Don Levin, JD, MPA, CLF, CSA, LTCP, CLTC

There is no doubt that we are in an incredibly unique, “once in a lifetime (if not century)” environment as COVID-19 continues to ravage our country, causing nearly 200,000 deaths at the time of this writing. For several months now we have continued to adapt to seemingly endless changes to what is now euphemistically referred to as the “New Normal.”

As you may know, I like change. I embrace it and view it as opportunity in its purest sense. Because of this mindset, the last few months have presented me with the opportunity to work on my business rather than just in it. I have attended more Zoom conference calls than I can shake a stick at, but have also learned a great deal about new products, sales, and operations processes, marketing techniques generally, digital marketing specifically, as well as taking advantage of the opportunity of investing time (as opposed to just spending it) on the creation and updating of our websites, marketing materials, and techniques (you could look at https://cloudcovermusic.com/music-for-business/streaming-services-retail/ for more ideas), and other proprietary intellectual property.

Sadly, I have had many professional associates lament about how frustrating and discouraging this time has been, and to those folks I can only say I am sorry, because I know that for some this has been a period of great growth and focused energy but only if they chose to make it so.

When I realized that this pandemic was going to be much larger and longer than originally portrayed by our nationally elected officials, I resolved that I was going to grow through it, and not simply go through it. I promised myself that I was going to be able to look back on this period and be able to quantify how I had invested my personal time as well as my professional time.

As a result, in addition to completing some major projects around the house, I also resolved to add relatives to my family tree by engaging in a regular rhythm of genealogy research, read countless books, write another book of my own in its entirety, and continuing to work on the other three that are in different stages of progress. I also resolved to write additional professional articles, the fifth of which is being published this month. I mention these accomplishments not to brag, but rather in the spirit of transparency and to report to my numerous accountability coaches. It has been time well invested.

Professionally, I have engaged in recruiting, training, and marketing efforts, and for the most part, aside from a total lack of travel, it has been business as usual because I chose to make it business as usual! Of course, only having to dress formally from the waist up for Zoom calls has been a summer treat.

Just as in the days following the tragedy of 9/11, people are recognizing that life can change in the blink of an eye. The stay at home orders and other issues that have precluded easy interstate travel have also raised the specter of long term care being/not being provided to loved ones by family members. These realizations have been the foundation of several personal sales that I have achieved as people respond to their own self-actuated call to action.

The economic upheaval and rollercoaster ride of the stock market has also raised awareness that not only are we physically vulnerable to the Coronavirus, but also financially vulnerable. Some of us have been approached by either prospects or complete strangers who are seeking out our expertise and assistance in constructing a plan that provides security and peace of mind against the scourge of long term care.

To this end nothing has changed. We have the expertise and technical acumen to assist people in creating a shield against the ravaging effects of long term care that ultimately safeguards themselves, their families, and their communities. To do this, however, we must get in front of these people. If they are not contacting us then it is incumbent upon us to continue our efforts to network and form strategic alliances and relationships; it is about being proactive and using available digital marketing strategies with which we can assist you to build your status as the Long Term Care Insurance Advocate in your marketplace.

I know that there are producers out there who are still mourning the passing of the company generated and provided direct mail lead-but those days are long gone. We have been in a new place for quite a while now, and the pandemic has served to solidify several new ways of doing business-not the least of which is the ability to offer our products and services virtually. Personally, while Uberconference, Join Me, and GoToMeeting have long been arrows in our quiver, I have no doubt that Zoom with all of its inherent flexibility has supplanted all of them as part of the New Normal.

From time to time I feel bad; not for myself, but rather for my grandkids who want to “experience first grade in person at school” (yes, my six year old granddaughter expressed it just that way) and for friends and family that are feeling trapped and isolated as summer quickly passed us by.

So that you too don’t fall into this trap I exhort you to do something! Do something that is going to provide you with a sense of accomplishment in the moment or for the day. It can be something as simple as finally getting around to organizing that file cabinet, cleaning out the desk, and making random calls to your existing clients. (I’ve done all these things too. The next project is the garage.) Reach out to those people you collected business cards from at the Chamber of Commerce or BNI meeting and simply have not “gotten around to calling.” You will be astounded at how good you will feel as a result of taking these small steps. The journey of one thousand miles starts with that first step!

Because we don’t know what the future holds or how long we will be battling the pandemic, resolve that you too are going to grow through it by setting some smart goals for yourself, your business, and your family, and make the balance of 2020 memorable for both growth and success.

In the 1990s, when I began my career in the long term care insurance industry, the average age of our client was 68 years old. These people were part of either the Silent or Greatest Generations, having fought in World War II or Korea, and coming of age during the Great Depression. They were retired, which meant they were home during the day and available for a daytime appointment. Morning or afternoon was the ultimate “either/or” close, as we dutifully filled up our daytime slots. All that was left to decide was whether I would be intruding during The Young and the Restless or Jeopardy! They usually were comfortably retired with a pension to support them (Social Security was often thought of as an “extra”), in a home that was mortgage-free, and there was no such thing as credit card debt for these folks. Nonetheless, they were just worried enough, or practical enough, about the potential cost and risk of going to a nursing home that they would tear off the card, fill in their personal data, and send the (lead) card back to the carrier who in turn would give it to someone like me so that I could call to set an appointment that would take place at their kitchen table.

Today, our clients may be Baby Boomers or Gen-Xers, as young as in their 40s and 50s or well into their 60s and 70s. While some are retired, most are not, still finding themselves working out of necessity as they prepare for a longer retirement with a defined contribution plan at best, Social Security filling a prominent amount of household revenue, a freshly re-financed mortgage because of the incredibly low interest rates and with student loans for their children and/or debt from the care of their parents. For those who have been caregivers or experienced writing the checks for parents requiring facility care, they are more than aware of the burden and financial devastation associated with long term care. Because of conflicting work schedules, we are now required to conduct an evening appointment that we consummate via Zoom and by sharing our computer screen to illustrate the various and sundry plans but also to complete the application electronically.

Some six months into the pandemic and the end of three months of staying close to home, there is no doubt that COVID-19 continues to be a huge wakeup call for a large number of people now faced with the daunting task of confronting both their morbidity and mortality. Our producers have received calls from individuals, as well as strategic partners in both the financial services industry and the practice of law, for assistance with their respective clients—all of whom want to guard against the potential of having to enter a long term care facility which has proven to be a deadly experience for a great number of Americans in 2020.

For some of us, who have fortunately avoided contracting COVID-19 by observing strict social distancing and the wearing of a mask when we do venture out from the safety of home, this pandemic has revealed the shortcomings and impracticalities of relying on family. While our children will always be busy with their own families, careers, and life challenges, the pandemic has cast a harsh reminder that one parent can care for five children, but five children may not always be able to care for one parent. The inability to travel and the fear of transmitting or contracting a deadly disease will definitely be a challenge to caregiving in the future.

In the course of talking to clients, as well as other professionals, I have not heard anyone clamoring for the opportunity to be placed in a skilled nursing facility; more than ever people want to stay within the secure and comfortable confines of their own home. These long term care facilities, often frequented by the elderly at the end of their lives, have been absolutely ravaged by the pandemic as residents and caregiving staff alike have succumbed to the coronavirus.

Some twenty-five years ago while still practicing law in Chicago, I helped move my maternal grandmother to a very nice skilled nursing facility. No longer able to reside in my mother’s home, her Parkinson’s, as well as related dementia and a broken hip, made the change in venue a necessary one. My grandmother was an elegant woman with well-coiffed hair and air of dignity about her. I saw her lose that dignity during her stay in the facility.

The cost in 1995 was $5,100 per month, but the average bill we received for payment from her assets usually exceeded $6,200 each and every month. While I had the option of paying five dollars and dining with her, consuming a lovely meal in the dining room where the tables were replete with linen table cloths, beautiful crystal, china, and silver tableware, when it came to care I was brought face to face with the ugly truth that there are certain things a man should never be called upon to do: Namely changing his grandmother’s diaper. My wife or I would pop in once or twice daily, and would often find my grandmother with a wet diaper. We would hit the call button, and after twenty minutes had gone by, find it easier to change the diaper ourselves. As one of my clients recently said to me, “Yeah, I want to pay big money to go to a facility and to have my basic needs ignored.”

I had occasion to visit a rather upscale facility in Houston, TX, last summer, long before the pandemic was on our horizon, and, candidly, I was uncomfortable from the time I entered until I left. The “smell” of the facility and the vacant stares of people seated strapped into wheelchairs or into beds, often sedated, only added to my level of discomfort and angst. The contrast offered by home health care never looked more appealing to me and made me grateful for the long term care insurance policy that is a cornerstone of our long term protection and financial plan.

The cost of care is going to continue to go up for any number of reasons. Annual increases in costs for care in facilities is nothing new, but now home care costs are increasing at a quicker pace as well. Care provided by home health care aides is now costlier than ever due to a variety of factors that include the following (based on preliminary research conducted with care providers from September 25 to October 3, 2018):

• Previously record low unemployment
• Wage pressures
• Regulatory changes
• Labor shortages
• More chronically ill patients
• Employee retention challenges

Covid-19 is exacerbating an already difficult situation.

If there is a silver lining to this otherwise dark cloud it is in the form of a wider spectrum of product offerings that we can make available to a general public committed more than ever to avoiding time in a long term care facility. Traditional long term care insurance remains the best means by which to leverage existing assets and cash flow in terms of premium paid and immediate access to policy benefits. Life insurance, living benefits, and annuities with varying riders that provide long term care protection also provide the practitioner and the policyowner with greater latitude in establishing a plan that is custom tailored to fit the needs, wants and desires of the policyowner.

This wide range of product offerings also provides more options to incorporate the concept of co-insuring the associated risks and costs of long term care if this is a desire of the consumer seeking protection.

Many are making the need for long term care an essential element of not only their financial plan, but also their long term vision as they contemplate where they want to receive their care. Many 55-and-older senior living communities are incorporating these physical needs into their floor plans and new construction. As a result, people are purchasing homes without stairs, with wide hallways and doorways that will accommodate a wheelchair or that are already equipped with grab bars and ramps in lavatories and key areas. If these items are not present, traditional long term care insurance plans have very generous allowances for home and equipment modification.

At the present time, 69 percent of all new long term care insurance claims originate with care beginning in a home environment. Later generations of these policies have placed an emphasis on keeping policyholders in this environment for as long as possible because it is more often than not cheaper for the carrier as well as better and more desirable for the policyholder. In the event the policyholder elects to move to an assisted living facility, either for socialization or medically-required treatment or custodial care, this is still a viable alternative for about 16 percent of claimants. For these reasons, only 15 percent end up in the skilled nursing facility where they will typically remain until death.

Older policies may very well offer alternate plans of care. We have found carriers often are very flexible in interpreting or establishing these alternate plans of care because they recognize that staying at home is a better scenario for the policyholder, the family, the caregivers, and the carrier. The home health care industry has literally exploded in the last several years as this critical need is being addressed by a wide range of entrepreneurs willing to address and answer this critical question of supply and demand.

Often overlooked is the consideration that family members are more apt to visit a private home rather than the facility and to do so on a more frequent basis. Family members do not feel as “freaked out” when visiting a loved one in the family home as they do when doing so in a facility. They are apt to stretch out the visit and stay longer, and may even spend the night if a long distance/travel is required to achieve the visit.

There is no doubt that everyone is happier with a private residential care scenario that also precludes the aforementioned ominous and distinctive smell of the facility. Often overlooked is the psychological impact of the nursing home on the family members as well as the patient.

At present, one in every six adults in the United States is an unpaid caregiver. That translates to 44 million caregivers. While most of these caregivers will provide the care for a spouse or parent when called upon to do so, the vast majority would most assuredly prefer to supervise the full time caregivers for which a long term care insurance policy will pay. Long term care insurance is of great assistance to them, and truly protects the family caregiver as much as it does the person requiring care by sparing them the physical, emotional and financial/career agonies ancillary to providing this care. In a large number of cases, family caregivers are worn down by this demanding responsibility and their own subsequent need for care is precipitated by this faithful service to a loved one. A long term care insurance policy is a great resource in that it provides choice and an alternative to the facility.

The key to procuring this protection is to do it while both young and healthy enough to qualify for coverage. While we pay for the associated premiums with our money, we buy this protection with our health.

Last week I wrote about the New Normal that has been inflicted on all of us as we deal with the Coronavirus as a global pandemic. Quite a bit has changed in a week. Now, over half of the population of the United States is under one form or another of a governmental or voluntary lockdown. Over 53 million kids are home from school, prompting parents from all walks of life to joke about “family distancing” in addition to social distancing.

In the past week, our carrier partners have been active in reaching out to us at the BGA level to determine what they can do to assist us as we assist you to maintain some form of New Normalcy as we collectively strive to serve our clients.

We know that this situation is not permanent, and that gradually we will return to the Old Normal where we will be free to congregate in groups of more than two, actually consume dinners in a restaurant, attend sporting events, movie theatres, and send our children back to school. But what do we do until the country does “re-open for business?”

Fortunately, we have a product that lends itself to being offered to clients over the phone and virtually by sharing our computer screen. For a good number of you it really has been “business as usual” as we continue to call leads, referrals, and continue our networking and prospecting activities via the phone.

Because our target market is not the hourly worker who is concerned about the loss of employment or how they are going to make ends meet this month, but rather the salaried middle class Baby Boomer/Gen-Xer who is now working from home, this is an opportune time to reach them, more often than not with time on their hands, as well as a desire to speak with us about something that they have knowingly been procrastinating.

I want to make sure that you don’t squander this opportunity and understand what it means to work from home. As more and more of my personal and work friends have begun the drudgery or challenge of working from home, I have been saying in a joking manner that the New Normal is pretty much my Old Normal of the past four years at least. As more and more carriers gave up their career sales forces and closed regional offices, for most long term care insurance producers working from home is nothing new. For our financial advisor, attorney, and other insurance producer partners, this might be something dramatically new to you. For all of you I want to share some of the things that I have learned over the past 40 years, half of which I have spent working from home.

• If you are an early bird, start work early. I started writing this piece at about 5:30 a.m., thought about it as I worked out, and then decided not to even check my email until I had captured these thoughts before they leaked out of my ears.
• Get your workout in. Even if you are a “gym rat” and cannot go to the gym or YMCA because it is closed, find something to do at home—elliptical, treadmill, walking, biking, or even an old workout video. Getting the blood circulating and shaking the cobwebs loose is critical. I always feel better prepared for my business day once my workout is checked off the list.
• Get showered and get dressed. It is hard to be taken seriously if you are sitting in a video conference in your pajamas and a bathrobe or you look like you just got home from the bar. For years I have known that when I dress for success, I feel more successful, and I more successful. I am not advocating a suit and tie, but business casual attire is enough for me to know that I am supposed to be in work mode, though summertime still means a pair of shorts but a nice shirt.
• Keep to a definitive schedule. If you start early and log your eight hours, hey, you’re done for the day. Go do something for yourself or with your family. Do something creative and take advantage of this “found” time.
• Take breaks every hour. I only recently started doing this mainly to improve my overall health and to feel better. Now I make a point of getting up from behind my desk and computer, walking around the house–inside or even better outside—and make the conscious effort to check my Fitbit for the extra steps I can put in. If I don’t have to be in front of my computer I am walking around and, as my neighbors can attest, it is not unusual to see me out on the driveway or walking laps around the backyard while on conference calls. Last Monday was a beautiful day here in Boise and, with about five hours of phone time, it was easy to log more than 25,000 steps on my Fitbit literally without breaking a sweat.
• Keep track of your time–billable hours if you will. From the time I was an attorney, and keenly aware that “billable hours” were the fruit of my labors with which I fed my family, I have always kept tabs on my work hours. It is how you know that you are not cheating yourself or employer and that you are achieving balance in your life.
• Finally, when you are done working, leave the work at the desk and leave the room so that you can “go home.” Without the “decompression” time in the car, be mindful of switching from work mode to family mode, especially if you have younger children or grandchildren in the vicinity.
• As we have said each year in our annual holiday selling tips, it is imperative that you know when you are working, and when you are playing. Set expectations for yourself, and boundaries for yourself and your family to be respected. It has been entertaining to watch late night host Jimmy Fallon attempt to do the Tonight Show from home as his young daughters interrupt the monologue or other guest interviews. He is one of the proponents of family distancing.
• Look for the bright side of things:
  • No commute and its accompanying frustrations. I jokingly say to my wife each morning, “Going to the office,” and close the door to my study as I enter the work world. She humors me.
  • No wasted time in the car. I love the fact that I am no longer commuting up Washington State Route 167, burning anywhere between 45 minutes and two hours to transit the 24 miles to my office twice daily. It is amazing how much happier and less frustrated I am by only having to transit 24 steps to complete my commute.
  • Extra time to do something you want to do. As some of you know, I am a closet author and genealogist. I love the fact that I can carve out time each day to follow these pursuits with no accompanying guilt.

Remember, this New Normal is not going to last forever. We will resume life as we knew it before this horrible sickness began to spread around the world. In the meantime, practice common sense and follow the guidelines about social distancing, washing your hands, and not taking unnecessary chances, and talk to your clients, other professionals, and centers of influence. More than ever before we all can live that Life of Significance as we have been challenged to do by Joe Jordan and others who have learned from bitter experience the impact of not having a plan for the future.

Avoiding The Tragedy Of Long Term Care

The word tragedy was derived from the Greek word tragoidia which literally means ”the song of the goat.” It is called “the song of the goat” because in ancient Greece the theater performers used to wear goatskin costumes to represent satyrs. Today in theater and literature a tragedy is a work that has an unhappy ending. The ending must include the main character’s downfall.

According to Aristotle, “A tragedy is the imitation of an action that is serious and also, as having magnitude, complete in itself; in appropriate and pleasurable language; in a dramatic rather than narrative form; with incidents arousing pity and fear, wherewith to accomplish a catharsis of these emotions.”

William Shakespeare wrote a great number of plays. They ranged from comedies to tragedies. A Shakespearean tragedy is characterized by a range of elements: A main character cursed by fate and possessed of a tragic flaw; a struggle between Good and Evil—external conflict imposed as a result of plot or opposing evil character, or an internal conflict where the hero has to struggle with his own demons.

Everyone considers the story of Romeo and Juliet as the quintessential love story but remember it was a tragedy—their love story most decidedly had a very unhappy ending.

A more contemporary definition of tragedy includes: “A lamentable, dreadful, or fatal event or affair; calamity, disaster.” In my minds eye, that definition would certainly include the ravaging effects of a long term care episode.

In our agency, we refer to ourselves as Long Term Care Advocates, but peel away the veneer, and we remain no different than anyone else with an insurance license: We sell an insurance product—we are sales people. While we remain more popular than a car salesman or member of Congress, like every other sales industry our carrier partners measure our success in the amount of premium generated each year.

Because we are sales people it can be very easy to lose ourselves in the numbers related to premium sales, find ourselves caught up in the excitement of being a leading producer, reaping the benefits of this status while enjoying the luxury of exotic trips offered by the carriers—all the while forgetting about the people behind the policies and the numbers.

As an attorney in a former life I had experienced crafting hundreds of wills, for a multitude of clients, without having any of them die. To this day I still have several file cartons containing hundreds of wills in my garage. And then it happened: One of my clients died, and I was instructed by a family member and executor of the will that I should file the will with the Clerk of the Court and consider myself retained to represent the estate in court. That was a huge reality check for me. I had fallen into the trap of thinking of these estate planning clients in the abstract; it never occurred to me that someday one of them might even die and this intellectual exercise of selecting trustees, guardians, and the considered disposition of their worldly possessions could become a reality.

Fortunately for me, my first claim in the long term care industry arose only about seven months after I entered this new profession. Ironically, both of my clients had purchased their policies only a few months before, while in excellent health, even achieving preferred health status at ages 78 and 75 respectively. What went wrong? Their health took dramatic changes for the worse, in ways unimaginable, and the end for both of them came on very suddenly. Because I had promised to be the “face of their policies,” when the need to file claims arose they reached out to me, and I was both honored and a little overwhelmed to assist them with initiating calls to the claims department of the carrier. Fate smiled on me, and a very helpful claims analyst seamlessly took charge of the process, mindful of making me “look good” to the clients and their family even though I was quite superfluous to the claims process equation, and provided great assistance in establishing care in the home for these two fine people.

A mere three months later I was walking through the post-funeral reception at their home, with their daughter on my arm gratefully introducing me as “Daddy’s long term care agent,” and encouraging people to take my business card (making me feel somewhat like a ghoul). Twenty years after that experience it still remains a surreal memory.

That otherwise tragic experience was a dramatic wake-up call for me and, without a doubt, made me into an advocate committed to spreading the word about how invaluable this insurance product can be if purchased early enough.

Those two gentle people, happy to still be mowing the lawn [in black knee socks, sandals, and Bermuda shorts] or working three days a week in a large retail store at the mall, enjoying life with their children and grandchildren, still remain larger than life memories to me. Meeting them, serving them, advocating on their behalf, impressed upon me how fragile life is for all of us, and how our worlds can be changed by an accident or a doctor’s visit or diagnosis; that our daily lives and routines remain subject to the randomness of fate and science.

Despite the fact that we live in the Time of Instant Everything, where information is literally at our fingertips with search engines such as Google, and news is available on a 24-hour basis, there are certain topics that remain far below the radar screen. While a baby is born to the Royal Family in England and the joyous news is spread instantaneously, or a plane crash anywhere in the world is a tragedy of which everyone becomes instantly aware, long term care is something so very few know anything about. Quite often it is not until a routine physical examination becomes a life changing event that people consciously begin to plan, much less think about, their long term care.

For years I have referenced Christopher Reeve and Michael J. Fox as “poster children” for long term care, even including them in the body of the home interview that I conduct with clients.

Christopher Reeve had it all. After studying at Cornell University and the Juilliard School in New York, he became known around the world as Superman. At 6’4” his natural physique allowed him to appear in this role in four major motion pictures. His life changed instantly and permanently, nay even tragically, when at age 43 he became paralyzed from the neck down following a horseback riding accident. He also required a respirator to assist with his breathing for the balance of his life. But for the good graces and fund raising efforts of close friends like Robin Williams (a fellow Julliard classmate) he and his family would have faced cataclysmic financial disaster in terms of his long term care. He died nine years later at age 52.

At the age of 29 Michael J. Fox was at the height of his career. He had starred in the highly acclaimed Back to the Future trilogy, as well as other feature films, and was starring in the top rated television show when he was diagnosed with Parkinson’s Disease. He was able to continue for an additional seven years before publicly revealing the diagnosis, but was forced to semi-retire from acting at age 39 when the symptoms became problematic.

Long term care. What is it? More often than not it is an event like Reeves’, or it can also be a slow decline in health like Fox’s. Essentially, it is an episode of our life when we can no longer take care of ourselves during which we may need assistance with the Activities of Daily Living (ADLs) which include bathing, toileting, transferring, eating, dressing, and continence, or suffer from a form of cognitive impairment requiring custodial care due to safety concerns.

Life expectancy for those alive when Teddy Roosevelt was president was age 47. By the time his fifth cousin Franklin Roosevelt signed Social Security into existence, life expectancy had risen to age 63. Today it is over 81. We are living longer, dying slower. Advances in medical and pharmaceutical treatments, and the ability to adopt healthier lifestyles, favorably impacts and alters the demographics of our society and we continue to age in place.

James Doohan, Jimmy Stewart, Glen Campbell, Rosa Parks, Peter Falk, Pat Summitt, Perry Como, Charles Bronson, Rita Hayworth, Norman Rockwell, Sugar Ray Robinson, Casey Kasem, Aaron Copeland, and Burgess Meredith. Robin Williams. Ronald Reagan. What do they have in common? Alzheimer’s Disease. Like many of the thousands of people we’ve talked with over the years, none of them seriously considered they would ever have to deal with something as devastating as this disease. For this reason I am grateful for the opportunity to have helped each and every person who has purchased a long term care insurance policy and addressed this major risk in their lives.

Sadly, Alzheimer’s is also known as The Long Goodbye, during which the afflicted patient slowly suffers mental and physical deterioration; it is a nefarious disease that effects people from all walks of life. It does not discriminate between the wealthy and the poor, the publicly famous and the private person. While hugely expensive financially, even worse is the emotional toll on the circle of family and friends as their loved one slowly slips away.

Alzheimers has always been with us. It was often referred to simply as dementia or as “hardening of the arteries,” but largely did not reveal itself unless the afflicted person lived into old age. Today we also battle other debilitating diseases: Parkinson’s and Muscular Sclerosis with Michael J. Fox, Muhammad Ali, Neil Diamond and Linda Ronstadt victims of these diseases, their voices being quieted.

When it impacts people we know due to their public profile, it may even temporarily raise awareness and maybe even serve as a call to action.

Global warming and climate change seems to be making weather across our country far more violent and extreme. We cannot alter it. But we can prepare for it. Likewise, we can’t prevent the onset of long term care, but we can prepare for it so that its impact is not devastating.

Ronald Reagan made his affliction with Alzheimer’s a matter of public record in order to raise awareness. I personally witnessed the courage and grace of his daughter Maureen, wife Nancy, and other family members as they publicly spoke lovingly and openly about the slow demise of this man.

Our clients, and those people not yet our clients, need to speak with us, to be educated, and to take action to be prepared for the pandemic impact of long term care. More than half of all claims are for cognitive impairment simply because we are living longer as a society, and over 71 percent are for female policyholders because of their greater natural longevity.

I resolved years ago that I was not content with being part of the problem, preferring instead to be part of the solution. I exhort all who are reading this to join me in this crusade.

Much has been written about the various generations and their buying and spending habits. From the Greatest Generation and their children, the Baby Boomers, to the Gen-Xers, the younger Gen-Yers on down to the ever growing influential force known as the Millennials.

Twenty years ago, when I joined the long term care industry on a full-time basis, life was simpler. While there were nearly ten times the number of carriers in the traditional long term care industry, most of us were captive agents—part of a particular carrier’s career shop. There may have been a few different versions of the long term care insurance policy to offer the client, but it was largely one-size-fits-all, and, because of contractual limitations, a great many of us were prompted to be myopic in our view of what to offer the client. Add to this scenario the fact that most of our clients were an average of sixty-eight years of age, retired, living on a fixed income consisting of an employer-provided pension supplemented by Social Security, with a paid off mortgage and little debt, it was easy to serve this relatively homogenous population segment.

Today our clients come from all walks of life, the various and sundry generations, with varying financial situations that demand our consideration of the financial suitability of the various products and carriers that we can now offer them. This is both the good news and the bad. As long term care advocates, it is now incumbent upon us to know a wider spectrum of product offerings ranging from the familiar traditional stand-alone long term care insurance (7702(b) tax-qualified, partnership eligible) plans to the hybrid and combination plans that bring the features and benefits of life insurance and long term care together, as well as the mixed underwriting with the contrary focuses on mortality and morbidity. Add to this the need to know the funding mechanisms permitted by applicable Federal regulatory and statutory laws, as well as the features and benefits offered by these plans, and it is far more demanding an industry for the average producer than in past years. There is no doubt that acquiring and maintaining the requisite technical acumen with which to best serve the client is also a challenge that must be met head on.

In addition to knowing the often subtle differentiators between products and the carriers offering them, the producer must now concern himself or herself with the need to market themselves. Leads are pretty much passé, and a producer has to network, market, and prospect with the intent of building a network of strategic alliances to get in front of more and more people.

What has not changed over the years is the need for producers to enhance the education and awareness of not only the general consumer, but also the strategic partners that already have the relationship with the client we are seeking. Teaching and counseling remain very successful and non-threatening means by which to help these clients and their advisors help themselves.

All of this notwithstanding, I believe that the single largest challenge rests with knowing your audience. How does a producer really know which product is going to serve the client best? Quite simply, by asking questions, listening intently and engaging in diligent fact-finding. To further facilitate this effort, I also believe that some general statements about the buying habits of the various generations can now be made based on the buying habits exhibited relative to other goods and services that they are purchasing.

To understand this concept we can apply the Law of Diffusion, but first, a bit of history. The concept of diffusion, as it was first known, was studied by the French sociologist Gabriel Tarde in the late 19th century and by German and Austrian anthropologists and geographers such as Friedrich Ratzel and Leo Frobenius.

The Diffusion of Innovation (DOI) Theory was subsequently developed and refined by Everett M. Rogers in 1962. Rogers was the Distinguished Professor Emeritus in the Department of Communication and Journalism at the University of New Mexico. It remains one of the oldest social science theories. It originated in communication to explain how, over time, an idea or product gains momentum and diffuses (or spreads) through a specific population or social system.

The theory essentially seeks to explain how, why, and at what rate new ideas and technology spread. Rogers proposes that four main elements influence the spread of a new idea: The innovation itself, communication channels, time, and a social system. This process relies heavily on human capital. The innovation must be widely adopted to be deemed self-sustainable. Within the rate of adoption there is a point at which an innovation reaches critical mass and general acceptance ensues.
With most goods and services, and the industry immaterial to this discussion, the law of diffusion mandates that the buying habits of the public can be broken down in the following manner:

If we apply the Law of Diffusion to products such as laptop computers, smart phones, DVD and Blu-Ray players it becomes apparent that there are those people who will stand in line for hours (or days in some cases) to be one of the first to have the latest innovation. At the same time there are those who will stand back and watch what all of the hoopla is about, and then some of us content to be part of the late majority who will jump on the bandwagon only after all of the bugs have been worked out or our own current version of the VHS player or the flip phone suffers an ignominious death.

If we look at it in generic terms and apply this concept to the heretofore identified generations utilizing ten year increments to the planning and buying habits relative to long term care insurance and related products, we see that the Law of Diffusion manifests itself largely along the same lines.

I believe many will draw the conclusion that the diffusion chart for LTCI looks to be on the identical path of VHS tapes, flip phones, etc. However, while chart segment definitions could be similar they certainly are not the same. With literally millions of years of client data, LTCI has never been more pertinent and needed than it is now. So, dive deeper… What happened? It may relate to a change in the way many people now think, and their desire to live today with all the “stuff” they can have now, including things bought on credit, as well as those things they do not yet have but strongly desire. Far beyond seizing the day, these people live for the day and worry about saving for the future later. Further complicating things are the misconceptions under which these people are now laboring. While some freely admit that they should have this valuable insurance, they believe that it is too expensive to purchase and maintain. Others may falsely believe that they will not personally need it, or that there will be time to worry about it later. These falsehoods represent the very heart of the challenges we face as LTCI advocates.

Further undermining the sales of these critically needed products is the laissez-faire attitude of producers, past and present, who demean themselves to the role of order taker. They ask a couple of questions. If the clients elect to buy, great. If they don’t, see you later. To be fair, some are better than others in guiding a prospect through the sales process that allows them to feel comfortable and focused on taking care of a future long term care need now. The most powerful tool for the producer in creating an immediate desire to buy LTCI is the experience of having cared for a family member for an extended period. With this experience in the client’s background it is not uncommon for us to hear, “I don’t want my kids to go through this with me.”

We know that Millennials are saving for retirement and do not believe that Social Security will be around in the same manner that their parents can rely upon. Some are actively pursuing retirement vehicles and even borrowing from some of these plans to simultaneously attain the status of homeowners. They want what we have and they believe they can achieve it because of the accelerated nature of the world in which we live, but also that it is easier to address such future needs now while they are young, healthy, and the product is available at very modest premiums.

Their parents often find themselves as part of the sandwich generation, namely caring for aging parents (or footing the bill for their care) while also supporting children in pursuit of higher education. This oftentimes is being done completely to their own financial detriment as they sacrifice their own long term care planning needs, saddling themselves with second mortgages or borrowing from their own retirement plans.

Why talk about the Law of Diffusion? Because it is imperative to know where along the Bell Curve your client falls in terms of their general mindset toward the line of products that we have to offer them as long term care advocates.

Opinion leaders have the most influence during the evaluation stage of the innovation-decision process particularly on late adopters. In addition, opinion leaders typically have greater exposure to the mass media, greater contact with change agents, higher socioeconomic status, and are more innovative than others. They in turn utilize people like Maria Shriver, Rob Lowe, Tom Selleck and Henry Winkler who are only a handful of celebrity endorsement partners employed to talk about the virtues of products ranging from long term care insurance to home wquity conversion mortgages (reverse mortgages).

Research was done in the early 1950s at the University of Chicago attempting to assess the cost-effectiveness of broadcast advertising on the diffusion of new products and services. The findings were that opinion leadership tended to be organized into a hierarchy within a society, with each level in the hierarchy having most influence over other members in the same level and on those in the next level below it. The lowest levels were generally larger in numbers and tended to coincide with various demographic attributes that might be targeted by mass advertising. However, it found that direct word of mouth and example were far more influential than broadcast messages, which were only effective if they reinforced the direct influences. This led to the conclusion that advertising was best targeted, if possible, on those next in line to adopt, and not on those not yet reached by the chain of influence. Think about the influence of commercials aired during the Super Bowl, or the mass appeal of the iPhone and how it has changed the very fabric of our society.

Prior to the introduction of the internet, it was argued that social networks had a crucial role in the diffusion of innovation. Imagine how your own buying habits were influenced by first print ads, radio, television commercials, and now social media. I dare say that anyone contemplating a major purchase of any kind begins the buying journey by engaging in a search on the internet.

Public consequences comprise the impact of an innovation on those other than the individual, while private consequences refer to the impact directly on the individual. Public consequences usually involve collective actors, such as countries, states, organizations or social movements. Can there be any doubt that long term care can bring down the Medicaid system as it remains the number one line item in each state’s budget, most of which are drowning in red ink? Can there be any doubt that the issue of long term care for our elderly has reached a level of pandemic importance? As noted, private consequences usually involve individuals or small collective entities, such as a community or, in our industry, the family. Can there be any doubt that caregivers suffer consequences ranging from poor health and loss of socialization to lost wages, retarded employment opportunities and lack of career advancement? The innovation of long term care insurance is most assuredly concerned with the improvement of quality of life as well as the reform of organizational or social structures.

It is with this very quality of life issue that we find ourselves most concerned as we continue to seek out the methodology that will permit us to reach the public and provide them with the critical information necessary for them to reach an informed decision and to answer the call to action necessary to protect themselves and their families against the scourge of long term care.

(D. Jeffrey Levin, Jr., MBA, CLTC, also contributed to this article.)