Cohousing-L Mailing List: Re: Long Term Care (LTC) Insurance - What are your facts?

[R Philip Dowds (rpdowds]

Excellent and realistic points from Ann.  From my experience as an eldercare 
architect (designer of nursing homes, assisted living, retirement housing, 
etc.), I’ll add some amplifications.

“Aging in place” is often a stated goal of home care programs serviced by 
visiting, part-time care givers.  It is favored by some public officials as 
being a low(er) cost alternative to nursing home care or other institutional 
care.  And it’s favored by many isolated, lonely and bored elderly because they 
know (or believe) that the alternative is worse.  That a move into an 
institution almost surely means loss of privacy, independence, and autonomy.  
And an increase in alienation and disempowerment.  Not for nothing do 
increasingly incapacitated elderly cling firmly, for as long as they can, to 
their poorly maintained and unsanitary houses or apartments.

And this is a challenge we’ve created for ourselves.  When social security was 
invented, average age at death was 65 years.  Modern medicine has relieved us 
of many curses — but it has also greatly prolonged the average life span 
without, unfortunately, a commensurate increase in the quality of life.  The 
industrialized world has no idea how to run or pay for * a society where 20% of 
the population is over 65.  This is Ann’s Tsunami.  We can see it on the 
horizon; I’m not sure I want to be around when it hits the shore.

Like assisted living, cohousing can help bridge the gap between independence 
and custodial care.  And probably at a considerably lower cost.  But we 
cohousers need to stay realistic about what we can and can’t do (or don’t want 
to do) for our friends and neighbors.  Do I really want to assist my neighbor 
across the hall with ADLs = Activities of Daily Living: bathing, dressing / 
grooming, feeding and toileting?  Or, do all his/her grocery shopping … even as 
I myself am having more trouble finding my car keys?  I’m 71.  Am I expecting 
my neighbor to do these things for me?
     I think most of us would agree that direct care with ADLs is probably 
mostly beyond the social contract, implicit or explicit, of cohousing.  Grocery 
shopping and meal prep for a neighbor is very much within our scope.  For a 
while.  But three meals a day, month after month?

Finally, we need to stay realistic about how much help old people can give to 
old people.  If an 80-year-old’s television or computer screen goes dark, or 
door sticks shut, chances are greater that it can be re-activated by a 
40-year-old than by another 80-year-old.  If supporting elderly neighbors is 
part of our mission, then there is much to be said for multi-generational 
communities.

Thanks,
Philip Dowds
Cornerstone Village Cohousing
Cambridge, MA

 * PS:  Long term care insurance?  ???  What’s that?  The insurance industry — 
peddling its products for considerable, dependable profit — wants us to believe 
that all of life’s problems and disappointments are “insurable”.  But we don’t 
actually want health care “insurance”.  What we REALLY want is health care.  
Once again, our attention has been diverted from the true problem ...

> On Dec 7, 2015, at 10:07 PM, Ann Zabaldo <zabaldo [at] earthlink.net> wrote:
> 
> "Aging in place" is just three words for dying alone. Keeping people in their 
> homes means keeping them isolated, lonely, and bored. The three scourges of 
> aging alone. Even when you have nurses come in every day there are still long 
> periods when you're alone. Even if you have 24 hour nursing care no one will 
> ever care for you and look after you the way someone who knows and loves you 
> will. That's why am a great believer in the power of relationships develop 
> through aging in community.   Unless we developed a social contract within 
> our "tribe" I don't think all the long-term care insurance will really help 
> the challenges that those of us who age beyond healthy aging will face.  
> Also… Not enough money in the known universe to support the 70 million 
> boomers who will be retiring. Even if only 5 million of those reach the age 
> between healthy aging and death… Not enough money in the known universe. 
> 
> We are not prepared for the Tsunami that is reaching are sure as we speak.