The insane cost of elder care

[Anonymous]

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Anonymous wrote:My parents thought they had planned carefully but had no comprehension of elder care costs in the 21st century (neither did us kids). They were an accountant and administrative assistant with modest pensions and <$1 million in other savings. It's all gone after years of those $10k/month bills. My Dad passed at 86 and my 88-year old Mom is moving to a Medicaid facility this summer.

Sometimes that's how it goes when you get old. I have no better suggestion other than to not be sick for very long at the end.

Precisely what happened to us. My dad went to level 4 LTC at Hebrew Home in Rockville at 15K/month. Previously he'd had 24-hour private nurses at his home at ca. 30k/month. We burned through his savings, and his house sale proceeds, like a match through dry grass.

Now that he has passed, I'm wondering what to do in my own old age. "Not being sick for very long at the end" is the only solution in the US, unless you are very wealthy indeed.

+1. Unless you/your family has recenlty had to deal with elder care, you just don't get it. Unless you are independently wealthy, you can never save enough. And this is why more and more parents are moving in with their children - the money starts to run out.

You don't have to be "independently wealthy" to buy LTC. People just don't choose to spend their money that way. My in-laws did. And we will too. My father is broke enough that we will just spend down his assets and use Medicaid.

This is just not true, this insurance is ridiculously expensive. My parents had two policies (that did not kick in for 180 days so you're stuck with the cost early on) and the lovely state of Md decided that it was okay for the premiums to increase even though their policy was sold as a lifetime locked premium. This from a very reputable insurance company. As soon as MD passed the law the insurance company doubled their monthly premiums and that was in their fifties. They had to let it go by the time they retired because the premium cost over time out weighed their possible redeeming any usage. It was not inexpensive and I hate when people throw it around as if you are a total loser for not having it. LTC is for the WEALTHY but it will become insolvent with all the wealthy boomers who purchased it once they start cashing in, there just aren't enough policy holders to support that coming disaster.

My in-laws paid $50k each upfront for their policies. No ongoing premiums.

LTC insurance is well-recognized to be in dire straits--either they offer a reasonable deal and the company goes under and doesn't pay out as expected or they are increasingly unaffordable. Your in-laws better check the fine print. They may be okay or they may not be. There are so many think tanks working on how to solve this problem.

It's also a case where the state insurance backstop for insolvency is basically worthless because they are capped far lower than the benefit

[Anonymous]

Anonymous wrote:This may sound kind of horrible, but my dad says he is relieved that both of his parents died in quick succession when we kids were toddlers.

Everyone wishes they will live to 100, but if they have to die, I think everyone wishes for a quick death.

Most people have DNRs in place, but I think all the pharmaceuticals also have a role. Even high blood pressure meds. When someone is very ill, advanced dementia, plus numerous other issues, why are they on meds? Is a stroke worse than dying from other ways? My grandparents lived until their late 90s and it was not a good quality of life. The most heartbreaking was my relative who was blind, deaf, dementia, GERD, unable to walk, and had a lot of intestinal pain.

[Anonymous]

Anonymous wrote:This may sound kind of horrible, but my dad says he is relieved that both of his parents died in quick succession when we kids were toddlers.

My parents died within 3 months of each other. It is horrible but it was also a relief that we didn't have to navigate this process. We started to look into care for my dad and it was $9000 per month. It would have bankrupted them and me and my siblings.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My parents thought they had planned carefully but had no comprehension of elder care costs in the 21st century (neither did us kids). They were an accountant and administrative assistant with modest pensions and <$1 million in other savings. It's all gone after years of those $10k/month bills. My Dad passed at 86 and my 88-year old Mom is moving to a Medicaid facility this summer.

Sometimes that's how it goes when you get old. I have no better suggestion other than to not be sick for very long at the end.

Precisely what happened to us. My dad went to level 4 LTC at Hebrew Home in Rockville at 15K/month. Previously he'd had 24-hour private nurses at his home at ca. 30k/month. We burned through his savings, and his house sale proceeds, like a match through dry grass.

Now that he has passed, I'm wondering what to do in my own old age. "Not being sick for very long at the end" is the only solution in the US, unless you are very wealthy indeed.

+1. Unless you/your family has recenlty had to deal with elder care, you just don't get it. Unless you are independently wealthy, you can never save enough. And this is why more and more parents are moving in with their children - the money starts to run out.

You don't have to be "independently wealthy" to buy LTC. People just don't choose to spend their money that way. My in-laws did. And we will too. My father is broke enough that we will just spend down his assets and use Medicaid.

This is just not true, this insurance is ridiculously expensive. My parents had two policies (that did not kick in for 180 days so you're stuck with the cost early on) and the lovely state of Md decided that it was okay for the premiums to increase even though their policy was sold as a lifetime locked premium. This from a very reputable insurance company. As soon as MD passed the law the insurance company doubled their monthly premiums and that was in their fifties. They had to let it go by the time they retired because the premium cost over time out weighed their possible redeeming any usage. It was not inexpensive and I hate when people throw it around as if you are a total loser for not having it. LTC is for the WEALTHY but it will become insolvent with all the wealthy boomers who purchased it once they start cashing in, there just aren't enough policy holders to support that coming disaster.

You can buy plans with only 90 day wait period, your parents chose the 180 day wait period. My LMC parents (never made more than $40K as a family even with 3 kids at home) somehow managed to purchase LTC insurance in their 50s and have kept it up. They make it a priority so us kids are not straddled with figuring it out. They also were extremely frugal and saved a ton so they can manage their own retirement with only a bit of help from the kids. They will get $200/day should they ever need it.
It is not only the wealthy who purchase it. The wealthy actually do NOT need it. If you have $4M+, you can afford to pay for care or plan to put yourself in a CCRC by early 70s while still healthy. In a CCRC you don't really need LTC, it's covered by your upfront entry fee without any extra costs to you

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any countries out there that provide an equivalent level/amount of care for the elderly as one would expect at one of these expensive facilities but for a much more reasonable cost? Or is this a US thing?

My neighbor is of Indian descent and her father still lives in India. Apparently, the gov. provides 24 hr care for him (he's 90+). He can't come to the US anymore b/c they can no longer buy temporary health ins. for him. And he gets better care in India.

I have family that got their parents green cards and they eventually became citizens. Now in their 80s, they qualify for Medicaid but the quality of care and services is terrible! Doctors appointments take forever. One of the parents needs extensive care - can't walk properly, needs someone to walk him to the bathroom (may fall and has fallen down several times if no one is watching, etc.) - but according to medicaid doctors not at a point, not enough to be recommended for a care facility. They complain about awesome things would have been in India - 24/7 care, same day access doctors/specialists and hospitals, etc. but can't return because all kids are here and no one in India to take care of them.

I call BS on this comment. I’ve seen very recent documentaries about the healthcare system in India where family has to come to the hospital to care for covid patients or they don’t get cared for. Overrun and swamped and underfunded. India is going into the cesspool under Modi, it wouldn’t be a luxury elder care experience over there either.

For elder care, they don't just put them in a "nursing home". You can care for them at home with full time nurses/aides. For less than $1K/month you can provide actual nurses who do round the clock care in your home. So if you have are UMC/have US relatives who can help pay, it is cheap. Did this with my ILs---round the clock care from 2 excellent nurses, they become family after a few weeks. Had them for over 5 years.

[Anonymous]

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Anonymous wrote:My husband and his brothers pay for non-licensed aides to take care of their mother round the clock in her own apartment. She has always said she did not wish to go to a nursing home. They looked for aides from her own community, speaking her own language and cooking her cuisine. They are cheaper than
"official" senior aides because they have practically no education (not sure they even graduated high school), but after a decade of shopping for my MIL, cooking, cleaning, giving massages, and helping with very complex medication needs and increasing toileting needs, they have proved themselves very caring and trustworthy people. They are supervised, of course, by the son who lives nearby.

So in the end it comes to less than 5K a month, for an advanced Parkinson's patient owning her own apartment and with one child able to physically visit once every two days.

$5k/month for round-the clock caregivers would mean less than $7.50/hour. Licensed or not, this doesn't add up.

Round-the-clock care means 168 hrs/week. If you're only paying $5k/month, that's less than $7.50 per hour.

My FIL's round-the-clock caregivers cost $30/hour. Entry level. For one caregiver on duty 24/7, that's $5,000 per WEEK.

PP you replied to. No, the price for night time is much cheaper than the cost for daytime, where shopping/cleaning/cooking/conversation is involved. At night the caregiver has their own room and sleeps, basically, only to be rung if ever my MIL needs help, which she doesn't right now, except the occasional bathroom visit. As I explained, there is no entry level, none of this follows standards, the people hired do not have any degrees. The aides are happy to get the work. Since they're all from my MIL's native country and speak the same language, it's hard to explain, but there is a sense of loyalty and there is a bond. They know my MIL will never fire them until she dies, because she knows they depend on the income. And they know they will be recommended to her friends and relatives if they are trustworthy. So it works out.

It's really nice. There are situations where it's best to do that rather than hire formally trained expensive nurses that have no particular loyalty to the patient.

Sorry, but the more you write, the more it sounds as though your family is taking advantage of these untrained aides. Please think about this and treat these people better.

PP you replied to. They know exactly what the market is like, PP. This is a community of war refugees. The people that made it here are not stupid, but some of them lack diplomas. The aides are paid a living wage, we know their husbands and children. The family paid to repatriate a husband who had fallen gravely ill abroad, and similar things beyond their wages. The aides understand exactly how much they can ask for beyond which the family could not afford to pay them.

You don't understand because perhaps you've never experienced this type of community before. These people all look after each other. There is no advantage taken. Also, and I don't mean to be rude or presume, but perhaps you prefer to think this way because you have not found such a system within the majority white community in which you live.

Excuses and rationalizations for taking advantage of people who are poor and less educated. But you and your parents are getting to pay less than the market rate and save your own money, so it’s okay to you.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:Unless you're wealthy, it's LTC insurance or Medicaid. Get your assets out of your name 5 years before you need Medicaid LTC or the state will take it all!

Well, no. That would be unethical. Why do you think others should pay for your health care? Are you a welfare queen, too? Do you like the dole?

DP. I know you are looking for a 'discussion' but why do you think a person, few years away from death, would really care about ethics or if society foots the bill? I wouldn't? We have enough money (and hopefully a lot more in 30 years when we hit our 80s) but I think it's society's job to take care of the elderly. Shame on you for not voting out every bast*rd that is trying to move the country in the opposite direction.

Society DOES take care of the elderly. What you are suggesting is that the elderly should be able to keep all their assets at the same time. That’s fine, if you raise the money for their care elsewhere (ie tax the rich or a consumption tax or whatever) but we don’t do that. Advocating FRAUD and sheltering assets to duck the cost of care under the current system is disgusting and unethical. Freeloaders suck.

Your ignorance is showing.. please come back when you have learned the difference between between tax planning and tax fraud.

Estate planning attorney here. “Medicaid planning” is impoverishing yourself on paper to qualify for gov’t benefits that are intended for the poor. Plain and simple. I agree the cost of long-term care is a terrible shame. But it doesn’t follow that I shouldn’t have to pay it because damnit I worked hard and I want my kids to get my money.

“Impoverishing yourself on paper” is a nasty, derogatory, calumny, used perjoratively to describe seeking and following expert legal advice to structure assets to obtain maximum benefits from a public benefit plan according to its legislative and regulatory terms. It is akin to prudent tax planning, including (yes) estate planning. Whatever someone else may think, these provisions are part of the law. Congress and the regulators know they are there. The envy, hatred and condescension toward people in need in US society is appalling. One would think that the detractors were being dragged to open their own checkbook for someone else.

Sorry, Medicaid is meant for the poor, not middle class people with assets who want their kids to inherit those assets instead of paying for their own care. It is out and out fraud to “structure” assets to take advantage of benefits meant for the poor.

If the benefits truly were meant for everyone, there would be no need to hide… er, I mean “structure” assets in order to appear eligible for the program.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:I know I shouldn’t be shocked but the cost of care for the elderly is insane. I’m researching assisted living places. In addition to the rent, which is significant, there are extra costs for medication administration and “level 1-4 care” which is from $400-$2500 extra per month on top of rent. There are special programs for people who suffer from memory issues (not a memory care facility but a group), and other types of extra group programs. These range from $1000-$1500 more a month.

Seriously looking at $9k-$11k per month. How do people afford that??

LTC is for the rich. The rich afford it because they have a lot of money. The rest of the population doesn't afford it. They either die or they have strong family bonds and live with family members who care for them.

My LMC parents purchased LTC because they didn't want to be a burden for the kids. They never made more than $40K total as a family. But they made it a priority. You do not have to be rich....in fact the rich dont' need it. It's the MC/LMC who need it.

How are they affording long term care on 40k?

Or do you mean to say they had insurance?

They purchased it in their late 50s. Are now retired and still pay the same rate. They afford it because they live frugally and make saving for retirement and this a priority. Retired, then sold their house at 75 and are worth close to $1M. All from living frugally and saving---including at least 3-4 time periods where nobody in the house had a job for at least 6-12 months (I know because that's when I would get free lunch at school). They had a huge garden so majority of their food came from it thru sweat and hard labor. Always did everything themselves around the house except for HVAC (I've helped reroof the house as a teen and put in new hot water heaters, all plumbing repairs, etc). Drove old cars, nothing fancy. No fancy vacations.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any countries out there that provide an equivalent level/amount of care for the elderly as one would expect at one of these expensive facilities but for a much more reasonable cost? Or is this a US thing?

My neighbor is of Indian descent and her father still lives in India. Apparently, the gov. provides 24 hr care for him (he's 90+). He can't come to the US anymore b/c they can no longer buy temporary health ins. for him. And he gets better care in India.

He was likely a govt worker to get that. But it doesn't matter really because in India you can spend the equivalent of ~$500 USD/month and have excellent round the clock nursing care--typically 2 nurses that work opposing shifts. That would cost $20K+/month in US, likely closer to $30K and no guarantee that the nurses don't just not show up---nursing care is hard to get consistency for only $25/hour.

I am Indian and you are painting a really rosy picture here. The poverty in India is shocking to me when I go back. The reason why things are so cheap is because the average Indian lives on a few dollars a day and the entire country has rampant slavery and extreme labor abuses. Most likely said nurse heads home to a slum at night.

Most Indians are taken care of by extended family not just out of necessity, but out of tradition.

I'm well aware of the poverty in India. Married into an Indian family. I agree most are taken care of by the family, but the fact is you can still get good in home care for a decent price. Just like most UMC have a "driver" because it's only $250USD/month, and still relatively cheap for UMC+ Indians. When you hire the in home help, you are providing them a safe, reliable job and paying them more than no job. We hired actual nurses, not just a warm body to be there. These were nurses who had completed their degree and training. They were happy to work in this environment rather than a hospital and they became family (we treated them well). Brought them to USA when ILs came where they lived in our homes---we provided everything and paid them well, and when ILs passed, we worked to get them the documentation for them to remain in the USA and continue their lives here. Win-win for everyone. They were extremely well treated and are forever grateful for being able to come to the USA. Their being our family nurses put their lives on a whole new trajectory.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My husband and his brothers pay for non-licensed aides to take care of their mother round the clock in her own apartment. She has always said she did not wish to go to a nursing home. They looked for aides from her own community, speaking her own language and cooking her cuisine. They are cheaper than
"official" senior aides because they have practically no education (not sure they even graduated high school), but after a decade of shopping for my MIL, cooking, cleaning, giving massages, and helping with very complex medication needs and increasing toileting needs, they have proved themselves very caring and trustworthy people. They are supervised, of course, by the son who lives nearby.

So in the end it comes to less than 5K a month, for an advanced Parkinson's patient owning her own apartment and with one child able to physically visit once every two days.

$5k/month for round-the clock caregivers would mean less than $7.50/hour. Licensed or not, this doesn't add up.

Round-the-clock care means 168 hrs/week. If you're only paying $5k/month, that's less than $7.50 per hour.

My FIL's round-the-clock caregivers cost $30/hour. Entry level. For one caregiver on duty 24/7, that's $5,000 per WEEK.

PP you replied to. No, the price for night time is much cheaper than the cost for daytime, where shopping/cleaning/cooking/conversation is involved. At night the caregiver has their own room and sleeps, basically, only to be rung if ever my MIL needs help, which she doesn't right now, except the occasional bathroom visit. As I explained, there is no entry level, none of this follows standards, the people hired do not have any degrees. The aides are happy to get the work. Since they're all from my MIL's native country and speak the same language, it's hard to explain, but there is a sense of loyalty and there is a bond. They know my MIL will never fire them until she dies, because she knows they depend on the income. And they know they will be recommended to her friends and relatives if they are trustworthy. So it works out.

It's really nice. There are situations where it's best to do that rather than hire formally trained expensive nurses that have no particular loyalty to the patient.

Sorry, but the more you write, the more it sounds as though your family is taking advantage of these untrained aides. Please think about this and treat these people better.

PP you replied to. They know exactly what the market is like, PP. This is a community of war refugees. The people that made it here are not stupid, but some of them lack diplomas. The aides are paid a living wage, we know their husbands and children. The family paid to repatriate a husband who had fallen gravely ill abroad, and similar things beyond their wages. The aides understand exactly how much they can ask for beyond which the family could not afford to pay them.

You don't understand because perhaps you've never experienced this type of community before. These people all look after each other. There is no advantage taken. Also, and I don't mean to be rude or presume, but perhaps you prefer to think this way because you have not found such a system within the majority white community in which you live.

+1

And your family member would likely never be fully comfortable with an "American nurse/aide". They likely love the fact they can trust/communicate with their aide. Most other cultures treat their elderly well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Both of my DH's parents, who are divorced and 93 years old, are in an assisted living facility in Anne Arundel County that costs $4,000/month. The facility has only 12 beds, is privately run, and hasn't increased in price for 3 years. Each of his parents has a separate small bedroom with attached bathroom (with shower), and there are a couple of common areas and nice back yards (with fencing). The best thing is the meals are made family-style, in house, from real food - no Sysco sort of prepurchased junk.

Both his parents have dementia and are mostly incontinent, and both are wheelchair-bound. There is live-in staff 24/7 with nursing care and doctor visits. They're responsive and wonderful.

The only extra cost we pay is to a local pharmacy who provides supplies - this tends to be about $40-$50/month.

Having said that, both his parents are about to run out of money. I know their current place will accept Medicaid, so that might be what happens next.

For DH and myself, who are in our late fifties/early sixties, we can no longer qualify for LTC insurance because of cancer diagnoses. We'll be running through our own funds if necessary, but thankfully our grown kids are doing well on their own and don't need to rely on inheritance.

Wait they are divorced and live in the same facility that only has 12 rooms?

Of all the nursing homes in all the world…

(I’m sorry I probably shouldn’t joke about the difficult situation you’re managing but it just struck me if they were lucid how ironic it might seem. Glad you found what sounds like a great place for them)

Yes, I know, it is strange! But they don't recognize each other, and it's the easiest and most efficient way for us (and DH's siblings) to visit and care for them.

I figured this was why---caring for our parents is so challenging, gotta do anything you can to simplify it

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any countries out there that provide an equivalent level/amount of care for the elderly as one would expect at one of these expensive facilities but for a much more reasonable cost? Or is this a US thing?

My neighbor is of Indian descent and her father still lives in India. Apparently, the gov. provides 24 hr care for him (he's 90+). He can't come to the US anymore b/c they can no longer buy temporary health ins. for him. And he gets better care in India.

I have family that got their parents green cards and they eventually became citizens. Now in their 80s, they qualify for Medicaid but the quality of care and services is terrible! Doctors appointments take forever. One of the parents needs extensive care - can't walk properly, needs someone to walk him to the bathroom (may fall and has fallen down several times if no one is watching, etc.) - but according to medicaid doctors not at a point, not enough to be recommended for a care facility. They complain about awesome things would have been in India - 24/7 care, same day access doctors/specialists and hospitals, etc. but can't return because all kids are here and no one in India to take care of them.

I call BS on this comment. I’ve seen very recent documentaries about the healthcare system in India where family has to come to the hospital to care for covid patients or they don’t get cared for. Overrun and swamped and underfunded. India is going into the cesspool under Modi, it wouldn’t be a luxury elder care experience over there either.

Your comment is about as ridiculous someone in India telling you that every American walks around with a gun and shoots others on sight! What you say happened. Similar things also happened in the US during covid, or have you forgotten? Remember the ventilator fiasco? The public healthcare system in India is swamped and underfunded. It is the most populous country in the world and is an emerging economy, so what do you expect? However, the private healthcare system there is very robust. In most cities (which is where these folks are from) you can see a specialist in any domain, the same day or within a day or two. The best you can do here is a nurse at CVS or Urgent care/emergency care at an exorbitant premium. As another poster noted, you can get full-time in-home care for a fraction of what it costs here without depending on the government or a cartel.

I posted recently on another thread - I got a prescription, had comprehensive blood work, abdominal scans and cervical MRIs done, had them reviewed by a doctor, purchased some prescribed medication all over the span of 3 days. Total cost about $250!. I'm trying to get an appointment with a specialist here for my DC who needs to see one before heading out of the country next month, and the earliest appointments I'm getting are for end of June!

I do agree on your last point. The eldercare experience in India is not a luxury experience, simply because it's not an organized corporate experience but is mostly in-house. There is no medicaid equivalent for the poor, but that's not what I'm talking about (nor care about in this context).

Given that the median monthly salary in India is ~$400/month this is still extremely expensive from a relative perspective. Yes as an American you can go get great deals on medical/elder care in developing countries but that doesn’t mean it’s affordable for the average person from the local population. And frankly you and other wealthy expats going to seek “bargain” medical care there is driving up costs and making it even less affordable for locals without alternatives.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you're wealthy, it's LTC insurance or Medicaid. Get your assets out of your name 5 years before you need Medicaid LTC or the state will take it all!

Well, no. That would be unethical. Why do you think others should pay for your health care? Are you a welfare queen, too? Do you like the dole?

DP. I know you are looking for a 'discussion' but why do you think a person, few years away from death, would really care about ethics or if society foots the bill? I wouldn't? We have enough money (and hopefully a lot more in 30 years when we hit our 80s) but I think it's society's job to take care of the elderly. Shame on you for not voting out every bast*rd that is trying to move the country in the opposite direction.

Society DOES take care of the elderly. What you are suggesting is that the elderly should be able to keep all their assets at the same time. That’s fine, if you raise the money for their care elsewhere (ie tax the rich or a consumption tax or whatever) but we don’t do that. Advocating FRAUD and sheltering assets to duck the cost of care under the current system is disgusting and unethical. Freeloaders suck.

Your ignorance is showing.. please come back when you have learned the difference between between tax planning and tax fraud.

Estate planning attorney here. “Medicaid planning” is impoverishing yourself on paper to qualify for gov’t benefits that are intended for the poor. Plain and simple. I agree the cost of long-term care is a terrible shame. But it doesn’t follow that I shouldn’t have to pay it because damnit I worked hard and I want my kids to get my money.

“Impoverishing yourself on paper” is a nasty, derogatory, calumny, used perjoratively to describe seeking and following expert legal advice to structure assets to obtain maximum benefits from a public benefit plan according to its legislative and regulatory terms. It is akin to prudent tax planning, including (yes) estate planning. Whatever someone else may think, these provisions are part of the law. Congress and the regulators know they are there. The envy, hatred and condescension toward people in need in US society is appalling. One would think that the detractors were being dragged to open their own checkbook for someone else.

Sorry, Medicaid is meant for the poor, not middle class people with assets who want their kids to inherit those assets instead of paying for their own care. It is out and out fraud to “structure” assets to take advantage of benefits meant for the poor.

If the benefits truly were meant for everyone, there would be no need to hide… er, I mean “structure” assets in order to appear eligible for the program.

Complying with the law is fraud? Because it offends your ignorant and judgmental sensibilities? You don’t have the slightest idea what you are talking about.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My husband and his brothers pay for non-licensed aides to take care of their mother round the clock in her own apartment. She has always said she did not wish to go to a nursing home. They looked for aides from her own community, speaking her own language and cooking her cuisine. They are cheaper than
"official" senior aides because they have practically no education (not sure they even graduated high school), but after a decade of shopping for my MIL, cooking, cleaning, giving massages, and helping with very complex medication needs and increasing toileting needs, they have proved themselves very caring and trustworthy people. They are supervised, of course, by the son who lives nearby.

So in the end it comes to less than 5K a month, for an advanced Parkinson's patient owning her own apartment and with one child able to physically visit once every two days.

$5k/month for round-the clock caregivers would mean less than $7.50/hour. Licensed or not, this doesn't add up.

Round-the-clock care means 168 hrs/week. If you're only paying $5k/month, that's less than $7.50 per hour.

My FIL's round-the-clock caregivers cost $30/hour. Entry level. For one caregiver on duty 24/7, that's $5,000 per WEEK.

PP you replied to. No, the price for night time is much cheaper than the cost for daytime, where shopping/cleaning/cooking/conversation is involved. At night the caregiver has their own room and sleeps, basically, only to be rung if ever my MIL needs help, which she doesn't right now, except the occasional bathroom visit. As I explained, there is no entry level, none of this follows standards, the people hired do not have any degrees. The aides are happy to get the work. Since they're all from my MIL's native country and speak the same language, it's hard to explain, but there is a sense of loyalty and there is a bond. They know my MIL will never fire them until she dies, because she knows they depend on the income. And they know they will be recommended to her friends and relatives if they are trustworthy. So it works out.

It's really nice. There are situations where it's best to do that rather than hire formally trained expensive nurses that have no particular loyalty to the patient.

Sorry, but the more you write, the more it sounds as though your family is taking advantage of these untrained aides. Please think about this and treat these people better.

PP you replied to. They know exactly what the market is like, PP. This is a community of war refugees. The people that made it here are not stupid, but some of them lack diplomas. The aides are paid a living wage, we know their husbands and children. The family paid to repatriate a husband who had fallen gravely ill abroad, and similar things beyond their wages. The aides understand exactly how much they can ask for beyond which the family could not afford to pay them.

You don't understand because perhaps you've never experienced this type of community before. These people all look after each other. There is no advantage taken. Also, and I don't mean to be rude or presume, but perhaps you prefer to think this way because you have not found such a system within the majority white community in which you live.

+1

And your family member would likely never be fully comfortable with an "American nurse/aide". They likely love the fact they can trust/communicate with their aide. Most other cultures treat their elderly well.

Workers deserve to be treated well no matter what race or culture they are from. It is shameful to treat people this way who are taking care of beloved family members.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you're wealthy, it's LTC insurance or Medicaid. Get your assets out of your name 5 years before you need Medicaid LTC or the state will take it all!

Well, no. That would be unethical. Why do you think others should pay for your health care? Are you a welfare queen, too? Do you like the dole?

DP. I know you are looking for a 'discussion' but why do you think a person, few years away from death, would really care about ethics or if society foots the bill? I wouldn't? We have enough money (and hopefully a lot more in 30 years when we hit our 80s) but I think it's society's job to take care of the elderly. Shame on you for not voting out every bast*rd that is trying to move the country in the opposite direction.

Society DOES take care of the elderly. What you are suggesting is that the elderly should be able to keep all their assets at the same time. That’s fine, if you raise the money for their care elsewhere (ie tax the rich or a consumption tax or whatever) but we don’t do that. Advocating FRAUD and sheltering assets to duck the cost of care under the current system is disgusting and unethical. Freeloaders suck.

Your ignorance is showing.. please come back when you have learned the difference between between tax planning and tax fraud.

Estate planning attorney here. “Medicaid planning” is impoverishing yourself on paper to qualify for gov’t benefits that are intended for the poor. Plain and simple. I agree the cost of long-term care is a terrible shame. But it doesn’t follow that I shouldn’t have to pay it because damnit I worked hard and I want my kids to get my money.

You are entitled to your opinion (and I agree with you on this) but it doesn't qualify as fraud, does it?