TH does far more than merely adjust your shift points. Unless your coach is small and lightly loaded, towing nothing, using Tow Haul all of the time is a good way to go. On a long flat/slight downhill stretch obviously disengaging TH is fine as well. The sheer weight of most motorhomes over 24' provide more than enough load for the advantages of TH to far out weigh minimal {if any} decrease in mpg.
On occasion I have simply forgotten to engage TH. This bit of foolishness on my part is quickly exposed when I glance at my Scan Gauge on even a slight grade and note the trans fluid temps climbing 12 - 15 degrees. An "Oops' followed by reengaging TH generates an almost immediate drop in trans fluid temps back to normal... :S
Following a rig on a long mountain descent it becomes immediately apparent if they are not using TH as they are constantly on their brakes often arrive at the bottom of the grade with significantly reduced braking capability due to their overheating. The other huge benefit to TH use on descents is that you are not burning a drop of fuel regardless of rpm. TH locks the the torque converter and shuts off the flow of fuel to the engine enhancing not only control but fuel efficiency as well.
:C