Published by the National Association of Insurance Commissioners (NAIC).

• Email mailto:editor@TheBusinessOwner.com and put “Shoppers Guide” in the subject line.

The National Center for Assisted Living

The assisted living voice of the American Health Care Association (AHCA), the nation’s largest organization representing long-term care.

• www.ncal.org

Eldercare Locator

A public service of the U.S. Administration on Aging. Links those who need assistance with state and local agencies.

• www.eldercare.gov or call 1-800-677-1116.

Carolyn K. Schultz, CLTC

• “Certified” long-term care specialist with Mass Mutual Insurance Company.
• Became a passionate advocate for long-term care planning following her own long-term care family tragedy.
• Call her at 918-428-5433 or by e-mail at ckschultz@finsvcs.com.

Long-term care, referred to as custodial care, is defined as needing assistance with activities of daily living such as toileting, bathing, dressing, eating, transferring from one point to another, and continence. It also includes cognitive impairment so severe that the individual needs constant supervision.

Most often, custodial care is provided in the home. Caregivers come to the home as needed by the patient, be it a modest schedule to give relief to family caregivers or round-the-clock care. Alternatives include independent retirement communities, assisted living facilities and nursing homes. Blended approaches include “adult day care” where the patient spends days at a care facility but lives at home.

We all know that people are living longer. Many are not aware, however, that modern medicine saves lives but is often unable to fully restore one’s ability to care for oneself. As a result, the need for custodial care is exploding. If this happens to a person in your family, the question is not who will take care of them, because it will be your family – one way or another. The question is what providing that care will do to your family and finances.

Who Covers the Cost?

Consumers must pay for their own long-term care. Unfortunately, the best thought-out retirement plan rarely covers the risk of living a long life. More particularly, the risk that you live many years that require custodial care.

Medicare, the primary health care program for retirees, is similar to health insurance. It pays only for skilled or rehabilitative care, not custodial care. Medicaid, a federal and state welfare-type program for financially needy individuals, will pay for custodial care but primarily in nursing homes.

The Role of Long-Term Care Insurance

Long-term care insurance fills the gaping hole created by the blessing of modern health care. We live longer, but our health care insurance does not provide for the assistance so many will need. Long-term care insurance is a smart way for you to deal with the substantial uncertainty of how long you will live and how much care you will need. Your retirement planning will be much simpler. You build assets and income to provide for yourself during retirement, absent the unpredictability of long-term care expenses. Fail to insure and you risk the unthinkable, including late age bankruptcy due to unforeseen assisted living costs and substandard care.

Finding and Selecting Long-Term Care Insurance

First, get personally familiar with the issues and options. Reading the articles in this issue of The Business Owner is a good start. Second, have your financial planning professional read these articles and then discuss with him/her your own situation and that of your family and its’ members. Third, find a long-term health care specialist that can provide:

a.    Projected future costs for long-term care, and

b.    Policy options and explanations for each, and

c.    Savvy and experienced counsel.

Fourth, make sure you select a company (underwriter) that is very highly rated. You don’t want to have to worry about your carrier running out of money or going out of business. Fifth, know the fine print of your policy. For example, will the policy pay for private assisted living or just nursing home care? Sixth, consult your tax advisor about the most tax-advantageous method for funding and holding the policy. Seventh, cut the first check, get the coverage in place, put it on auto-pay, and place the policy in your safety deposit box. Eighth, be sure your family members, including your children, are aware of what you put in place.

The following experts contributed their expertise to the articles in this special section:

• Carolyn K. Schultz, a Certified in Long-Term Care specialist. She can be reached at the Henderson Financial Group, 918-428-5433 or ckschultz@finsvcs.com.
• Diane Hambric, President of Gold Medallion Senior Housing and Health Care – an owner-operator of retirement and assisted living communities and skilled nursing facilities in Oklahoma. She can be reached at 918-523-0222.

Q: Isn’t this long-term care insurance thing just another insurance company creation? Twenty years ago, this problem … and this insurance product … did not even exist. And, there are millions of people getting daily “custodial” living assistance today. Most did not have long-term care insurance. Please explain why I should take this seriously.

A: True, this insurance product has emerged in the last twenty years. But, the reason is not because of the insurance companies, but because of the rapid advancement of life expectancy. Medicine and medical care are saving lives and people are living longer, but many are unable to fully care for themselves. If you end up needing extensive assistance, there are only two options – your loved ones provide it or you pay someone to provide it. Securing and managing outside providers is expensive and time consuming. If you don’t have insurance to fund it, you’ll simply have to pay from your income or assets. The risk is that your income will not be sufficient to cover the cost. Keep in mind that it’s a pretty difficult planning task because you don’t know whether you’ll ever need living assistance or if you’ll need round the clock care for 30 years. If your income is not sufficient, you’ll need to liquidate assets – home equity, retirement accounts and even life insurance benefits (hardship advanced on death benefits). If you go broke, there’s Medicaid … but you don’t want the government-provided level of care. If you don’t believe me, visit a nursing home that takes Medicaid funds.

Burnout.

A word so overused it’s a cliché. But, is there something there to which we should pay attention? Is there a trap door along the path of high achievement? An entry fee to the theater of success? Are we at risk of derailment just before we grasp the brass ring?

You’d better believe it. Take heed of the warnings signs:

Anhedonia

This is psychology’s way of saying, “I’ve lost that loving feeling,” for almost everything I used to enjoy or find fulfilling. It’s a loss of passion – the juice that powers our engine. What used to light you up doesn’t anymore and you can’t seem to find a flame anywhere!

A first cousin of depression, anhedonia is invited into our life when we’re emotionally overloaded. It’s invited in when an imbalance exists in our work-life equation and our personal life is being devitalized.

Tip: Restore the balance by taking more personal time. Engage in non-work activities. Consider a mental health consultation if balancing does not improve your condition.

Restless Agitation

Do you find yourself losing your temper? Easily irritated by people and every day events? Are you acting out in ways that are inconsistent with whom you really are such as drinking too much, spending more money than you have or embarrassing your guests?

Physiologically, burnout manifests itself as low-grade anxiety – like, “I need to do something to not feel this way but I don’t know what to do.”

Push yourself into rigorous exercise and physical activity. It should calm the demons and settle your soul.

Boredom

Your mind is a vast reservoir of capabilities and potentialities. People who are “burning” feel as if their potential either has passed them by or is seriously underutilized. The response is a dull, unenthusiastic, and muted response to what used to be challenging. Sometimes, it’s motivationally challenged to the point of inaction.

Tip: The hidden gift of burnout is the wakeup call embedded within its symptoms. Ask yourself what this dark night of the soul may be requiring of you.

Unfortunately, Pee Wee Herman was right when he lamented, “Everyone has a big but(t).” You see, you thought you had insured away the major risks of life, BUT … substantial advances in average life span have added a fat new slot to your random financial disaster roulette wheel – the 50% chance you will need basic living assistance as you age.

To explain, health insurance is designed to “get you better” when you become ill

or injured. If you neither die nor get better (i.e. regain your ability to live without assistance), you’re in big trouble. Your life insurance policy won’t pay (you’re not dead) and neither will your health insurance (you’re not sick and getting better).

Let’s go over that again. Studies project that, as medical advances prolong life, there’s a 50% chance any individual will need assistance with basic living: bathing, dressing, eating, medicating, transportation, etc. Your health insurance will not pay for these. Sure, your loved ones could, but how much?  What if you need round-the-clock care? What if your spouse can’t lift you? What if your spouse needs to work?  What if you don’t have a spouse? What if you don’t want your spouse, or children, to have to clean you each day? For 10 or 20 years, possibly?

Today, according to MetLife, the average annual cost of private nursing home care is $75,000. If you want better than average, it will be more. If you want in-home care, as most do, it’s expensive.

How will you pay for it?

Long-term care is a BIG hole in most people’s financial planning. It can wipe out a lifetime of prudence and wealth building. It can put a family into the poor house, literally. It can also tear it apart as they argue over who will personally provide, or pay for, your care.

Talk to your financial planning professional about long-term care cost contingencies. And, don’t forget that the time to obtain health, disability, life and long-term care insurance is when you are healthy!

• I’m too busy.
• Exercise takes time away from my family.
• I get sweaty.
• I look funny in leotards.
• I get out of breath.
• It’s too dark, too light, too cold, too wet to exercise.
• My Aunty Sybl is coming to town.
• I (fill in the blank)

Have you found your favorite excuse? Here’s why your excuses are no excuse:

I’m too busy to exercise. No one is too busy to exercise. The President finds time to exercise, so you can, too.

Exercise takes time away from my family. Include your family. Take a walk after dinner with your daughter, son, husband or wife. Leave the car at home and walk your spouse to and from the bus, subway or train. Take a bike ride with your family on the weekend. Exercise wonÕt hurt them a bit. In fact, it will help them.

I get all sweaty. Walking at a moderate pace should not make you sweaty. If your chosen exercise causes excessive perspiration, exercise at a place where showering is possible. Too hot outside? Walk inside.

I look funny in leotards. Don’t wear leotards. Wear comfortable shorts. If you look funny in shorts, who cares? The exercise is for you. And, if you eat right and exercise, you will soon look great in shorts.

I get out of breath. Take it easy. After all, if you haven’t exercised in a long time you are probably out of shape. Start slowly, a few minutes a day, and work up to 30 minutes of walking a day. However, you should check with your physician before you begin any exercise program.

It’s too dark, too light, too cold, too wet to exercise. Come on! You can find a solution to any problem if you try. If the weather is bad, take a walk in a covered mall, exercise at home on a stationary bike, mini- trampoline, NordicTrack, rowing machine or treadmill; or pop an exercise tape into your VCR and move with the beat.

My Aunty Syl is coming to town. You make time for what is important to you. If someone gave you a free ticket to a football game or a concert, you’d be able to fit it in. Fit your exercise in.

Source:  Choose To Lose

1.    Make Exercise a Part of Your Daily Routine. Schedule exercise at a specific time. The same time, every day, such as the first 30 minutes of every weekday. Do it even if you’re not in the mood. Force yourself. Eventually you won’t resent it; rather it will quickly become a normal, enjoyable part of your life.

2.    Walking Fits in Everywhere. Incorporating walking into your schedule is probably the easiest and most practical exercise program. You can do it anywhere, any time, no cost or equipment required. Maybe just walk to work or part way by getting off the bus early or parking your car 30 to 40 minutes away.

3.    Walk on Your Lunch Break. Walk for 30 minutes at lunchtime. It’s good to get out of the office and into the fresh air. You can combine the walk with errands, but remember that the exercise must be continuous. Walking 5 minutes to the bank and standing in line for 15 minutes doesn’t count.

4.    Do Exercise You Enjoy. Choose an exercise you enjoy or make the exercise you do more enjoyable. If you find a stationary bike too strenuous, walk. If you find walking boring, plug in earphones and listen to your favorite music, talk show, language tapes or books on tape. Watch television as you stride on your treadmill, ride your bike, or jump on a mini-trampoline.

5.    Exercise with a Buddy. Exercising with another person can be more fun than exercising alone. Make it a family affair. Instead of spending an hour every evening gathered around the kitchen table nibbling and chatting, spend the time taking a walk and chatting. Let it become a ritual. Exercising with a friend can also give you the added nudge you need. How can you say, “Sorry, I’d rather sleep,” when Barbara comes by to drive you to the 9 o’clock aerobics class?

6.    Exercise Alone. Exercise can be a special time for you to be by yourself. Many busy people call the time they exercise “my time.” No phones, no children, no distractions.

7.    Wear the Best Equipment: Good Shoes. Be sure to wear comfortable shoes with good support. Buying $125 sneakers with bubble-filled soles and foam-layered heels is not required. In fact, you might find tie-up leather shoes more comfortable for walking. Whatever type of shoe you prefer, make sure they fit and offer support.

Source:  Choose To Lose

Studies show that just 20 minutes a day of walking is enough to see real gains. Forty minutes, four days per week of aerobic activity will deliver substantial results. A little resistance training – you’ll be unstoppable!

However, Dr. Ron Goor suggests you exercise every day. “If you exercise every day, you are never at risk of putting it off until tomorrow. The best, easiest and safest exercise is plain old walking.”

Lower Levels of Anxiety and Depression: Exercise lowers stress. Owning and running a company is stressful. Constant stress lowers mental performance and wears down the physical body. It makes you more prone to illness and can lead to serious health problems, like heart disease.

Lose Weight: Exercise is the healthy way to reduce body fat, and high body fat is the number one cause of health problems. Jane BrodyÕs nutrition book cites studies showing that as little as five percent excess body fat reduces life expectancy, and a 50 year old who is fifty pounds over weight has half the remaining life expectancy of her slender peer. Exercise also lowers blood pressure, reduces risk of heart disease, helps protect against osteoporosis, reduces risk of cancer, and more.

Sharper Decision-Making Ability: A 2005 study published in the Journal of Exercise Physiology found in students a high level of correlation between test scores and overall levels of fitness. Similarly, a 2003 article in the journal Acta Psychologica concluded that “… aerobic exercise can facilitate cognitive functioning.”

Positive Example For Employees and Family Members: Want your kids to develop healthy habits? You are their role model.  Want your employees to be more productive and miss less work? You are their role model. Consider building a healthy work culture. Discourage “junk food” in the workplace. Stock healthy snacks instead, as an employee benefit. Offer free health screenings annually. Give incentives for healthy activities, like finishing a local 5K race.

Think and Feel Younger: “Aerobic exercise yielded a 20 percent improvement in (mental) performance” of senior citizens, in a study published in a 2004 issue of the Proceedings of the National Academy of Sciences. The Journal of the American Medical Association published a study last September that found, among the more than 18,000 older women studied, “long-term regular physical activity, including walking, is associated with significantly better cognitive function and less cognitive decline in older women.”

Sleep Better: Poor or inadequate sleep reduces mental and physical performance. Exercise is proven to improve the quality of sleep, including the amount of time that it takes to fall asleep and the ability to remain asleep. Are you taking drugs to help you fall asleep? Exercise is the best sleeping pill known to man, and it’s free (and no undesirable side effects!).

Dr. Ron Goor and Nancy Goor, authors of best-selling nutrition and health books, say, “Please yell the following line as loud as you can: EXERCISE IS ESSENTIAL!”

You gotta do it.

However, Dr. David Brennan, exercise physiologist, cautions us to start slow as we begin our transition to a “fit” lifestyle. Let’s face it, most of us are overweight, and the extra pounds cause added stress on our joints when we exercise. Low impact exercises is where we should start … or even stay … such as water based exercise, cycling or walking. Doing so will reduce the chance of injury. Finally, for burning calories and stimulating “happy hormones” (endorphins), full body activities performed with rhythmic contractions for extended periods of time are the most effective.

Height & Weight Table For Medium Frame

Height  Women    Men

5′ 2″   118-132  131-141

5′ 3″   121-135  133-143

5′ 4″   124-138  135-145

5′ 5″   127-141  137-148

5′ 6″   130-144  139-151

5′ 7″   133-147  142-154

5′ 8″   136-150  145-157

5′ 9″   139-153  148-160

5′ 10″  142-156  151-163

5′ 11″  145-159  154-166

6′ 0″   148-162  157-170

6′ 1″   N/A      160-174

6′ 2″   N/A      164-178

6′ 3″   N/A      167-182

6′ 4″   N/A      171-187

Source: Metropolitan Life Insurance Company

Erect a sleep tent: Wear a hat with a visor and then pull a blanket over your head … so the visor pushes the blanket away from your nose and mouth.

Noise cancellation headphones: Pricey, but possibly worth the investment. Bose QuietComfort 2 Acoustic Noise Canceling Headphones sell for $199 at Amazon.com.

Avoid caffeine and alcohol: Both can interfere with a good night’s sleep.

Dine before boarding: You can skip the in-flight meal and work on some sleep.

Carry on a change of clothes: Things like spills and lost luggage happen. Be prepared with an extra change of clothes in your carry-on bag.

Book your hotel for the night before: If you arrive in the morning, you might not be able to check into your room until the afternoon. Buy the prior evening and you can check right in and get some z’s.

Give yourself a day to recover: Don’t book important meetings until you’ve had a day to recover.

Avoid big meals: Big meals won’t help you stay fresh. Don’t make big dinner plans for the night of your arrival nor regularly during your trip.

Go to bed early: Don’t stay up late. You need rest and your body wants its usual routine. Try to stay with it.

Exercise, preferably in the sunshine: Exercise gives you energy and adrenaline. Go for a run, in the sun if possible.

Andy Core of Core Wellness

All Aboard!

While traveling, or being crammed into an uncomfortable seat, your body is under stress that it’s not designed to handle. The primary problem with being seated for extended periods is that it stresses your lower back and neck, significantly reduces blood flow and slows digestion. The quickest way to improve all these conditions is to pry yourself out of the seat every hour or so and take walk breaks. Walking contracts the muscles of your legs and stimulates blood flow throughout your body. Below are three additional strategies to bolster your resilience when seated for long periods.

Picture Perfect Posture

Improving your seated posture is the best and fastest way to decrease back and neck pain. By restoring the natural curvature in your lower back, you can reduce the pressure on the discs of your spine by over 100 pounds. The easiest way to do this is to place a lumbar roll, or rolled up pillow or blanket, in the small of your back and sit as tall as possible.

Trunk and Hip Twist

Another great way to give your spine a break and to significantly improve digestion is to do some light rotation. This exercise/stretch starts by sitting tall and placing both hands on the leg you are twisting toward. Then, using your hands as support, twist with light effort until you feel a good stretch and then hold for twenty seconds. Repeat it on the other side.

Heel Toe Pump

When seated for extended periods, blood pools in your feet and lower legs. This is uncomfortable and has been associated with a life threatening condition called thrombophlebitis (abnormal blood clotting). In combination with walking, the heel-toe pump can be a life saver. Simply alternate lifting your heels and toes as high as possible and pause at the top for three seconds. Repeat 15 times, twice.

Andy Core of Core Wellness contributed his expertise to this article.  He can be reached at Andy@AndyCore.com.