Are we witness to a slow-motion car crash?

The scourge of dementia

Peggy Steele

American insurance broker, Stephen Forman observed the following as he sat in his doctor’s waiting room. In one corner of the room was a professional-looking woman — clipboard in hand, briefcase at her side — who was steadily and calmly posing questions to a woman in her 50s who looked a bit bewildered. As soon as he heard a question or two about "orientation to time and place," his hair stood up. He recognized what he was witnessing.

Could this be the legendary Minnesota Cognitive Acuity Screen, reported to accurately identify cognitive functioning in over 98 percent of cases? Surely no one expected to be disturbed in this little-used lobby on a Saturday afternoon. Quiet as a page-turn, he slipped into a chair as far away as he could, embarrassed to be there, but fascinated just the same. For obvious reasons, insurance carriers are loathe to reveal the exact content of these tests to producers, for fear they will coach their applicants.

Forman sat there in total silence attempting to commit the test to memory. It was 90 minutes before he could get back to his office and transcribe his mental notes. The following is what he wrote, and some of the lady’s answers:

• Who is the current president? Do you know who the president was before him?
  
  

• How many seconds are there in a minute? How many weeks are in a year? (Her answer: "21") Do you know how many days are in a year? (Her answer: "300 something")

• What day comes after Monday?

• What did you do last Friday?

• Name three animals with tails (Her answer: "dog, cat, rat")

• Can you tell me what borders Washington State? (Her answer: "Oregon, Idaho... I give up.")

• Can you tell me why some people would say having friends is a good thing to have? (Her answer: "They’re not, they stab you in the back.")

• If you were lost in the forest in the daytime, what would you do? (Her answer: "I’d follow the creek or river downstream.")

• If you were lost in a crowded mall, what would you do? (Her answer: "I’d be scared.")

• I’m going to list eight words. When I’m done, I’d like you to repeat as many as you can remember: hippopotamus, frog, bicycle, brush, camel, toothpaste, lightbulb, fork. (Her answer: "hippo, frog...hippo, frog...that’s all, I give up.")

• [later] I’m going to list three words, and then in five minutes, I’m going to ask you to remember these three words and repeat them, all right? The three words are: apple, dog, baseball. [The interviewer then asked about three intervening questions, by no means was it five minutes, maybe two or three at most, and asked for the three words.] (Her answer: "apple, dog.")

• Can you tell me why it costs more to live in the city than out in the country? (Her answer: "Because of the taxes to pay for schools and police and firefighters.")

• Do you recall how many other people were in this waiting room when we began?

• Do you remember my name?

• Can you name five major cities in the United States? (Her answer: "You mean like Seattle?" “Yes.” "Seattle, San Francisco, Oklahoma City ... that’s all.")

• What’s 35 + 47? (Answer: "I’d need a calculator!")

• All right, what’s 6 x 8? (Answer: "40?")

• Can you tell me 20 divided by 5? (Her answer: "I was never very good at math.")

There were some morality-based questions ("Can you tell me why we shouldn't shoplift?") and some critical thinking questions (Can you tell me why it’s a good idea to get a license to drive a car?).

This piece speaks to the tragedy of cognitive impairment in general; this scourge that we hope to insure against, but only if we're fortunate enough that people reach us in time.

If not, then to be that fly on the wall — as Forman was — is to be a witness of a slow-motion car crash. Knowing that the incidence of Alzheimer's disease doubles every five years after age 65, Forman has urged us to do everything we can to make sure we are insured with a long-term care plan before tragedy strikes.

As I mentioned in my last newsletter, two of my clients have gone on claim with their long-term care plan – one has developed Alzheimers, and the other stroke-related dementia. Both had paid premiums for only four years. (Once you go on claim, premiums stop.) Now they are collecting tax-free money to pay for their care. As an insurance broker, I feel so grateful to have been instrumental in setting up their plans.

If you require information about long-term care plans, don’t wait until you are too old or ill to qualify the coverage. Look into it while you are young, healthy and the premiums are affordable. Contact Peggy Steele at 613-256-6762.