The Basics of Long-Term-Care Insurance

     "No American should ever have to spend their golden years at the mercy of insurance companies."  -- Barack Obama.

     And yet that's just what I've done. I've applied for a long-term-care insurance policy. I'm giving the company about $2000 a year, every year for the rest of my life. And in return the company promises to cover a portion of the costs of my care when and if I get old and infirm, those that Medicare and medical insurance don't cover -- the cost of a nursing home, or the cost of having an aide come to my house and help me eat and go to the bathroom and clean myself up.

     But there's a limit. The company will pay up to a maximum of $5,500 a month; and my total benefit will not exceed $200,000.

     Does this sound like a good deal to you?

     I got started on this because B has been hounding me about it. She took out a long-term-care policy for herself about ten years ago, after her husband died. At the time she had two teenage boys, and no husband, and she figured she'd have no one to take care of her when she got older.

     But also, B likes security, and she sleeps better knowing that when and if she becomes infirm, she has the resources to pay someone to take care of her. Besides, she has a better policy than the one being offered to me. Back then, when long-term-care policies were relatively new and untested, the insurance company agreed to cover all of her costs for up to three years, with no dollar limit, and then she somehow becomes eligible for Medicaid without losing her home and all her money.

     B's mother is now 97 years old, and only last year did she move into an assisted-living facility. All the women in B's family have lived a long time, and so B has every expectation that she will survive into her 90s, and probably end up needing some kind of long-term care.

     We've been to visit B's mother in her facility twice so far. It's a nice place in Pennsylvania -- relatively new and very clean, and it has a friendly, caring staff. Last time we went, we took her down to the dining room for dinner. There were maybe 30 tables in the room, with a sprinkling of white-haired people bent over the tables. And there the future was laid starkly before me. Elderly women, some in wheelchairs, others with walkers standing beside their chairs. And the men? There were no men.

     Or, nearly so. I did a quick count, and came up with 45 women sitting at the tables. And 7 men.

     So why do I need long-term-care insurance? Men don't live long enough to use long-term-care facilities.

     The insurance salesman told me 70% of people need some kind of long-term care at some point in their lives. He did allow that the percentage is higher for women, lower for men. I'm not sure if I believe him. But it did occur to me why B wants me to get the insurance. The men get sick and become infirm while their wives are still alive and still around to take care of them. The women outlive the men, and there's nobody left to take care of them.

     (Of course, this is a generalization. My own dad outlived my mother, and took care of her before she went into a Hospice for the last two weeks of her life.)

     Regardless, my long-term-care insurance will let me hire someone to take care of those bathroom and bathing needs, so B doesn't have to do it for me.

     So I've applied for the insurance. I checked out a policy being offered through my university. I checked out Genworth, the biggest in the industry. I ended up going with B's company because I get a couple's discount.

     At this point, there's no guarantee I'll be accepted for the policy. The company pulls your medical records; and also does its own physical exam, plus a memory test to see if you have any sign of Alzheimer's. I do not know how the insurance company decides whether a person is eligible for a policy. But it sounds as though if you have any serious medical issues, you're out of luck. In other words, if the insurance company thinks you'll need long-term-care anytime soon, it will not take you on.

     I'm pretty healthy. I'm assuming I'll be accepted (but you never know). And I will pay the premium, year after year, and I figure, if in 20 years I need some care, the amount I paid in will surely be less than what my maximum benefit is. I also get a 20% tax credit for my payments from the state, and because I file a Schedule C on my Federal taxes, I can take a deduction on my Federal tax as well (although how much longer I'll be working and filing a Schedule C is an open question).

     And then I just have to hope that 20 years from now, the insurance company will keep its promise to pay for my care.

    

Are You Getting Alzheimer's?

     I've applied to get long-term health insurance. It's not something I would necessarily recommend for everyone. It costs a lot of money. And the insurance company doesn't want to take you on as a policyholder if there could possibly be anything wrong with you.

     I'll address the whole question of long-term health insurance in my next post. But for right now, I want to focus on one aspect of the process -- the question of whether or not you're likely to get Alzheimer's or any other kind of dementia.

     The insurance company wants to know your entire medical history, including your family history. They're looking for any hereditary problems ... and Alzheimer's is one of them. Research shows that the cause of the disease is "most likely due to a combination of a variety of genetic and other factors," according to WebMD. Apparently there is a link between Alzheimer's and genes on four particular chromosomes, and the disease does have a tendency to run in families.

     In my case, my parents lived to age 89 and 91, and neither showed any signs of cognitive impairment. But the insurance company was not satisfied with just knowing that. They wanted to send a person over to my house to do a medical exam. Part of that exam is to take a test for Alzheimer's.

     To be honest, after a woman called and set up an appointment with me, I went online and checked out tests for Alzheimer's. Have you heard of the peanut butter test? Apparently Alzheimer's affects your sense of smell. A researcher had test subjects smell peanut butter, and found that people with early stage Alzheimer's had a dramatic difference in detecting odor between the left and right nostril -- the left nostril was impaired and did not detect the peanut butter odor nearly as well.

     I wasn't going to take the peanut butter test. But I did find several quick memory tests online at Test Your Memory for Alzheimer's (5 Best Memory Tests.) The first one was the most comprehensive and said it would take 15 minutes, although I did it in less than that. It's called the Self-Administered Gerocognitive Exam (SAGE) from Ohio State University. The test requires you to draw a geometric pattern, draw a clock with the time, name 12 fruits and vegetables. There is no answer sheet. You're supposed to show the results to someone who will intrepret the meaning of the test. But I got the clock right, and I had no trouble naming 12 vegetables. So I figured I was all right.

     There are other, shorter tests linked to the website. They all seem to want you to draw a clock. And so when the medical technician came to my house yesterday, I was all ready to draw a clock.

     She began by asking me my name and address and birthday and telephone number. And the date. (Being retired -- I hope you sympathize with me -- I don't always know what the date is!) But anyway, I suppose this was actually the beginning of the test. If you can't remember your address, you ain't getting long-term care insurance!

     Then she told me she would administer the test. And of course, there was no clock to draw. She wrote down ten words on a piece of paper. She showed them to me and read them out aloud. Then she held them up for me to study for about 20 seconds. She put the paper down and asked me to repeat as many as I could remember. I remembered six of the ten words:

cup
taste
sedentary
risk
learn
brand
. . . 

     Then she showed me the words again. She read them again, and let me study them for another 20 seconds. She put the paper down and again asked me to repeat them. This time I got all ten words. (Don't ask me to remember them all now -- I took the test yesterday morning, some 24 hours ago.)

     Then she proceeded with the rest of the test. She asked me to associate various animals. She'd name three animals -- giraffe, monkey, sheep -- and ask which one didn't belong. There is no right or wrong answer, she assured me. We went through the animals, about two dozen examples.

     Then she asked me to name all the animals in the test. Actually, I found that easier than remembering the ten random words. Maybe because I wasn't trynig so hard; or wasn't anxious about it, because I didn't know in advance I was supposed to remember them. Anyway, I got them all right.

     So, I don't know. I remembered six of those words. Is that enough for the insurance company to convince themselves that I'm not on the road to dementia? I get the results back in about three weeks. I'll let you know.

If You're Retired, Do You Have to Travel?

     A lot of people say they want to travel when they retire. It almost seems as if travel is a prerequisite for a fulfilling retirement, like it's part of the package of the successful middle-class retirement lifestyle.

     I've been to Costa Rica and Ecuador, people tell me, walked the El Camino de Santiago, and chartered a river boat down the Rhine. Where have you been?

     And I mumble in return, Uh, I was in New Jersey last weekend.

     I admit that I don't really like to travel all that much. And when I do travel I mostly stay close to home.

     Does that make me a failure at retirement? Do people feel sorry for me, because I can't afford to travel, or don't have the imagination or the curiosity to want to visit strange, foreign lands?

     For one thing, I do not like to fly. There's getting to the airport. Then the crowds. I don't like being herded through security and corralled into a narrow aluminum tube. You squeeze into a narrow seat, and a stranger guns the engines and you start trundling down a runway, hoping the heavier-than-air machine will actually lift off the ground before it smashes against the fence at the end of the pavement.

     No, I don't like to fly. And when I do, I pop a couple of pills, taking advantage of a little psychological aid called Lorazepam. Some people take Xanax instead. I wonder ... do you rely on a mood-altering drug when you fly, and does it help ease anxiety?

     Honestly, I don't really like to drive either -- dealing with the truckers, the speeders, the lane-changers and tailgaters. And then the hours and hours of sheer boredom as you sit there staring out the windshield at the ribbon of road ahead of you.

     All of this is worth it if you really, really want to be where you're going. And I do confess I'm ready to put up with the inconvenience of traveling when the weather gets cold in January, and the sun has disappeared, and my fingers are cracking from the cold, dry air -- and I just have to find a warm, tropical environment to bask in for a little while. I usually drive to Florida, where I take respite in the sun and the moist air for two or three weeks. A few times, I've bitten the bullet and stepped into an airplane for a flight to California or Arizona. Sometimes you just need a change of pace. And an airplane does get you there faster.

     But traveling to Europe or Asia or South America. Why? They don't even speak English there!

     Seriously, when I was younger and more adaptable, I traveled to Europe several times. I spent a summer in college bumming around Europe -- Spain, Italy, France, Germany, England and Ireland. But that was when I didn't mind sharing a bathroom with random strangers, and it didn't phase me to arrive in a city and not know where I'd be sleeping that night. I didn't mind struggling to communicate with people in a different language. In fact, I enjoyed unpacking my high-school French to see if it would work in the real world.

     And I do remember, later on, vacationing for two weeks in France with my wife. By the end of our stay, in Paris and beyond, and after a couple of weeks of practice, we could actually hold something that resembled a conversation with real, French-speaking people.

     But now? It's been a long time since I've spoken any French, and I only remember a few words, and the prospect of struggling through the language while impatient French people roll their eyes just seems like an unecessary annoyance.

     And forget about trying to navigate a vacation to Eastern Europe, South America or Asia, where I have no idea what the language is all about. Yes, some people speak English. But mostly it's the people who deal with American tourists, and it's their job to talk to you. To me that seems artificial. You get the tourist experience, but not the experience of the people who actually live there. Not to mention the fact that you don't know what they're saying behind your back!

     Besides, being a tourist doesn't appeal to me. You stand around and watch things. You go somewhere else and watch more things. Then you go back to your hotel (or cruise ship, but don't get me started on cruise ships!) and bed down in a generically furnished room. 

     I once proposed to B that after she retires we could take a trip around the world -- but only go to countries where they speak English. We'd go to England and Ireland, Israel, South Africa, India, Hong Kong, Australia. I thought it might be fun. And I wanted to prove to myself that the world is actually round. But B scoffed at the idea. She's not interested ... and probably thought I wasn't being serious anyway.

     To retirees who like to travel, I say more power to you. I admire your sense of adventure. But as for the rest of us, we shouldn't feel that we're missing something by not liking to travel. We shouldn't feel that we're somehow cheating our retirement years. Travel is one thing to do in retirement; but it's not the only thing, and it's not something we should feel required to "check off" in order to fullfill our retirement dreams.

     Besides, I say there's plenty to see in the world, even if you never travel more than a couple of hundred miles from home. For me, I can go to Boston and Cape Cod; to Vermont and New Hampshire, to New York City and the Hamptons, to Pennsylvania and the Jersey Shore and Washington DC. We've got the mountains and the beach; the city and the country; and all the cultural enrichments anyone could possibly want.

     Mais ... J'aime Paris au printemps. Peut-être qu'un de ces jours.

Can You Go on Vacation When You're Retired?

     Last week I wrote a post called A Weekend Away, reporting on a short visit B and I made to Pennsylvania. In response reader Kirk wondered:  "Does it count as a 'vacation' when you're retired?"

     Kirk, I don't know if you're retired yet, or just contemplating it, but you raise an excellent point. If you're not working, how can you take a vacation?

     I bet a lot of you -- those who have just returned home from Thailand or Tucson or Texas, for example -- may have your own view on the matter. But for me to answer the question I have to take a slight detour.

     I remember when I was working I once took a stay-at-home vacation. I looked forward to cleaning out the basement, fixing a window frame in the garage that had rotted out, and doing some yard work. I wanted to build a fence around our garden to keep out the raccoons, the deer, and whatever else was gobbling up our vegetables.

     So I made arrangements to take a week off from work. During the first weekend, my wife and I just did our usual activities with the family. Then, on Monday, I figured I could luxuriate for a while in my free time. After all, I was on vacation! I planned to get up late, relax over a long breakfast, maybe read the paper, then start in on my work around the house.

     Instead, on Monday, my wife decided that I should drive our daughter to pre-school, while she took care of the baby. This would give her a much-needed break. Oh, and how about picking up a few groceries on the way home.

     So that morning, as usual, I gulped down a cup of coffee, then instead of rushing off to work, I rushed my daughter off to pre-school. After that I went to the grocery store. I had to go to the gas station; and then stop at Home Depot pick up some shelves and some bins for the basement.

My basement today: What's my excuse now?

     I actually got to the basement about 3 p.m., and spent an hour clearing things out, before heading back upstairs and getting embroiled once again in the kids and the evening routine. Tuesday went pretty much the same way as Monday. Then on Wednesday I did do some work in the morning.

     At the time we had a standing date with a babysitter on Wednesday evenings. It was a night out for my wife and me. But that Wednesday I decided I was falling behind and better get some work done. So my wife went to the movies with one of her girlfriends, while I was chopping away at rotten wood in the garage, then sawing boards and trying to slot them into the window frame. I got halfway done before my wife came home, the babysitter left, and I hit the shower to wash off the dirt and grime and tend to a few scrapes and scratches.

     I did finally get the window fixed that week. Then I started on the garden fence -- although I ran out of time and ended up taking a few shortcuts, so the fence was never put in to proper specifications. My fence did keep out some casual visitors to the garden; but never the determined residents of my yard. We got some vegetables that year, but fewer than I'd envisioned.

     By the end of the week I was exhausted and frustrated. And that was the last time I ever took a vacation and stayed at home. Because when you stay home, it's no vacation at all.

     After that experience, we spent vacations at the beach, or we went to visit grandma and grandpa, or we'd go for a week at a family-type resort. We'd go anywhere just to get away from our normal routine, have some real time off -- and so I wouldn't have to spend a week trolling around the basement and garage and digging in the dirt.

     Now, many years later, people ask me: If you're not working, if you don't have responsibility for kids, how can you go on vacation? Aren't you on vacation all the time?

     The answer is no. Because when you're home you still have your routine and your responsibilities. Maybe it's not a job. But it might be your volunteer work. Maybe it's not the kids; but it might be your grandchildren. And you still have a house to take care of -- or at least I do. And the car to fix, and the bills to pay, and dinner to cook and dishes to wash, and beds to make and groceries to buy.

     So Kirk, take some advice from this grizzled old veteran: If you want a vacation, a real care-free vacation, go away from home.

Boomer Blogs Go Bragh

     These are exciting times. Tomorrow is St. Patrick's Day. Tonight there's a full moon. It's Purim. And today I bring you the latest edition of the Best of Boomer Blogs.

     Contrary to myth, a full moon does not bring out the werewolves, nor does it result in any more lunacy than any other time of year. The studies I found show that there are no additional emergency room visits on nights of the full moon, and there is no connection of any significance between the moon and the female menstrual cycle.

     But one study from Colorado State University found approximately 25% more visits to veterinary clinics for both cats and dogs on days surrounding full moons. Why? Nobody knows. It could be that people tend to take pets out more during the full moon, raising the odds of an injury. But then you would expect more visits to the emergency room from people as well, wouldn't you? So I can only conclude: Despite all our scientific progress, we are still surrounded by the mysteries of the universe.

     Speaking of scientific progress, Laura Lee, aka the Midlife Crisis Queen, says that this week we said Happy Birthday to the World Wide Web. Laura Lee was an academic librarian back then, so she remembers, and not too fondly, those stupid "gophers" and TCP/IP applications we had to learn about!

     Bart Drolenga of The Highway Is My Home is going another way this week. He spoke with Allen Egan, an artist born in Zimbabwe in 1962 who moved to South Africa and now lives in Gatineau, Quebec. His paintings are beautiful, intriguing and a little sinister. (Like the full moon?) His colorful life-size canvasses depict realistic scenes often with a touch of the surreal.

     And you might want to read about what Egan says it was like to live in Zimbabwe, and how he feels about getting older and what he has learned in life so far.

     Turning from the moon to that other celestial orb, Karen at The Generation Above Me says, "Now that spring is on its way, it's time to store up on Vitamin D by getting 10 to 15 minutes of sun a day." She reminds us that older people are at greater risk for osteomalacia and osteopenia, and she explores the health benefits of getting a little sun in her post Sunshine and Vitamin D. If you have any worries about your bones, you should check out Karen's research.

     On another health note, Rita R. Robison of The Survive and Thrive Boomer Guide writes about a study that shows more than 20 percent of older adults are being treated with drugs that work at odds with each other – the medication used for one condition can make the other condition worse. Boomer consumers, she advises, need to talk with their health care providers about possible drug interactions when they’re prescribed a new medication.

     As for me, my Irish roots go back through my mother's family to two brothers, Tom and Patrick Kiernan, who left their potato farm near Mullingar, in County Westmeath, around 1850, and eventually made their way to New York. But right now I've got my mind not on my health, or my ancestry, but on monetary matters.

     I'm one of the few throwbacks who actually does his own taxes. Why do I put myself through that crucible? Well, I'm not very good at any other do-it-yourself projects. I can't replace a light switch or fix a leaky toilet. But I am able to wade through the tax forms and the IRS website. So I figure I can at least do something to save a few non-tax-deductible dollars.

     I also believe that, in a democracy, a tax code ought to be accessible to ordinary citizens. In our country it's really not. The tax code, at about 8 gazillion pages, is written mostly for the benefit of corporations, wealthy individuals and special interests. It favors investors over workers, the wealthy over the middle class, rural residents over urban and suburban dwellers.

     So anyway, I've been busy with my calculator. Besides, I've already said what I need to say about our tax code, so I'll just refer you to Ten Lessons You Learn By Doing Your Own Taxes.

     Gee, I wonder if anybody has done a study about the association between lunacy, werewolves and the appearance of April 15 looming on the horizon.