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‘I don’t want to put my family through this’

This is the fifth installment in an occasional series of articles focusing on the role reversal taking place in society today as adult children face the challenges of aging parents.

BARRETT — Caring for an aging loved one can bring all kinds of harsh realizations — most commonly: “That could be me one day.” Such was the case for Billie Sharon Dingess.

“I was taking care of my grandmother, who more or less raised me, when I realized that I could someday be facing a very similar situation,” said Dingess, 59, of Barrett, Boone County.

She gave the woman she called “Mommy” nearly constant care for the final four years of her life. Her grandmother died in January 1998.

“Doing that job is a headache — I don’t mean to say headache — it’s a heartache,” Dingess explained. “I decided that with all the shortages and cutbacks in Medicare, I didn’t want to put my family through this.”

She turned to long-term care insurance. She read up on it, then contacted her daughter, Lisa Godwin, a State Farm agent in Sissonville.

Long-term care insurance is a complex web of coverage that pays for such services as in-home or nursing home care by providing a daily cash benefit.

Dingess had one stipulation for her daughter: “Don’t tell your father.”

“For one thing, he’ll be troubled, thinking I have something wrong with me,” she recalled telling Godwin. “And for another, it’s an added expense.”

Dingess began doing odd jobs and renting out her grandmother’s vacant house to pay premiums totaling “a little over $100 a month.”

Her husband, Donald, did find out, and he wasn’t upset. In fact, the 62-year-old had tried to take out a policy of his own. But a lifetime of smoking and 20 years in the mines left him an unlikely candidate for coverage.

There’s one big hitch to long-term care insurance — you have to buy it before you get sick.

“People my age try to put it off,” Dingess said. “They like to foresee not having to pay. They say, ‘I’ll probably just die of a massive heart attack,’ but it doesn’t always happen that way.”


More than 3,000 possible prices


Long-term care insurance is still a relatively new form of coverage, but it’s catching on much faster these days — in some areas.

A North Carolina state study showed that while coverage nationwide grew 142 percent from 1992 to 1998, the growth was occurring mostly in a handful of states.

The percentage of covered individuals in states such as North Carolina and West Virginia falls in the single digits.

One reason may be the cost. Premiums are based on age, health and the myriad options offered in any single plan.

According to the Long Term Care Insurance Buyer’s Advocate Alliance, there are more than 3,000 possible prices for each person.

A premiums chart offered on the group’s Internet site (www.longtermcareinsurance.org) lists ballpark figures for minimal coverage and “generous” coverage. For instance, a 60-year-old applicant could get minimal coverage for about $60 a year, while generous coverage is more like $2,600 a year.

The alliance lists three major decisions and three optional decisions applicants must consider when buying a policy:

  • Daily benefit — how much you want your policy to pay per day for your care.

  • Benefit period — how many years you want your coverage to last.

  • Deductible — the number of days you will pay for your own care before coverage kicks in.

    The optional decisions to consider are:

  • Inflation protection — allows your daily benefit to grow with inflation.

  • Home health care — allows you to receive care in your home.

  • Nonforfeiture — provides some coverage for the amount you paid into the plan, even if you allow your policy to lapse.

    There are numerous other ways to customize a plan. Check with your agent to receive full details or call 877-987-4463, a toll-free help line operated by the state Bureau of Senior Services to answer questions about Medicare and Medicaid, prescription drugs and long-term care insurance.

    The American Association of Retired Persons also offers advice on its Internet site (www.aarp.org) about long-term care insurance.

    AARP warns those considering a policy to be wary of taking the leap if paying the premiums means a lower standard of living or giving up things they need.

    “If you would quickly qualify for Medicaid if you needed long-term care, a long-term policy would not make sense for you,” AARP advises.

    ‘It was a rude awakening for me’


    The 1990s were a time of great pain and great change in the life of Tom McMillan.

    His father developed cancer, spent eight months in hospice and died at age 89 in 1994. His mother had been showing signs of dementia, but once her husband died, the symptoms really set in.

    McMillan, 61, grew up in Charleston and stayed in the capital city to make his living. His two brothers scattered to Martinsburg and North Carolina.

    As problems with Mom worsened, he was the one who got the calls.

    “She’d call 15 or 16 times a day,” he said. “She locked herself out of the apartment, or she left the bath running and it ran down into the apartment below...

    “The last straw was when I went over to visit and there was a pan on the stove that was literally on fire. The reality set in that not only was she a danger to herself, but now to others.”

    He got together with his brothers and his family and shopped for assisted living.

    “It was a very traumatic decision, because, well, that’s your mother,” he explained.

    Shortly after she settled in to their choice of facilities, she fell and broke her hip.

    “She had an operation, but because of the dementia, she couldn’t remember how to rehab herself,” McMillan said. “So, after 21 days, Medicare cut her off. If a patient is not showing improvement after 21 days, Medicare stops paying. It was a rude awakening for me.”

    As she worsened, the family moved her into a nursing home, where she lived for six months before her death at age 86 in 1997.

    McMillan was shocked at how fast his mother’s money was depleted for her care.

    “We were very close to mother running out of assets,” he said. “Of course, my brothers and I would never have let anything happen, but it was amazing how fast it was used up.”

    Then, McMillan heard about long-term care insurance. After what he had been through, he was intrigued by it. He started studying the intricacies of the coverage, and before long, he knew what he wanted to do.

    He put his decades as a stockbroker on a shelf, and started the lengthy process of becoming certified to sell long-term care insurance.

    “I know this sounds corny, but I felt like doing this was more like helping people,” said McMillan, now a long-term care specialist with Silverstein, Maddox, Wallace & Associates, on Smith Street in Charleston.

    “A couple I worked with, one of the first things they did after leaving this office was to go home and write a letter to their kids saying, ‘We got you a present,’ ” McMillan said. “I think that’s wonderful.”

    To contact staff writer Robert J. Byers, use e-mail or call 348-1236.

    The final installment in this series appears in Monday’s Healthwatch section of The Charleston Gazette.


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