Friday, January 25, 2013

The Most Off-Putting Blog Topic Ever

No, it's not death, but close.  It's Long Term Care--what we'll all probably need if we aren't cut down in our prime by cancer, cardiac arrest, a drunk driver or someone with a gun.

Have you clicked me into oblivion yet?

Inspired by my mother, whose insurance is saving her descendants from financial ruin now that she's in a nursing home, last fall I researched the average costs long term care in Vermont.  I realized that the insurance my husband and I had signed up for in our carefree forties was woefully inadequate. 

There followed a flurry of phone calls and consultations with agents and financial planners.  Large packets of information, featuring disconcertingly white-haired young people on the covers, arrived in the mail.  My husband and I endless hours over these, comparing apples to oranges and avocados and forcing ourselves to speculate on the vagaries of fate:  how long did we expect to live?  Of what did we think we would die?  Would we, alone or together, stay in our house to the bitter end, and if so, would we need assistance with the "activities of daily living"?  Or would we prefer a nursing home, and would we want a private or a semi-private room?

Who wants to think about this stuff? 

But we gritted our teeth and thought of our descendants and filled out the applications.  Next, the insurance companies told us, they would request our medical records, and then they would send a nurse to our house to look us over for physical and mental flaws.

Yesterday afternoon we had our home visit.  It was conducted by a friendly local nurse who insisted on meeting our dogs.  After a cursory physical exam came the cognitive part.  I must confess that being put on the spot to do simple multiplication and division in my head freaked me out a little, since it reminded me of third grade and my German nuns. 

The other questions were easier, but I found them more disturbing because they gave me insight into the depths of deterioration that the insurance company anticipated of someone of my advanced years.  One question was, where would I store ice cream?  I came close to messing up on this one--we haven't had ice cream in the house in ages, and I almost said "the fridge" instead of "the freezer."  What, the nurse wanted to know next, would I do if I accidentally swallowed poison?  Then she asked me to walk from the dining room into the kitchen and back, while she timed me.

Is it possible that one day I won't know where the ice cream goes?  That I'll swallow bleach by mistake and won't know who to call?  That I'll barely be able to make it from the kitchen to the dining room?  The answer, of course, is yes.

Ash Wednesday is coming soon.  Every year while I was in school the priest would trace a cross of ashes on our childish foreheads while he muttered pulvus eris et pulvus reverteris--dust thou art, and to dust thou shalt return.  These days one doesn't get many formal reminders of mortality or of the deterioration that will most likely precede it.  I should be grateful to Mutual of Omaha for reminding me of what actuarial tables show with depressing certainty:  that none of us lives forever, that we  cannot count on retaining even the humblest skills--walking to the kitchen, knowing where to put the ice cream--while we are still alive.  And that we'd better strengthen our spiritual and emotional muscles so we'll be able deal with the future, when it comes.

15 comments :

  1. Gah. That ash wed blessing used to bother me. Wait, it still does.

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  2. Bridgett, it didn't really get to me, because I thought it didn't apply....

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  3. this post does not put me off. i have seen too much aging, too much death. my mother is 85 and in excellent health but hoards her money like a miser, worried that she will need it for a nursing home. (i think she won't. but who knows? who ever knows?)

    i looked into the kind of insurance that you are getting. it was prohibitively, prohibitively expensive. there was no way i could afford it. i'll just have to roll the dice.

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  4. Laurie, it's so hard to know what's the right thing to do. I should clarify that we're simply going ahead with the application because the approval process takes a couple of months. Meanwhile, we're consulting with our financial adviser to see what makes the most sense. It may turn out that self funding, the way your mother is doing it, is best.

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  5. My 88 year old mother is in assisted living right now after having been in a nursing home for several months. She took a fall a few years back in which she dislocated and broke her shoulder. From that point forward she has been caught in a downward spiral.

    This is a woman who lived on her own for some 35 years after my father died. Took care of every aspect of her own life. But didn't plan for her future. Fortunately my brothers and I, along with the help of Medicare and other such agencies, were able to get her into one of the better assisted living communities in FL (which is where she chose to be). She can't walk anymore, has minimal use of one arm, can't hear, and her mind is slipping fast.

    My brothers and I love her dearly, and would do anything to see that she gets the best care, and is as comfortable as possible for whatever time she has left. But that's not to say it hasn't put an unnecessary burden on us--her children. If she had done the right things financially when my father died, considering her situation at the time, most, if not all, of that burden could have been avoided.

    I applaud you both for taking the measures you're taking now in order to make the transition as easy as possible for everyone involved.

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  6. I assume I am going to live to a grand old age and die of it. I will not sit and woory about all sorts of horror scenarios. I am alive now and want to enjoy it. The Dutch do take care of their againg population.

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    1. That last sentence makes all the difference. Unfortunately, the U.S. is less enlightened in this respect.

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  7. This is an issue I often think about, especially as my mother is or will be facing this issue very shortly, and I'll be learning much more about what will be available for us too (in, I hope, due course). Living in NZ, there is always assistance for the elderly, though it is not - I suspect - as generous as in the Netherlands. The financial thing is one issue. It's the emotional support and help as you start to deteriorate mentally that my mother needs, even though she is still living in her own home. Fortunately my sisters and I are there to help her with the transition. But I won't have that, and will need to make all preparations well in advance. Hopefully though, not just yet!

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    1. Mali, the emotional aspects of assisted living/nursing homes may not be as bad as we think. My mother was in assisted living for a month before she lost her mental faculties and, though she had resisted going to assisted living for years, she was happier than she'd been in a long time. There was structure to her days, and friendly faces, and a social life of sorts--all things that the elderly often don't have enough of.

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  8. Excellent, thoughtful, helpful, couragous post, once again, Lali. Thank you.

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  9. My great-aunt also resisted and after she went into an assisted living place, a very nice one with caring folks and nothing like what she'd expected, she said that she'd waited too long (and she had lived on her own after her husband died for nearly 30 years before making the decision). She lived in assisted care, never the full nursing floor, for only a year before suddenly dying. But she was cleaner, happier, less stressed, better fed, and far less lonely in that last year than she'd been in the 5 years previous.

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  10. I've bookmarked this one, because of all the hopeful positive things in it.

    Husband and I got LTC insurance a number of years ago, but have always wondered if it will really work. It's expensive - but we don't want to burden our kids when we should have been making our own decisions proactively.

    Your words about people being happy in assisted living are a consolation as well. We're looking for the CCRC to move into, and it is scary to think that decisions now will affect our lives in thirty years, if we are that lucky.

    I have always heard that many people feel they should have moved sooner, AFTER they finally move (or their children move them).

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