29. Money

Frank and Jean are not poor people. But they have discovered a vulnerability. A major threat to their finances.

The proverbial good news and bad news of human life.

For Frank and Jean, the good and bad news scenarios overlap based on a health-related continuum. Medicare, the good news, supports that continuum for most physical illnesses.

If a disability does not involve a reduction in cognitive functioning, the afflicted person can mentally participate in caregiving processes. That often allows in-home care, supplemented with incidental outside assistance.

The bad news is Alzheimer’s. Medicare and other forms of insurance do not support full-time assisted living.

A necessary service as the syndrome advances.


I live in a +50 community in which many couples take care of each other. It works well if both partners communicate cogently.

If both stay mentally and emotionally healthy enough to keep the relationship moving forward.

Some may struggle financially, but Medicare and other forms of insurance keep them afloat. The continuum may fluctuate. But it remains good news in terms of money.

That is NOT true when dementia enters the picture. The continuum tends to drift from bad news to worse news. In terms of money, physical decline, and emotional stress.

There is no Medicare safe harbor.

If the situation degrades further, the couple or family ends up in a financial salvage yard called Medicaid.


The tug of war called American politics sabotages solutions to problems such as those encountered by Frank and Jean. In a different political reality, Medicare might be expanded to include SOME coverage for long-term assisted living. 

That day may come. But not soon.

Alzheimer’s and other forms of dementia have already reached epidemic levels in older Americans. It is expected to become much worse as people live longer. And costs increase.

Unless a cure or better forms of treatment are found, memory issues and other disorders could almost bankrupt our country. One way or another.

In the meantime, Frank and Jean are doing everything they know to do.

I purposely created Frank and Jean as responsible and hard-working Americans. They pay their own way in life. They save money. No one in the family is addicted to drugs, alcohol, gambling, or anything else. Their lifestyle is not extravagant. The house and cars are paid for. They do not take expensive vacations. They even exercise and eat right.

Yet they face the possibility of financial difficulties if Jean’s Alzheimer’s worsens.

At some point, Frank might hope that Jean’s long-term care is shorter than expected. He would hate himself for thinking that way because he does not want Jean to die.

But years of expensive custodial care seem like such a waste.

Hundreds of thousands of dollars to care for a human being, albeit his wife, to live in a near vegetative state at $6500 a month. What if he ends up the same way? Surviving only because Medicaid pays for his demented survival in a subpar facility.

Bad news morphing into worse news.


The only way to put a more positive spin on the story of Frank and Jean is if they purchased long-term care insurance while in their 40s. When premiums were comparatively low. And coverage good, with a payout of over $100 a day for five years. For EACH of them.

That would cut their custodial costs nearly in half for five years of coverage. And it would certainly help.

But I eliminated that element of the story because, like many couples, Jean and Frank did not think they would need it.

Today, finding long-term care insurance is a challenge. And it is expensive.

Given that both Jean and Frank are now over 60 with pre-existing conditions, they would not likely find available policies. If they did, the annual premiums could be $5000 or more. With possible increases at the discretion of the company.

On the plus side, I spun the storyline using long-term care costs found in the Midwest. Less than costs on the east or west coasts. Sometimes much less.


Notice I included networking in the storyline. Frank and Jean are working with an estate planner, and that is always a good move. And not prohibitively expensive.

With their daughter’s assistance, they are also reaching out to organizations focused on challenges such as theirs.

What Frank and Jean did in terms of networking is unusual.

It is amazing how many people would rather avoid making connections during retirement.

Others do. They often gather for breakfast at McDonalds or participate in a diversion: playing card games, watching soap operas, being engrossed with sports either as a participant or spectator, and working with hobbies. Others stay active with various church functions.

There is nothing wrong with diversions and socialization.

But the kind of networking I am talking about is more focused on making contributions. Or doing more than just coping. Learning about options, available support systems, and other community-based structures that keep everyone connected. 

One of the first actions I took as an Alzheimer’s caregiver was to reach out to AARP. I made an intentional effort to meet and become friends with my neighbors, joined a small and supportive church, and continued professional affiliations as much as possible.

And I made sure my family was always in the loop one way or another. 

Staying engaged was imperative for me. And the same is true for the fictional Frank and Jean.

However, the kind of critical engagement I am thinking about is with service organizations. Those connected with governmental decision-making bodies and community-based support systems.

Organizations that actively study problems older people face. Groups that are sensitive to all challenges associated with Alzheimer’s and are either willing to do something about them or locate people who can.

One of my professional colleagues was fond of saying, “Always keep stirring the pot. You never know what might pop up!” 

He was right.

Continue to seek ways to take care of yourself.

©2020 Stu Ervay – All Rights Reserved

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