My wife has an absolutely captivating accent gifted from her formative years spent in small town North Carolina. Just one of myriad traits that served to enchant me almost from the moment we met and continue to do so today. I say almost because, oddly enough, the first time we met, an industry meeting in Texas I believe, she was afflicted with a bad case of laryngitis and barely said a word to me, leaving me with the all too understandable impression…that she was decidedly less than impressed. Well, I’m not sure what combination of visual and perceptive disability coupled with a restricted prospect pool caused her to miraculously choose to embrace a life with me, but please don’t pinch her…I pray every day that she remains unwoke to the reality of her current spousal predicament.
But one of her loveable quirks is the somewhat sheltered belief that country music is somehow an exclusive possession of the South and that non-southerners likely should keep an enthusiasm for fiddles, banjos, steel guitars and the Boot Scootin’ Boogie predominantly closeted for fear of prosecution for cultural appropriation. I’m still a bit fuzzy on why it’s OK for Coke (Atlanta) and Pepsi (New Bern, NC) to be enjoyed openly north of the Mason-Dixon and yet Elvira (Giddy up, oom poppa, omm poppa, mow mow) should somehow be restricted access. She doesn’t seem to mind that the McDonald’s down the street sells sweet tea…
I’m a fan of many types of music. My father instilled in me a love of jazz and classical, my mom used to have hair down to her waist and played folk songs on her Martin guitar, my early teens were spent speeding around a skating rink “dancing” to KC And The Sunshine Band, and my rebellious later teens and twenties were dedicated to 70s and 80s rock. Somewhere along the way I purchased a cowboy hat, several pairs of boots and spent many a night in country bars developing a love for that genre as well. One of my favorite performers is Toby Keith, though I haven’t seen him in person yet, and the song that quite loosely pertains to the vastly belated point of this column is As Good As I Once Was. Although the vast majority of the lyrics are about as distant from my experience as the Pulitzer Prize is certain to be, two lines of the chorus loosely support my forthcoming point: “I ain’t as good as I once was, But I’m as good once as I ever was.”
Although this issue is the Life Insurance issue, it also boasts our 23rd Annual LTCI Survey—and it’s long term care insurance I’m about to critique based on my experience. My disappointments may likely be due to the reticence of one particular company trying to limit outflow with no prospect of new income—they’re out of the LTCI business now—but I encountered an unforeseen, perhaps due to my ignorance, decline of claim due to the strictures of the ADL provisions of my mother’s policy (and I suspect many others).
Backtrack a bit. Mom fell and broke her hip in March 2020, went to a rehab facility for about three months, and then returned to her home. As is too often the case with those in their 80s, her health and fitness slowly declined until her passing this February. We found a marvelous care coordinator/advocate and arranged initially for 18 hours of care—12 hours including overnight and four hours in the middle of the day. The purpose at that point was mainly to have someone there to help with chores that caused too great a strain, and to be there if another fall or other emergency happened. But that evolved as she declined into providing help (or at least oversight) for standing, sitting back down, trips to the restroom, etc. She could do these things herself, with varying degrees of struggle, but it was a mercy to have someone help her and a moral imperative to have these efforts at least supervised. Around that time it was decided we needed to get 24 hour care, and we did so. Somewhere in there we filed a claim for her in-home care and a representative came to evaluate her.
Back to Toby: “Now my body says, ‘You can’t do this boy,’
But my pride says, ‘Oh, yes you can.’”
Cognitive issues were off of the table. Mom was sharp as ever. But she showed that with great strain she could grab her walker and the side rail we had installed on her bed and raise herself to her feet. She showed that she could very slowly walk to her bathroom with her walker. She could transfer food from a plate to her mouth, and said that if forced to she could struggle to the kitchen and microwave a Lean Cuisine. She admitted that if on the seat in her shower she could clean herself and that she could pull on loose leisurewear and slide her feet into slippers. Most of these things (except the physical task of eating) caused great exertion, stress and discomfort, but could technically be done. The very real and severe danger that at any time during any of these activities she could fall and seriously injure herself if unattended apparently wasn’t a factor in consideration of the claim. The claim was denied, but by the time we received that notice she had declined further and actually had to be physically assisted in all but the transfer of food to mouth. Hospice was initiated and she passed only a few weeks later. Thank God as comfortable as possible, in her sleep, in her own bed.
Mom’s 24 hour care cost more than $5000 per week ($30x24x7). Thank God again that she could afford it. Her LTCI policy would/should have paid $123 per day. Quite frankly I just can’t see myself fighting as hard as need be to maybe recoup somewhere between $2500 and $7500 for however many months or years it would take.
I’ve found a great life serving this, I believe, noble business—don’t get me wrong—and I have great faith in many parts of it to help those in their times of greatest need or sorrow. My point is really that the adjudication of ADLs should at least more frequently take into account the stress, amount of exertion necessary, and risk of injury if unattended or unsupervised, rather than simply if, due to stubborn pride combined with a life tenet of honesty, a given set of tasks can, by strictest definition, be accomplished on this particular occasion by oneself.
Stats show that only a small percentage of brokers actively try to sell LTCI. It’s postulated that underwriting strictness, the spectre of dramatic rate increases, and the “use it or lose it” negative perception of the prospect combines to cause agents to shy away from the LTCI sale. I wonder, though, how many producers spurn LTCI sales because of pissed off clients who’ve had claims for just 17 percent of the daily cost of care similarly denied.
At this writing Hope’s been back in NC visiting family for four days, with five more “the thing most dear is absent” days to go until she returns. I’m still vacillating on whether or not to have Alabama playing on the Sirius when I pick her up from the airport.[SPH]
