% of all LTC claims get paid. Normally, the reasons LTC claims don’t get paid are that trigger criteria aren’t met or the claim is incomplete. If the claim is incomplete or incorrect, we correct it, re-submit, and the claim gets paid. The claims process is pretty uncomplicated. It’s becoming quite routine for home health agencies and assisted living facilities to complete claim paperwork. There are plenty of sources for these facts that you failed to use. So now you have one more column with a negative spin on responsible LTC planning. You have further discouraged the vast wave of Baby Boomers, who are already ill prepared and who will probably need lots of long-term care in a giant bulge, from considering reasonably priced LTC. Because of your inadequate research, you have done the public a bad service.

Funny Video Explains Medicaid Paid Care

Here’s a brief youtube video posted by the Pacific Research Institute that makes me chuckle.

With humor, it concisely points out the glaring Medicaid loopholes that are being abused by the American middle class.

Medicaid, a program established for the indigent and handicapped, pays for approximately half the long-term care in the US.

This video explains how middle class people can “game the system” and get Medicaid to pay for long-term care. With proper legal guidance, it’s just not that difficult.

This is a big reason why sales of long-term care insurance (LTCi) languish. Even though Medicaid-paid care usually takes place in under funded nursing homes, many Americans are seduced into getting the government to pick up the tab via Medicaid.  Why spend money on LTCi premiums, they reason, even though LTCi gives a full spectrum of choices and options far more appealing than a Medicaid facility? 

I have two questions for these people.  First, how much longer do they think government funded Medicaid will pay for the care of people who are not really indigent?  Second, why would anyone choose to wait until they need care to discover the difference between a Medicaid funded facility and the luxury of a facility funded via LTCi?

Are People Clueless About Recognizing Cognitive Impairment?

Here’s a piece by Pamela Fayerman of the Vancouver Sun that ran on January 4, 2011. It’s titled “Why are men so much more clueless about Alzheimer’s Disease?”

Ms. Fayerman writes about how people do not recognize the signs of mild cognitive impairment and Alzheimer’s disease.

I beg to differ with her. I believe she is confusing cluelessness with denial. In fact, here are my posted comments on Ms. Fayerman’s fine piece:

“Thanks for this very useful blog, calling attention to the bewildering disconnect the public seems to enjoy wallowing in. I think the public is not so much clueless as they are in denial. The same “cluelessness” you observe I see on my side of the fence when people are reluctant to talk with me about what would happen if they fell into the 70+% of us who will need long-term care (see “Medicare and You 2011” p. 110: published by the US Department of Health and Human Services).  I will never understand this “cluelessness”/denial. You can give them abundant facts and they seem to rationalize them away. But more often, people refuse my offer to have a conversation about rational, responsible long-term care planning before the event requiring care occurs. I have seen some crazy first-hand examples of denial, where the loved one had flagrant cognitive impairment and the family and loved one refused to admit it, made excuses, or assisted in covering for the loved one. This is why I don’t think the public is clueless. What we are observing is actually denial.

Thanks as well for the reference to Jacqueline Marcell’s book, which I will investigate.”

Innovations in Alzheimer’s Care

A December 31, 2010 New York Times story by Pam Belluck titled “Giving Alzheimer’s Patients Their Own Way, Even Chocolate,” describes recent innovations in long-term care. In particular, the article describes at length what is being done for Alzheimer’s patients at the Beatitudes campus in Phoenix, AZ.

It seems Beatitudes is going out of its way not to be a conventional nursing facility. Strict institutional schedules deliberately yield to individual needs. For example, meals are served at all hours. Patients can eat whatever they want and follow whatever schedule makes them happiest.

From the article:

“Dementia patients at Beatitudes are allowed practically anything that brings comfort, even an alcoholic ‘nip at night’,” said Tena Alonzo, director of research. “Whatever your vice is, we’re your folks,” she continued.

All this makes great sense to me.

Being cared for at Beatitudes costs money. Lots of it. Yet this article doesn’t mention anywhere how much Alzheimer’s care at Beatitudes costs. This is the first thing I wanted to know when I read the article, and I’m sure I’m not the only reader wanting this information. The media often seems to sweep such useful information under the carpet, which continues to amaze me.

It’s a continuing mystery to me how and why the public, often aided and abetted by the media, suffers a “disconnect” when it comes to dealing with the need for responsible long-term care planning that can fund wonderful options like Beatitudes.

Dear Abby tackles long-term care issues

In her December 19, 2011 column, quoted completely, below, Dear Abby published a letter about someone who is 99.9% likely to NOT own long-term care insurance (LTCi). I say this not just because statistically, only 10% of Americans in optimum age range and income brackets do (see my blog on the Urban Institute report). If the lady described below owned LTCi, she might have been less hesitant to access the long-term care she sadly, and very evidently needs. LTCi would have pumped money with which care could be paid for. I informally observe that when insurance pays, people get the right kind of care earlier and more often.

The situation below is very sad, and largely avoidable when long-term care planning has been done. Unfortunately, we see similar situations very often.

 “DEAR ABBY: I have an elderly neighbor I have been friends with for many years. Over the past several years she has had numerous medical problems. I have done everything I can to be her friend. I do things around the house, bring her meals, whatever I can. She has no family and only one other friend besides me.

She is depressed and stays in bed most of the day, which contributes to her aches and pains. I keep telling her she needs to get up and walk or her pain will get worse. It has reached the point where she’s so nasty about everything that I don’t even want to talk to her.

I understand that she’s scared and feels beaten up. I try to talk about things that are noncontroversial — happy things. It doesn’t work. She turns everything into an argument. I don’t know what to do. I hate to ignore her, but it’s really taking a toll on me. Am I a fair-weather friend? — TRYING TO BE A GOOD NEIGHBOR IN MASSACHUSETTS

DEAR GOOD NEIGHBOR: No, you are a caring friend. Your elderly neighbor is ill, and she may be becoming demented. Because she is no longer able to care for herself or her home, contact the nearest hospital or senior center and ask to speak with a social worker on staff. The woman you describe may need more help than you can give her, from people with the training to do it.”