Denial with Long Term Care Revisited

An exclusive written by LTC Tree Advisor, Joe Houston.
        
In follow-up to a previous article on the subject of denial and how it impacts people’s decisions as to whether or not to purchase long term care insurance, we wish to expand on the psychological defense mechanism of denial and how it plays into such decision making.    

First let’s get a good definition of denial. In their text, Principles of General Psychology, Kimble and Garmezy define denial as “A mechanism of defense in which an unpleasant external reality is rejected and replaced by a more pleasurable and wish-fulfilling fantasy pattern.”   They note several aspects of denial that are of particular interest, namely escapism, indecision, and fantasy.  In our sub-conscious minds these aspects are, of course, intertwined, and come out in everyday behavior that others can observe.  For example, we may delay making decisions in those situations which are fearful or which make us feel uncomfortable.  Or, we engage in other activities to give us “legitimate” excuses for not having the time to do those things we should do.  Or, we can dwell in daydreaming, and, in our own minds construct a world as we wish it to be, which in turn can lead to increasing immobilization and difficulty dealing with the real world around us.       

Please note that these defense mechanisms are not all bad—and we all engage in them to varying degrees.  Their positive benefits are that they help us deal with the daily struggles that life demands of us. It’s only when they get in the way of doing those things we need to do, that problems arise.  Jourard, in his book, Personal Adjustment, notes that  “…a reaction to handicap must be adjudged unhealthy when it interferes with the person’s capacity to find meaningful satisfactions in ways that are personally and socially acceptable.”   You will note that he uses the word “handicap,” and many of you readers may find it difficult to relate to that concept in your own case, especially if you are healthy now.  However, please note that no one gets out of life alive, and though we may be relatively healthy for most of our lives, as we get older we almost always start developing “handicapping” conditions, such as high blood pressure, arthritis, diabetes, heart problems, cancer, cataracts, Alzheimer’s, dementia, etc. which can all lead to needing long term care.  It is our contention that individuals need to assess their own personal health and lifestyle needs, project into the future as much as possible, based on your own and family histories, and make the necessary arrangements for a satisfactory life from here on out, which should include long term care insurance, among other provisions.         

There is another aspect of denial that should be addressed by all people, and that is the spiritual or religious aspect of our lives.  A review of all the major—and minor—religions of the world show that they all have one thing in common: they present us with explanations of what happens to us after we die.  These explanations are, of course, belief systems, not subject to scientific scrutiny—nor should they be.  Science should only investigate those things subject to the scientific method, and thus far life after death is strictly in the spiritual realm. So what one person believes about what happens after we die is a personal view and just as legitimate as the next person’s.  But denial can become infused into our religious worlds, whereby our beliefs about the hereafter are imagined to take care of us while we are alive in this world.  But outside the instances of rare, miraculous interventions, we know this doesn’t happen.                        

For our purposes, it is also true that all the religions present explanations to a universal problem that afflicts all mankind—namely that of suffering.  And, as we all know, suffering is definitely a this world problem.  If one develops one of the above mentioned handicaps, that could be classified as a case of individual suffering.  Miracles aside (for which explanations elude us), we find that suffering in this life has to handled by the individual, the family, the community, and the nation, using whatever resources are available to us.  Long term care insurance is just one of many resources available to us.

Denial can play tricks with one's mind when they begin to think about their own mortality.  Imagining oneself in a nursing home or dependent on another person to perform basic tasks such as bathing is a tough thing to swallow.  We will all face the risk in needing long term care so planning ahead is the key.  If you'd like to learn more about long term care insurance please fill in the form below.  Thank you for reading today's article.

1. Gregory Kimble, Ph.D. & Norman Garmezy, Ph.D.,  pp 468-470, The Ronald Press Company, New York, 1968
2. Sidney Jourard, Ph.D.,  pp 140-142, The Macmillan Company, 1970