The insane cost of elder care

[Anonymous]

Anonymous wrote:

Anonymous wrote:I mean, the people on this board actually like everyone needs 15 years of round the clock care. Statistically that just isn’t true. The vast majority are under 24 months.

1) You don't know which you will be, and couples are rolling the dice twice. And even two years of care x 2 currently equals 400k on average.
2) You don't know what the future will hold for all of us on average. How will medical advancements impact this?
3) We are a society that has not solved this problem that in any way seems remotely reasonable and are too politically divided to likely make progress any time soon. The current system has a not small chance of bankrupting one spouse even in households that have earned well and prudently saved over their lifetimes.

And it's weird because the people making these laws and those voting for the lawmakers, are boomers, presumably people who will need LTC.

[Anonymous]

Anonymous wrote:

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

https://www.nbcconnecticut.com/investigations/nbc-ct-responds/exclusive-famous-soap-opera-stars-family-shares-frustration-over-long-term-care-policy/3032493/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My plan for when I hit retirement is to buy a small unit with lifetime continuing care in a retirement complex and a second house or condo somewhere either for winters (six months in Florida) or coastal New England (five months in spring to fall). When the time comes, I can sell the second property and upgrade the unit to a bigger 2-bedroom and live there full time. But I will have a foot in the door so they can't kick me out if I suddenly start declining, physically or cognitively. I am single, will always be single so no spouse to help take care of me. I want the guarantee of lifetime care no matter what happens. Yes, expensive, but I can make it happen. This plan is based on what good friends of my parents have done.

CCRCs are the way to go---good goal to be able to get in. If you can afford one, it's the best way to know you will be well taken care of. Paid entry fee to get my parents in (they have enough to qualify minus the entry fee). Best thing we ever did. They are a distance from us and refused to move closer. This way they are well taken care of and should they need more than independent living, it will seamlessly happen, and will not cost them (or us) a penny more---that's what the huge entry fee is for. Best part is, even if they "run out of money", the CCRC will still continue service---you are guaranteed to live your life there and they do NOT touch your monthly SS. Most who have run out of money are women over 95---there are 4 of them currently living there who pay nothing each month, husbands have long since died. 2 are still in independent living, the other 2 are in assisted living.

If you plan well it can happen---my parents are not wealthy. But made it happen.

Do you have any numbers to share? Which CCRCs are you talking about? What's the entrance fee? monthly cost? etc.

I'm not the PP you quoted, but I posted earlier, naming Collington in Bowie and Riderwood in Silver Spring.

There's a chart on this page with some sample pricing for Collington: https://collington.kendal.org/living-options/pricing-information/

They don't detail the "entrance fee." And you don't get all of that back. So, the monthly fee looks low because it isn't including a portion for the entrance fee.

Also, I noticed that the service level for "memory care" does not include assistance for daily grooming and toileting. That doesn't count as an amenity until you are in long term nursing care. The details on the website are lacking and of course they want you to think it's a good deal...to get you in the door.

If it diunds too good to be true, it probably is.

The entrance fees are on that chart.

My mom is currently in independent living there, so I don't yet have firsthand experience with the assisted living areas, but so far we are really happy with it. She wasn't to the point of needing help every day, but she would have recurring incidents (for instance, a UTI causing momentary dementia) that were hard for me to keep tabs on alone. Collington does things like wellness checks if you haven't opened your front door in 24 hours. Not to mention she's made tons of friends, who check in on her as well. The residents are well-educated (former) professionals for the most part, and there are tons of seminars and concerts and activities to keep people engaged. Very happy with it so far.

If you have two parents sharing a 2bd, for example, would you have to pay just one entry fee for the unit and two service packages? Or two entry fees even though sharing a unit?

That's a good question, and I'm sorry, I don't know the answer.

For my parents (not in DCUM, but a bit outside), they paid one entry fee ($450K) plus the 2nd person add on ($85K). Then there is the monthly rent (~4500) for first person plus the 2nd person addition (~$1500). For a 2bed/2bath, ~1200 sq ft. The entry fee "value back" declines by 2% each month for the first 49 months (4 years)---so if you die/no longer live there, you get an amount refunded accordingly during that time. After the 4 years, you get nothing returned.

If one person goes to nursing care, assisted living, or dementia care within the CCRC, the prices do not change drastically for the couple and the other gets to remain in the same 2 bed/2 bath. If one person dies, the other gets to remain for just the $4.5K monthly rent, but can choose to downsize to a smaller unit to save $$ if desired. The only price increase is for 3 meals/day cost that are provided in assisted living/nursing/dementia care, as in independent living you have $360/month per person which gives you easily dinner everyday and another 2-4 meals per week, possibly more depending which restaurant you choose to dine in. So you likely will pay an extra $200-300/month for meals and that is it. The added care levels is included in the entrance fee you paid (the $450K+ for the couple).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

Nope. There are plenty of places that are $3-5k a month.

They may start you out at that rate... but 6 mos later, that place is bought out by XXX company, and the price goes up to $6500/mo. Then another 6 mos later, they do an assessment and decide the needs have increased (although it's mostly the same as it was in the beginning) and the price goes up to $8000/mo. By this point, your parent is familiar with the routines/people at this place, so you don't want to move him/her b/c it will likely cause agitation and even more confusion.... and besides that, there are waiting lists for the other places (that are cheaper). So, you figure it can't be THAT long before they don't need any care at all. And time goes on...

The "retirement savings" of $250,000 are dwindling down month by month (after using all the parent's SS and military pension first, and then drawing the remaining balance from the retirement savings). The parent who is fully healthy stays in the marital home, but honestly, is going to be a lot better off financially when the dementia parent dies b/c she will get the use of the spousal portion of the military pension and the widow portion of the SS. For people in the midwest who stopped working 20+ yrs ago (now in their 80's) -- whose salaries were never comparable to what people earn today (and on the coasts), $250k was a very respectable retirement nestegg. But, when you start drawing down several thousand per month, and that goes on for years... it shows you where the gaps are in our care system.

I don't think it's correct to suggest that there are places for people with dementia at $3-5k/mo. That's more of a way to get people into the facility... and it assumes they are low-needs/high-functioning. That's just not the case for most people who are progressing through dementia -- they need full care.

We did not experience this. There was a small increase the second year.

Yes, there absolutely are places that are $3-5k per month for dementia.

Please provide a link to this place!

Here is one company

https://www.avalonresidentialliving.com/

There are companies like this all over the US. Numerous ones in the dmv. Half the price as larger places like Atria. You certainly don’t need to spend $10-12k per month.

These look awful. Are these Medicaid homes?

+1

Whoa. Someone bought up old homes and are claiming that they are a care plan? Wow.

“Someone” didn’t buy up old homes. The individual homes are run just like any other care facility. In fact, it can be a better option for some dementia patients to have fewer staff and residents. The qualifications of the staff are the same as at large facilities. They have medical care on-site, daily activities and meals are cooked on-site.

You’re passing a lot of judgement and likely have never visited one of these places or done any research. I’m so glad there are options for someone not wanting to spend $10k a month to an Atria like facility.

A lot of people are throwing around 9-12k figures for monthly care. It doesn’t make sense that care should cost this month! Especially the corporate owned facilities paying close to minimum wage. This is a highly profitable business. You don’t have to spend that kind of money if you don’t want to.

Yes it’s a lot of money, but considering many parents are paying $2500+ for ~ 45-50 hour/ week of daycare which often doesn’t even include meals, 9-12k for 24/7 care including room and board doesn’t seem unreasonable.

+1 Plus, that 9-12K for 24/7 care does include some medical staff on duty--there will be fully trained nurses on staff, not just 25yo workers trained to feed, bathe, cloth, etc a patient.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My plan for when I hit retirement is to buy a small unit with lifetime continuing care in a retirement complex and a second house or condo somewhere either for winters (six months in Florida) or coastal New England (five months in spring to fall). When the time comes, I can sell the second property and upgrade the unit to a bigger 2-bedroom and live there full time. But I will have a foot in the door so they can't kick me out if I suddenly start declining, physically or cognitively. I am single, will always be single so no spouse to help take care of me. I want the guarantee of lifetime care no matter what happens. Yes, expensive, but I can make it happen. This plan is based on what good friends of my parents have done.

CCRCs are the way to go---good goal to be able to get in. If you can afford one, it's the best way to know you will be well taken care of. Paid entry fee to get my parents in (they have enough to qualify minus the entry fee). Best thing we ever did. They are a distance from us and refused to move closer. This way they are well taken care of and should they need more than independent living, it will seamlessly happen, and will not cost them (or us) a penny more---that's what the huge entry fee is for. Best part is, even if they "run out of money", the CCRC will still continue service---you are guaranteed to live your life there and they do NOT touch your monthly SS. Most who have run out of money are women over 95---there are 4 of them currently living there who pay nothing each month, husbands have long since died. 2 are still in independent living, the other 2 are in assisted living.

If you plan well it can happen---my parents are not wealthy. But made it happen.

Do you have any numbers to share? Which CCRCs are you talking about? What's the entrance fee? monthly cost? etc.

I'm not the PP you quoted, but I posted earlier, naming Collington in Bowie and Riderwood in Silver Spring.

There's a chart on this page with some sample pricing for Collington: https://collington.kendal.org/living-options/pricing-information/

They don't detail the "entrance fee." And you don't get all of that back. So, the monthly fee looks low because it isn't including a portion for the entrance fee.

Also, I noticed that the service level for "memory care" does not include assistance for daily grooming and toileting. That doesn't count as an amenity until you are in long term nursing care. The details on the website are lacking and of course they want you to think it's a good deal...to get you in the door.

If it diunds too good to be true, it probably is.

The entrance fees are on that chart.

My mom is currently in independent living there, so I don't yet have firsthand experience with the assisted living areas, but so far we are really happy with it. She wasn't to the point of needing help every day, but she would have recurring incidents (for instance, a UTI causing momentary dementia) that were hard for me to keep tabs on alone. Collington does things like wellness checks if you haven't opened your front door in 24 hours. Not to mention she's made tons of friends, who check in on her as well. The residents are well-educated (former) professionals for the most part, and there are tons of seminars and concerts and activities to keep people engaged. Very happy with it so far.

If you have two parents sharing a 2bd, for example, would you have to pay just one entry fee for the unit and two service packages? Or two entry fees even though sharing a unit?

That's a good question, and I'm sorry, I don't know the answer.

For my parents (not in DCUM, but a bit outside), they paid one entry fee ($450K) plus the 2nd person add on ($85K). Then there is the monthly rent (~4500) for first person plus the 2nd person addition (~$1500). For a 2bed/2bath, ~1200 sq ft. The entry fee "value back" declines by 2% each month for the first 49 months (4 years)---so if you die/no longer live there, you get an amount refunded accordingly during that time. After the 4 years, you get nothing returned.

If one person goes to nursing care, assisted living, or dementia care within the CCRC, the prices do not change drastically for the couple and the other gets to remain in the same 2 bed/2 bath. If one person dies, the other gets to remain for just the $4.5K monthly rent, but can choose to downsize to a smaller unit to save $$ if desired. The only price increase is for 3 meals/day cost that are provided in assisted living/nursing/dementia care, as in independent living you have $360/month per person which gives you easily dinner everyday and another 2-4 meals per week, possibly more depending which restaurant you choose to dine in. So you likely will pay an extra $200-300/month for meals and that is it. The added care levels is included in the entrance fee you paid (the $450K+ for the couple).

Your parents are in a very expensive place. I think it's great that they can afford it, but not everyone needs or wants that level of comfort and care.

[Anonymous]

https://medicareguide.com/best-and-worst-states-for-long-term-care-331669

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

This. It is the middle class that needs LTC insurance. It is not crazy expensive. Rich don’t need it.

+1

Yup, the rich can fund 2-3 years of round the clock care at in their home without issues. The rich are also more likely to put themselves into a CCRC while still healthy in early 70s or sooner, where the incremental costs of full time care are paid with one upfront entrance fee.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My plan for when I hit retirement is to buy a small unit with lifetime continuing care in a retirement complex and a second house or condo somewhere either for winters (six months in Florida) or coastal New England (five months in spring to fall). When the time comes, I can sell the second property and upgrade the unit to a bigger 2-bedroom and live there full time. But I will have a foot in the door so they can't kick me out if I suddenly start declining, physically or cognitively. I am single, will always be single so no spouse to help take care of me. I want the guarantee of lifetime care no matter what happens. Yes, expensive, but I can make it happen. This plan is based on what good friends of my parents have done.

CCRCs are the way to go---good goal to be able to get in. If you can afford one, it's the best way to know you will be well taken care of. Paid entry fee to get my parents in (they have enough to qualify minus the entry fee). Best thing we ever did. They are a distance from us and refused to move closer. This way they are well taken care of and should they need more than independent living, it will seamlessly happen, and will not cost them (or us) a penny more---that's what the huge entry fee is for. Best part is, even if they "run out of money", the CCRC will still continue service---you are guaranteed to live your life there and they do NOT touch your monthly SS. Most who have run out of money are women over 95---there are 4 of them currently living there who pay nothing each month, husbands have long since died. 2 are still in independent living, the other 2 are in assisted living.

If you plan well it can happen---my parents are not wealthy. But made it happen.

Do you have any numbers to share? Which CCRCs are you talking about? What's the entrance fee? monthly cost? etc.

I'm not the PP you quoted, but I posted earlier, naming Collington in Bowie and Riderwood in Silver Spring.

There's a chart on this page with some sample pricing for Collington: https://collington.kendal.org/living-options/pricing-information/

They don't detail the "entrance fee." And you don't get all of that back. So, the monthly fee looks low because it isn't including a portion for the entrance fee.

Also, I noticed that the service level for "memory care" does not include assistance for daily grooming and toileting. That doesn't count as an amenity until you are in long term nursing care. The details on the website are lacking and of course they want you to think it's a good deal...to get you in the door.

If it diunds too good to be true, it probably is.

The entrance fees are on that chart.

My mom is currently in independent living there, so I don't yet have firsthand experience with the assisted living areas, but so far we are really happy with it. She wasn't to the point of needing help every day, but she would have recurring incidents (for instance, a UTI causing momentary dementia) that were hard for me to keep tabs on alone. Collington does things like wellness checks if you haven't opened your front door in 24 hours. Not to mention she's made tons of friends, who check in on her as well. The residents are well-educated (former) professionals for the most part, and there are tons of seminars and concerts and activities to keep people engaged. Very happy with it so far.

If you have two parents sharing a 2bd, for example, would you have to pay just one entry fee for the unit and two service packages? Or two entry fees even though sharing a unit?

That's a good question, and I'm sorry, I don't know the answer.

For my parents (not in DCUM, but a bit outside), they paid one entry fee ($450K) plus the 2nd person add on ($85K). Then there is the monthly rent (~4500) for first person plus the 2nd person addition (~$1500). For a 2bed/2bath, ~1200 sq ft. The entry fee "value back" declines by 2% each month for the first 49 months (4 years)---so if you die/no longer live there, you get an amount refunded accordingly during that time. After the 4 years, you get nothing returned.

If one person goes to nursing care, assisted living, or dementia care within the CCRC, the prices do not change drastically for the couple and the other gets to remain in the same 2 bed/2 bath. If one person dies, the other gets to remain for just the $4.5K monthly rent, but can choose to downsize to a smaller unit to save $$ if desired. The only price increase is for 3 meals/day cost that are provided in assisted living/nursing/dementia care, as in independent living you have $360/month per person which gives you easily dinner everyday and another 2-4 meals per week, possibly more depending which restaurant you choose to dine in. So you likely will pay an extra $200-300/month for meals and that is it. The added care levels is included in the entrance fee you paid (the $450K+ for the couple).

This is a crazy amount of money and not financially prudent for obvious reasons.

I know someone who makes bad financial decisions and his parents do too. Sure enough he’s moving his able bodied parents into one of these communities and thinks it’s a great deal. These places are businesses and out to make money.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

Nope. There are plenty of places that are $3-5k a month.

They may start you out at that rate... but 6 mos later, that place is bought out by XXX company, and the price goes up to $6500/mo. Then another 6 mos later, they do an assessment and decide the needs have increased (although it's mostly the same as it was in the beginning) and the price goes up to $8000/mo. By this point, your parent is familiar with the routines/people at this place, so you don't want to move him/her b/c it will likely cause agitation and even more confusion.... and besides that, there are waiting lists for the other places (that are cheaper). So, you figure it can't be THAT long before they don't need any care at all. And time goes on...

The "retirement savings" of $250,000 are dwindling down month by month (after using all the parent's SS and military pension first, and then drawing the remaining balance from the retirement savings). The parent who is fully healthy stays in the marital home, but honestly, is going to be a lot better off financially when the dementia parent dies b/c she will get the use of the spousal portion of the military pension and the widow portion of the SS. For people in the midwest who stopped working 20+ yrs ago (now in their 80's) -- whose salaries were never comparable to what people earn today (and on the coasts), $250k was a very respectable retirement nestegg. But, when you start drawing down several thousand per month, and that goes on for years... it shows you where the gaps are in our care system.

I don't think it's correct to suggest that there are places for people with dementia at $3-5k/mo. That's more of a way to get people into the facility... and it assumes they are low-needs/high-functioning. That's just not the case for most people who are progressing through dementia -- they need full care.

We did not experience this. There was a small increase the second year.

Yes, there absolutely are places that are $3-5k per month for dementia.

Please provide a link to this place!

Here is one company

https://www.avalonresidentialliving.com/

There are companies like this all over the US. Numerous ones in the dmv. Half the price as larger places like Atria. You certainly don’t need to spend $10-12k per month.

These look awful. Are these Medicaid homes?

+1

Whoa. Someone bought up old homes and are claiming that they are a care plan? Wow.

“Someone” didn’t buy up old homes. The individual homes are run just like any other care facility. In fact, it can be a better option for some dementia patients to have fewer staff and residents. The qualifications of the staff are the same as at large facilities. They have medical care on-site, daily activities and meals are cooked on-site.

You’re passing a lot of judgement and likely have never visited one of these places or done any research. I’m so glad there are options for someone not wanting to spend $10k a month to an Atria like facility.

A lot of people are throwing around 9-12k figures for monthly care. It doesn’t make sense that care should cost this month! Especially the corporate owned facilities paying close to minimum wage. This is a highly profitable business. You don’t have to spend that kind of money if you don’t want to.

This is probably the equivalent of an in home daycare vs sending your kid to a large daycare or preschool.

This is a great analogy. It’s a good option for someone who isn’t wealthy but isn’t poor enough to go on Medicaid.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My plan for when I hit retirement is to buy a small unit with lifetime continuing care in a retirement complex and a second house or condo somewhere either for winters (six months in Florida) or coastal New England (five months in spring to fall). When the time comes, I can sell the second property and upgrade the unit to a bigger 2-bedroom and live there full time. But I will have a foot in the door so they can't kick me out if I suddenly start declining, physically or cognitively. I am single, will always be single so no spouse to help take care of me. I want the guarantee of lifetime care no matter what happens. Yes, expensive, but I can make it happen. This plan is based on what good friends of my parents have done.

CCRCs are the way to go---good goal to be able to get in. If you can afford one, it's the best way to know you will be well taken care of. Paid entry fee to get my parents in (they have enough to qualify minus the entry fee). Best thing we ever did. They are a distance from us and refused to move closer. This way they are well taken care of and should they need more than independent living, it will seamlessly happen, and will not cost them (or us) a penny more---that's what the huge entry fee is for. Best part is, even if they "run out of money", the CCRC will still continue service---you are guaranteed to live your life there and they do NOT touch your monthly SS. Most who have run out of money are women over 95---there are 4 of them currently living there who pay nothing each month, husbands have long since died. 2 are still in independent living, the other 2 are in assisted living.

If you plan well it can happen---my parents are not wealthy. But made it happen.

Do you have any numbers to share? Which CCRCs are you talking about? What's the entrance fee? monthly cost? etc.

I'm not the PP you quoted, but I posted earlier, naming Collington in Bowie and Riderwood in Silver Spring.

There's a chart on this page with some sample pricing for Collington: https://collington.kendal.org/living-options/pricing-information/

They don't detail the "entrance fee." And you don't get all of that back. So, the monthly fee looks low because it isn't including a portion for the entrance fee.

Also, I noticed that the service level for "memory care" does not include assistance for daily grooming and toileting. That doesn't count as an amenity until you are in long term nursing care. The details on the website are lacking and of course they want you to think it's a good deal...to get you in the door.

If it diunds too good to be true, it probably is.

The entrance fees are on that chart.

My mom is currently in independent living there, so I don't yet have firsthand experience with the assisted living areas, but so far we are really happy with it. She wasn't to the point of needing help every day, but she would have recurring incidents (for instance, a UTI causing momentary dementia) that were hard for me to keep tabs on alone. Collington does things like wellness checks if you haven't opened your front door in 24 hours. Not to mention she's made tons of friends, who check in on her as well. The residents are well-educated (former) professionals for the most part, and there are tons of seminars and concerts and activities to keep people engaged. Very happy with it so far.

If you have two parents sharing a 2bd, for example, would you have to pay just one entry fee for the unit and two service packages? Or two entry fees even though sharing a unit?

That's a good question, and I'm sorry, I don't know the answer.

For my parents (not in DCUM, but a bit outside), they paid one entry fee ($450K) plus the 2nd person add on ($85K). Then there is the monthly rent (~4500) for first person plus the 2nd person addition (~$1500). For a 2bed/2bath, ~1200 sq ft. The entry fee "value back" declines by 2% each month for the first 49 months (4 years)---so if you die/no longer live there, you get an amount refunded accordingly during that time. After the 4 years, you get nothing returned.

If one person goes to nursing care, assisted living, or dementia care within the CCRC, the prices do not change drastically for the couple and the other gets to remain in the same 2 bed/2 bath. If one person dies, the other gets to remain for just the $4.5K monthly rent, but can choose to downsize to a smaller unit to save $$ if desired. The only price increase is for 3 meals/day cost that are provided in assisted living/nursing/dementia care, as in independent living you have $360/month per person which gives you easily dinner everyday and another 2-4 meals per week, possibly more depending which restaurant you choose to dine in. So you likely will pay an extra $200-300/month for meals and that is it. The added care levels is included in the entrance fee you paid (the $450K+ for the couple).

Your parents are in a very expensive place. I think it's great that they can afford it, but not everyone needs or wants that level of comfort and care.

Yes, they are in a very nice place/expensive place. For them, it's weird being surrounded by rich people--they are LMC/frugal people and both grew up very poor and never made much as adults. They saved to have a decent retirement, but still needed family to pay half the entrance fee, which family did so they are well cared for at a distance with no family nearby. But minus the entrance fee (which is a lot I agree), they qualified with what they had saved and family only needed to pay half the entrance fee. They also have LTC insurance so if they ever go to assisted/nursing/memory care they will not pay more than for meals and will use their insurance to collect what is due to them.

So they were only ~$225K short of qualifying for this amazing place based on what they saved for, all while being not well off at all (I ate free lunch several years growing up at school) So if they can plan for this, many people could choose to plan and find a slightly more affordable place. People need to save for retirement and plan accordingly, because care is not cheap

[Anonymous]

PP here. Thanks for your explanation. You clearly come from a loving, supportive family. Although we don't have a much money, we also help our family members as able. Wonderful family is a blessing in this life!

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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.

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

https://www.nbcconnecticut.com/investigations/nbc-ct-responds/exclusive-famous-soap-opera-stars-family-shares-frustration-over-long-term-care-policy/3032493/

Most policies are at least 90 days before they kick in. That is pretty standard and you know this when you purchase the policy if you read what you are buying. Try to save money and you can get them with 180 days before it kicks in. So nothing shocking about this. So as you plan, you should have 90 days/3 months in savings to pay for LTC before you plan kicks in. Not difficult to know that you need to do that. Not a scam, just what you purchased.

Much akin to buying health insurance with a lower monthly rate and complaining you have a $10K deductible and how that sucks. You had a choice to select a lower deductible but along with that comes a higher monthly payment. Nothing is hidden in these scenarios, it's all in big print, you just have to read and process what you are purchasing.

[Anonymous]

Anonymous wrote:My plan for when I hit retirement is to buy a small unit with lifetime continuing care in a retirement complex and a second house or condo somewhere either for winters (six months in Florida) or coastal New England (five months in spring to fall). When the time comes, I can sell the second property and upgrade the unit to a bigger 2-bedroom and live there full time. But I will have a foot in the door so they can't kick me out if I suddenly start declining, physically or cognitively. I am single, will always be single so no spouse to help take care of me. I want the guarantee of lifetime care no matter what happens. Yes, expensive, but I can make it happen. This plan is based on what good friends of my parents have done.

Be careful and do your research. These types of places are notorious for kicking out people once they need more extensive care. My idiot brother wanted to put my idiot mother in once of these place when she was still younger and very able. They both thought they were sooo smart and gaming the system for her to get free high-end care for the rest of her life. The rest of us siblings had to talk them out of this. They will take every last cent you own before they give you anything free, then kick you out without a penny to your name based on a claim that they can't meet your specific medical needs. Plus you still have to pay other living expenses outside of what they provide. They're businesses; not philanthropists.

If you're still able enough to live alone for half the year, then you'll go broke paying for this assisted living place before you ever need the extensive care.

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Anonymous wrote:My plan for when I hit retirement is to buy a small unit with lifetime continuing care in a retirement complex and a second house or condo somewhere either for winters (six months in Florida) or coastal New England (five months in spring to fall). When the time comes, I can sell the second property and upgrade the unit to a bigger 2-bedroom and live there full time. But I will have a foot in the door so they can't kick me out if I suddenly start declining, physically or cognitively. I am single, will always be single so no spouse to help take care of me. I want the guarantee of lifetime care no matter what happens. Yes, expensive, but I can make it happen. This plan is based on what good friends of my parents have done.

CCRCs are the way to go---good goal to be able to get in. If you can afford one, it's the best way to know you will be well taken care of. Paid entry fee to get my parents in (they have enough to qualify minus the entry fee). Best thing we ever did. They are a distance from us and refused to move closer. This way they are well taken care of and should they need more than independent living, it will seamlessly happen, and will not cost them (or us) a penny more---that's what the huge entry fee is for. Best part is, even if they "run out of money", the CCRC will still continue service---you are guaranteed to live your life there and they do NOT touch your monthly SS. Most who have run out of money are women over 95---there are 4 of them currently living there who pay nothing each month, husbands have long since died. 2 are still in independent living, the other 2 are in assisted living.

If you plan well it can happen---my parents are not wealthy. But made it happen.

Do you have any numbers to share? Which CCRCs are you talking about? What's the entrance fee? monthly cost? etc.

I'm not the PP you quoted, but I posted earlier, naming Collington in Bowie and Riderwood in Silver Spring.

There's a chart on this page with some sample pricing for Collington: https://collington.kendal.org/living-options/pricing-information/

They don't detail the "entrance fee." And you don't get all of that back. So, the monthly fee looks low because it isn't including a portion for the entrance fee.

Also, I noticed that the service level for "memory care" does not include assistance for daily grooming and toileting. That doesn't count as an amenity until you are in long term nursing care. The details on the website are lacking and of course they want you to think it's a good deal...to get you in the door.

If it diunds too good to be true, it probably is.

The entrance fees are on that chart.

My mom is currently in independent living there, so I don't yet have firsthand experience with the assisted living areas, but so far we are really happy with it. She wasn't to the point of needing help every day, but she would have recurring incidents (for instance, a UTI causing momentary dementia) that were hard for me to keep tabs on alone. Collington does things like wellness checks if you haven't opened your front door in 24 hours. Not to mention she's made tons of friends, who check in on her as well. The residents are well-educated (former) professionals for the most part, and there are tons of seminars and concerts and activities to keep people engaged. Very happy with it so far.

If you have two parents sharing a 2bd, for example, would you have to pay just one entry fee for the unit and two service packages? Or two entry fees even though sharing a unit?

That's a good question, and I'm sorry, I don't know the answer.

For my parents (not in DCUM, but a bit outside), they paid one entry fee ($450K) plus the 2nd person add on ($85K). Then there is the monthly rent (~4500) for first person plus the 2nd person addition (~$1500). For a 2bed/2bath, ~1200 sq ft. The entry fee "value back" declines by 2% each month for the first 49 months (4 years)---so if you die/no longer live there, you get an amount refunded accordingly during that time. After the 4 years, you get nothing returned.

If one person goes to nursing care, assisted living, or dementia care within the CCRC, the prices do not change drastically for the couple and the other gets to remain in the same 2 bed/2 bath. If one person dies, the other gets to remain for just the $4.5K monthly rent, but can choose to downsize to a smaller unit to save $$ if desired. The only price increase is for 3 meals/day cost that are provided in assisted living/nursing/dementia care, as in independent living you have $360/month per person which gives you easily dinner everyday and another 2-4 meals per week, possibly more depending which restaurant you choose to dine in. So you likely will pay an extra $200-300/month for meals and that is it. The added care levels is included in the entrance fee you paid (the $450K+ for the couple).

This is a crazy amount of money and not financially prudent for obvious reasons.

I know someone who makes bad financial decisions and his parents do too. Sure enough he’s moving his able bodied parents into one of these communities and thinks it’s a great deal. These places are businesses and out to make money.

You can't take your money with you when you die. I don't need any inheritance from my parents. My parents worked hard for their money and deserve to be happy and safe. This is by far the nicest they have ever lived in their lives and all it took was $225K from me. Since they wont move closer to me, this was the best way to ensure they are safe and well taken care of.

If you can afford it, how exactly is in not financially prudent? You are paying for being well taken care of in your old age. I know people spending $15K/month to have round the clock care for their elderly parents in their home (because that is what you pay to have good qualified care). They still have to manage this from a distance and worry constantly of what happens if the next aide/nurse does not show up/calls in sick and the one on duty needs to leave. And they still have the costs of maintaining the home and all that goes with that, often in an older home, one they constantly have to improve to make it safe/ADA accessible.
$15K-6K is 9K/month. 4 years of that and you are near the entrance fee to the CCRC. But oh, you might still have to put a new roof on your parents home or new water heater, or there's a leak so $5K to fix that and all the damages, etc.

My parents pay their monthly fee, apt is fully ada accessible, was newly refinished when they moved it, there are pull strings in shower, toilet, and bedrooms and kitchen. They have a devices to carry/wear they can push a button and someone will come to them in 2-3 mins or less anywhere on the property and help with whatever issue, all while still in independent living. No extra costs for appliances breaking, a leak, etc. No utility bills, cable, phone, etc. All included. Also there are tons of activities for them to keep them social and active. Evening performances, game nights, knitting clubs, you name it if old people do it its happening. My parents are more social now than when they lived alone in a SFH. That's a good thing for mental status as they age.

If your family is not nearby, do you know how difficult it is to manage when an elderly parent takes a fall, has a heart attack, needs surgery, etc? If I have to drop everything I am doing and fly there whenever something happens, it will cost me a lot, not to mention I have a job and obligations at home. I can't easily just go live with them for 6 weeks if they need care after a surgery. Or for longer. If you are not already in a place like this, finding one when you need it could take a few weeks or more and that place might be 30 miles from the other parent and may not be the best facility, just one that has space and able to take you at that point.

If my parents "run out of money" they will still remain there with the same level of care needed, and SS income is not available for the CCRC to collect. I know this for a fact since there are currently 4 in their 90s widowed women who are doing so (it's normally the women who hit this point, as there are not that many men in their late 90s). My parents only expenses are $150/month for extra food/groceries/toiletries, their car and medical. Everything else is taken care of.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My plan for when I hit retirement is to buy a small unit with lifetime continuing care in a retirement complex and a second house or condo somewhere either for winters (six months in Florida) or coastal New England (five months in spring to fall). When the time comes, I can sell the second property and upgrade the unit to a bigger 2-bedroom and live there full time. But I will have a foot in the door so they can't kick me out if I suddenly start declining, physically or cognitively. I am single, will always be single so no spouse to help take care of me. I want the guarantee of lifetime care no matter what happens. Yes, expensive, but I can make it happen. This plan is based on what good friends of my parents have done.

Be careful and do your research. These types of places are notorious for kicking out people once they need more extensive care. My idiot brother wanted to put my idiot mother in once of these place when she was still younger and very able. They both thought they were sooo smart and gaming the system for her to get free high-end care for the rest of her life. The rest of us siblings had to talk them out of this. They will take every last cent you own before they give you anything free, then kick you out without a penny to your name based on a claim that they can't meet your specific medical needs. Plus you still have to pay other living expenses outside of what they provide. They're businesses; not philanthropists.

If you're still able enough to live alone for half the year, then you'll go broke paying for this assisted living place before you ever need the extensive care.

Do your research, there are reputable CCRCs. My parents know of 4 in their 90s widows in theirs who are no longer paying "rent" as they have drained their resources and the CCRC does not consider SS a "resource" to touch. Two are still in independent living, 1 is in assisted and one in dementia care. They have all been that way for at least 1 year, one over 3 years. They will not be kicked out, that is what the large entrance fee is for--it's calculated so statistically they still make money overall. Some they loose, most they probably make money, since most people are in anything more than independent live-ing for less than 2 years (statistically). Invest the $400K+ they are getting from all new entrants, and the interest/gains alone is likely paying for majority of people in "elevated care". I'm certain they review their costs yearly and the entrance fee is adjusted accordingly to ensure they are still making money.