The Health Care Promises We Cannot Keep

The Health Care Promises
We Cannot Keep

By Judith Graham , Kaiser Health News
December 12, 2019


Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

It was a promise Matt Perrin wasn’t able to keep.   “I’ll never take away your independence,” he’d told his mother, Rosemary, then 71, who lived alone on Cape Cod, Mass., in a much-loved cottage.

That was before Rosemary started calling Perrin and her brother, confused and disoriented, when she was out driving. Her Alzheimer’s disease was progressing.  Worried about the potential for a dangerous accident, Perrin took away his mother’s car keys, then got rid of her car. She was furious.

For family caregivers, this is a common, anxiety-provoking dilemma. They’ll promise Mom or Dad that they can stay at home through the end of their lives and never go to assisted living or a nursing home. Or they’ll commit to taking care of a spouse’s needs and not bringing paid help into the home. Or they’ll vow to pursue every possible medical intervention in a medical crisis.

Eventually, though, the unforeseen will arise ― after a devastating stroke or a heart attack, for instance, or a diagnosis of advanced cancer or dementia ― and these promises will be broken.

“My mother-in-law and I got into a disagreement; I don’t remember what it was about. But I remember her saying to me, ‘You promised you would take care of me,’ and making it clear that she felt I’d let her down. And I said, ‘I know, I was wrong ― I can’t do it all,’” she remembered. “I still feel bad about that.”

“No caregiver I know sets out to deceive another person: It’s just that none of us have a crystal ball or can predict what the future will hold,” she said. “And the best we can do isn’t always as much as we thought was possible.” “We have to figure out a way to forgive ourselves.”


Have you made that promise?  Have your children?  You know what comes next: use liquid money first, then retirement accounts (don’t forget the IRS imposed penalties for certain withdrawals as most LTC is NOT deductible), then sell the family home. Then, .when all the money is spent on care, the loved one eventually needs to go on a welfare program called Medicaid which may only be accepted at welfare nursing homes.

I want a nice assisted living facility with attentive and caring staff, a pool, happy hour, lots of activities and good meals.  I want the end of my life to be as comfortable and fun as it can be.  I can afford this because 18 years ago I bought a LTC insurance policy.

How will you pay for their care when your health changes?  Or will you need to sell assets at fire sale prices because you need the cash, regardless of what the market is like?

Contact Romeo Raabe LUTCF, LTCP (920) 884-3030



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