ddunca1944 wrote:Puakinekine wrote:
We decided this year to stop our LTC payments. I don't think the pool will be large enough going forward for any of the insurers to survive and we should be able to self insure. I apologize if anyone has posted this article in previous threads, but it brings up what for me is the elephant in the room. After watching my father "dwindle" for ten years in a care facility, I do not want this for myself or my husband.
http://nymag.com/news/features/parent-h ... re-2012-5/
I read that story in its entirety. I also read all of the comments on it. I had two responses:
1) The author seems to be saying he did not buy LTCi because he's going to work out a do it yourself exit strategy (he doesn't say exactly what it is). There are a couple of problems with planning to "do it yourself". It's much, much more difficult to actually do. If you have a stroke in your sleep in the middle of the night, you've lost all control. If you slip into dementia you may forget where the location of the pills you hid, or you may not even realize you have a problem (my mother was in denial about her memory issues until she forgot who everyone was). So, the author may well be sentencing his kids to make the decisions and bear the costs.
2) The author is frustrated with the doctors and other healthcare professionals - understandably. But it was HE, with his sister who consented to heart surgery for an 84 year old woman with dementia (over the objections of his brother and the woman herself). Surely he and his sister bear the brunt of responsibility for her long decline. My sister and I are in agreement that mom will have no surgery, no invasive procedures, nothing other than comfort care should she be diagnosed with a physical problem.
3) Everyone should have the conversation with their immediate family (and follow up with an advance directive). My family has been told in no uncertain terms that if I am ever diagnosed with dementia I want nothing that will prolong my life: no surgery, no antibiotics, no insulin. nothing. If I develop dementia, my life will effectively be over and I don't want it physically prolonged.
4) Although the author admits that his mother is able to stay in a comfortable room with 24x7 personal care due to the LTCi she had combined with family contributions, he seems to blame LTCi for her lingering in the twylight. All LTCi does is make that lingering more comfortable. It did not create her problem. The author and his sister created the situation.
I did not look at what the author wrote in quite as black and white terms. I think the author very much knows and lives with the fact that he and his sister made the wrong decision. He writes with a tremendous amount of pain and grief and imperfect humanity. The author and his siblings had never done this before. They were in an extremely agitated, vulnerable, emotional state when making decisions, while receiving calm advice from professionals. I don’t know if you have been there with a parent or family member, but I think without knowing how badly things can go, it is very easy to let the professionals decide. They seem to know what they are doing, while you are out of your depth on all levels. We are programmed for optimism and certainly the medical system encourages this. Western medicine is designed to keep people alive. It is how people are trained. We are now discovering that at the end of life, this may not be such a good thing.
Yes, the author approved the surgery, and the article itself is in part a confession and in part a cry for a better way. What he says in conclusion is that “Anyway, after due consideration, I decided on my own that I plainly would never want what LTC insurance buys, and, too, that this would be a bad deal.” I read that slightly differently then you, not as an indictment of LTC insurance per se, but the system of horror that
partially enabled the misery he, his mother and his siblings endured. The money allowed it to happen, but he does not spell out what would have happened without it.
I too, was less then satisfied with the author’s plans for his future. But, if the author has plans to kill himself, or ask his wife to assist him, which in part seems to be the only way out of this situation, of course he can’t say that in the article. When I get to thinking about my plans, I can’t even say this to myself. I don’t know if I will have the courage. His children don’t seem to be able yet to face the conversation at all. I hope they read their father’s article.
Most of us dread the idea of being a financial or emotional burden to our children. I commend you for making your desires perfectly clear. But you can end up in a helpless state even without unusual medical interventions. That is what happened to my father. What then?
