Real Celebrity: Extended care, part 2

The risk factors for stroke read like a description of America in some respects: smoking, obesity, high blood pressure and lack of exercise.

The direct costs of stroke treatment are expected to exceed $180 billion per year by 2030, while the economic impact of lost productivity adds another $56 billion. Since the greatest uptick in stroke is expected to occur among adults ages 45 to 64, those people's personal finances will be further strained. Unless they can get through the difficult Social Security Disability Insurance claim process, they will be unable to receive Medicare.

Kathleen Turner: Arthritis

Kathleen Turner is perhaps best-known for her sultry, intelligent roles, among them "Body Heat", "Prizzi's Honor", and "The War of the Roses." 

Her feistiness erupted off-screen when—upon learning she'd have to spend the rest of her life wheelchair-bound— she fired her physician on the spot.

The early 1990s were not easy for Turner. She was diagnosed with the auto-immune disorder rheumatoid arthritis (RA), then underwent nine surgeries in the ensuing decade (including double knee replacement) to maintain her mobility and flexibility and to ensure she would remain wheelchair-free.

Turner fits the profile of a typical RA sufferer: a woman between the ages of 40 and 60. Since RA typically affects the small joints of the hands and feet — causing painfull swelling, bone erosion and joint deformity — it's not hard to imagine how such an illness could potentially lead to the loss of "activities of daily living" — ADL — independence.

While rheumatoid arthritis is an auto-immune disease (and perhaps more closely tied to fibromyalgia and lupus), osteoarthritis is "your grandmother's arthritis," affecting 48 percent of people over age 65. Because it is correlated with obesity, heart disease and diabetes, our national arthritis rate is expected to climb.

Pain, stiffness and fatigue are hallmarks of both versions of arthritis, and both types can lead to a need for assistance. The type of services needed may range from help with household chores and medication management to help with writing, dressing and bathing.

Next week: Read about how one other public figure has used extended care — and about another public figure's experience as a caregiver.

See also:

• LTCI sales boosters: 5 tools
• Real socialism
• Real acronyms: LTC or LTSS?