What's worse than a prison sentence?

I found this story linked on my daily email from Senior Housing News.

A serial drunk driving 48 year old woman has been ordered to serve her five year sentence in a Nursing Home.

Talk about bad PR for the nursing home industry.

This reminds me of a joke my Dad used to tell about the location of his employer’s world headquarters.

Guy #1. Hey, I just won first prize in a contest…. a one week trip to Philadelphia.

Guy #2 What was second prize?

Guy #1 A two week trip to Philadelphia.

One sure way to drop the turkey is failing to properly manage our addictions.

What really counts?

What I have found particularly frustrating about this whole “what to do about healthcare” imbroglio is not so much the answers that the politicians are coming up with. Those actually make sense when you consider the questions they’re asking. What has me talking back to the radio and the TV set like a crazy person isn’t their answers, it’s their total failure to ask the right question.

For what it’s worth, here’s what I think the right question is. The personal computer and the MRI machine were invented around the same time. WHY does a Personal Computer cost so little and work so well that it has become completely ubiquitous, and the MRI remains the same rare and expensive commodity it was 30 years ago? Answer that question, and you can solve the health care “crisis” pretty darn quickly and without a lot of pain.

But, I digress. The title of this post is “what really counts.”

In order to lead the best life possible, we should spend more time asking questions than looking to offer answers.

I’m going to go out on a limb here and make a bold assertion. The most important of all the questions you could ask is this: “What really counts?”

Lately I’ve found that question to be pretty helpful in planning my day and beyond. When I fail to ask it, I usually wind up having a bad day.

Asking what really counts is a good way to keep your turkey off the floor.

We’re all going to die

I’m sorry if you’re reading it hear for the first time, but, yes, it’s true. We’re all going to die.

Of all the thousands of interactions I had with older folks when I worked in the retirement community business, one that sticks out in my mind was between me and a lady who prefaced a question thusly: Now, if I should die, God forbid….

Now, I would never win a prize for being able to keep my attention focused for a long period of time, but I can’t remember what her question was now, and I probably didn’t hear it then.

If I should die, God forbid???? For an easily distracted person like me, that was a real conversation stopper.

Should I have been the one to break the news to her? If???? And, God forbid??? Most rational healthy people don’t spend a lot of time obsessing about their own deaths, but like it or not, it’s coming for all of us.

Just to put this into context, this wasn't a teenager about to embark on rock climbing trip, or a middle aged man about to go in for a heart surgery... This was a woman in her 80's moving to a retirement community.

It seems to me that once we deal with some of the taboos that exist around death than enable us to talk about it without a lot of “God forbid” prefacing, the better.

Denial of our own mortality is not a healthy thing. It leads to bad decision making, unnecessary hurt feelings, and a lot of pointless worry.

Remembering and acknowledging our mortality is a good thing. It reminds us to treat our friends and family better. It gets us making plans that will make it easier for the people who matter most to us. It brings us closer to God or whatever higher power we’re connected to.

Being okay with our mortality helps keep turkeys from hitting the deck.

No such thing as a free lunch

I’m enjoying the mini-revolt being aimed at the AARP by a small percentage of its membership. I read this week that the group has shed 60,000 members this month in protest of the group’s support of the so-called “health insurance reform” bills that are wending their way through Congress.

Without getting political, I just want to state what I have found to be a great truth in life which is that there really is no such thing as a free lunch.

For years, middle class folks who maintain all different kinds of insurance policies haven’t insured against long term care. The most rational reason for not making that purchase is that two federal programs, Medicare and Medicaid, will provide that kind of care for free.

Really….Don’t we all know that someone is paying for this care, and it’s the generation that follows the recipients of this care that picks up the tab? Not so free after all…

The other thing about “free” care of this nature is that in order to qualify on a long term basis, you need to be on Medicaid, the same program that pays for the care of unwed mothers, orphans, and the poor. In a more candid time, we called that welfare. So, there is a social cost to this “free” care.

Finally, there are the practical limitations. Medicaid pays for semi-private accommodations. Before you decide not to purchase private long term care insurance, you might want to pay a visit to a Medicaid nursing home and see just what kind of care “free care” provides.

Even the best of us can drop the turkey. What’s your contingency plan if you do?

Ageism. It's not funny.

Did you ever wonder why it is so socially acceptable to poke fun at older people?

I have, and I have a theory.

We feel okay about teasing old people because it’s rare for even the oldest of the oldest of us to think of ourselves as old. When someone makes a crack about the elderly, even the elderly chuckle because they think we’re talking about someone else.

Still, even though you don’t hear a lot of people complaining about ageism, it’s out there, and I don’t like it one bit.

When you hear it, speak up and challenge the person spewing it. We’re all getting older, and like it or not, if it’s left unchecked, someday that venom will be directed at us.

Hang on or let go?

When I logged onto my brokerage account website this morning, there was an article that I had to read. It was written by Peter Keating from SmartMoney, and entitled, “Hanging on at home.”

It’s a very well written piece, and talks about the steps one ought to consider taking in order to stay put in a house as opposed to moving to a new space as one ages.

What I found most interesting was that at the end, the author concedes that sometimes, the house just isn’t going to be a good fit. For example, since it makes a lot of sense to avoid stairs, a two story house may simply not be worth keeping as we age.

A shortcoming of the article for me was the author’s failure to talk about the other big and largely unacknowledged peril of the house: social isolation, a topic I seem to get back to all the time.

The title says it all: Hanging on. When you think about it, that’s what the effort to stay in the house is, an exercise in hanging on. Think of what this image conjures up… For me, it’s the rock climber holding on for dear life to avoid falling to a sudden and painful death.

Rather than advocating for hanging on, I think that retirement brings about great opportunities for letting go. Not letting go to crash on the rocks below, but a careful, thoughtful, and planned letting go that lets you come to a soft landing in a place where you’re biggest concern isn’t holding on for dear life, but less existential concerns, like who to enjoy dinner with, or what charity you’d like to volunteer to support.

The irony is that we hang on because we value our independence, and it's that hanging on the poses the greatest threat to our independence. It's the letting go that sets us free.

It’s hard to keep both hands on that turkey platter if you're already using them to hang on for dear life.

Long Term Care Insurance… Inspiration from a modern day Don Quixote

When I worked in the retirement community business, I became aware of a fellow by the name of Steve Moses who founded an entity with the highly forgettable name of “The Center for Long Term Care Reform, Inc.” He showed up at our community one day with an RV that he was driving across the country trying to get his message out about the need for reforming how we pay for long term care in the United Sates. He’s a wonderful speaker with a wonderful message that absolutely no one is paying attention to. If the world were fair, he would have been on 60 Minutes last Sunday, and not Michael Vick.


Here’s my paraphrase of Steve’s message. We buy insurance for all kinds of things in this country. One thing that we ought to be buying insurance for is our long term care needs. Like most things we buy insurance for, like premature death or severe car crashes, there is very low risk that the thing we’re insuring against will happen to us, but a very high cost if it does. In the case of long term care, less than 10% of us will ever need it long enough to ruin us financially. However, if you do need it, ruin you it can and rather rapidly unless you can pay $10,000 a month without dipping into your savings.


This sounds like a good formula for entrepreneurially minded insurance company to make a lot of money. However, the few who have tried are not doing very well at all. They’ve done a bad job on the actuarial side (they underestimated how much they would actually have to pay out), and on the sales side. Turns out, this isn’t such an easy sale after all.


Why not? As Steve puts it on a recent blog post, “LTC insurers struggle to sell a product profitably that the government has given away (through Medicaid and Medicare) for forty-four years.”


The purpose of my blog is to prevent the crisis. If you are one of the many of us who has a hard time justifying paying for insurance that “the government” is already providing for free, I don’t blame you one bit. In all honesty, I don’t have one of those private policies either. However, my belief is that the handwriting is on the wall here, and the days of middle class and even wealthy people rearranging their assets to qualify for free care are numbered. Eventually common sense and an impending financial tipping point are going to prevail, and this entitlement will end or be greatly curtailed.


There’s a silver lining to this. Once the third party payer is out of the picture, I predict that the cost of getting long term care will go down, and the quality will go up as people start making these purchases on their own. More importantly, reforming this system will also be extremely good for our states which are already drowning in their long term care Medicaid obligations.


In the mean time, talk to a good financial planner, and consider buying private long term care insurance. Its time is coming soon, and the younger you are when you buy, the cheaper the premium will be, and the more control you will have about how and where you live should you ever require long term care.