Health Care : Insuring Against Hard Realities of Age and Illness

Agnes Herman is a writer, lecturer and retired social worker living in Lake San Marcos

None of us expects to be struck by a long-term, debilitating illness. Our unspoken feelings of invincibility keep us from planning sufficiently, if at all, for what could be a vulnerable future. "It cannot happen to me! It dare not," we tell ourselves.

We do not expect to fall prey to Parkinson's or Alzheimer's diseases, diabetes, a disabling auto accident, or the lesser complications of old age. But what we expect and what we get are frequently opposites.

When we feel well, we are usually able to cope with the challenges of making our life safe and comfortable in our homes. But when our ability to do this is threaten- ed or dimin- ished by serious illness or injury, we scramble frantically to find satisfact- ory and comfort- able arrangements. Confronted suddenly by the high cost of medical care, jarred by the reality of the shrinking dollar, we exacerbate the stress of the illness and thus complicate the planning process.

For our generation, care and comfort should be attainable goals for the second, and final half of our life. To ensure that, pre-retirement and retirement planning should include long-term health care coverage.

Some of us are confident that, if physical disaster strikes, our children will come to the rescue. I can't help but recall the old Jewish maxim: "One parent can take care of 10 children, but 10 children cannot take care of one parent!" Overconfidence, or poorly placed confidence, can create serious pitfalls on the road to security.

Our children mean well, but they do not always do well. A single parent working to raise children alone is not able to run between kids, parents and job with ease. Two-career family members may have the desire to help, but time is already cut into so many fragments: car pools, homework, extended working hours, housekeeping and cooking leaving little uncommitted time. Even those of our children sitting on empty nests may have the time, but not the stamina, the extra room or the inclination to provide a haven for parents unable to care for themselves.

Many of our children live far from California, and we hesitate to expect them to uproot their families for our well-being. But we do not look forward to a drastic geographic change, either. These realities--whether they strike us as harsh, hurtful or just plain honest--force us to plan for the moment when we might no longer, on our own, rise and shine in the morning, ready to take charge of the day.

I think of an uninsured relative who entered a home for the elderly at age 100. She did not require "skilled" nursing care, but she did need help to dress, to bathe and, frequently, to eat. She was fortunate; her funds were adequate to the challenge and she was able to afford the expense for proper custodial care. But every day of her life in that home she fretted that she would soon run out of money. She became sick with fear. The quality of her life suffered drastically.

There is a gentleman I know who suffers from Parkinson's, an illness that is robbing him, as eventually it robs all of its victims, of every shred of independence. He, too, does not require "skilled" nursing help, so his family pays a huge monthly fee to keep him comfortable and safe in a care facility. Barring a serious accident or a complicated pneumonia, this uninsured 72-year-old could live a long time, and his family's financial security could be blasted from its foundations.

Medicare does not cover "unskilled," custodial care. One can receive government-- usually, state--help only when one is impoverished. Although there are various national proposals to address health care issues, they are not likely to be in place soon.

Craig Perry is a health insurance agent who leads seminars in mobile home parks, senior centers and clubs in North County. He notes that, although one in 90 of us will suffer a loss due to a fire, one in three who are over 65 will require long-term health care.

We purchase fire insurance the moment we acquire property. We protect what we own. Yet, when it comes to protecting our dignity and our financial estate, modest or large, many of us are unwilling to face reality; someday, we may have to trade our independence for some kind of nursing home or custodial care.

We owe it to ourselves and to our families to guard against that eventuality. The earlier we consider this kind of insurance, the better; the cost is less when we are younger, more with the passage of each birthday. But it is never too late to catch up on long-term health care coverage--unless we wait until we are too sick to qualify.

It behooves each of us to find a qualified, professional health insurance specialist. There are a variety of policies offering a range of benefits. Insurance is not cheap. That is why choosing the proper agent is vital.

We need to think of the agent as a potential employee who must be trusted and will need to measure up to our expectations. A referral from a friend or family member can be helpful. Others in the insurance industry--such as your home or auto insurance representative-- may also have recommendations you want to consider. It is important to interview a prospective agent, to ask for and contact references.

Go to seminars on the subject--they are offered regularly through hospitals, insurance providers and schools. Do not be afraid to ask questions. Last June, Consumer Reports published a review of the overall market.

Have confidence in your own "vibes." Do you trust this person; are you comfortable with him or her? Is the company sound? Above all, begin planning for yourself.

According to a report published in Newsweek, July 16, 1990, only about 10% of the disabled elderly are in nursing homes. The rest are struggling alone, couples taking care of each other or dependent upon grown children, usually daughters.

One such daughter, who eventually had to place her mother in a home, still feels guilty. She states: "You think you should be able to do it all, but you can't. First you care for your children, then your mother. Pretty soon you just give your whole self to other people."

When my husband and I talked about the future to our adult daughter and mentioned the possibilities of debilitating illnesses, she got weepy: "Mom and Dad, I do not know if I could handle it!"

We do not want her to have to try.

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