The insane cost of elder care

[Anonymous]

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.

[Anonymous]

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?

[Anonymous]

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.

[Anonymous]

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.

[Anonymous]

My plan is to be poor on paper, same for my dad. The state should take care of it hopefully.
I can even become his caregiver and get “hours” for his care, but of course that is only for if he is as healthy as now. If things become worse then we hire a state subsidized in home support person.

[Anonymous]

[twitter]

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?

These two posts are perfect examples of harmful misinformation that gets spread around:

Medicaid planning involves far more than attempting to “get your assets out of your name, years before the unknown date at which the need will arise. This is precisely the amateur thinking that gets people into a jam.

Taking advantage of a public benefit program in accordance with its structure and regulations is not “having others pay for your health care,” or “the dole” any more than driving on public roads, using police and fire services, accepting appropriate tax breaks, and the like are unjustifiably shifting a person’s obligations to someone else. The claim to the contrary is nasty, selfish, insecure and quite frankly ignorant. Very wealthy people can afford private care that typically is much better than that provided by Medicaid. The unsuccessful, but also the irresponsible, self-indulgent and spendthrift, have nothing to spend away. Medicare planning is a tool for the hard working, responsible middle class person who has slaved and deprived themselves all their life, only to become (absent planning) a fat chicken to be plucked at the end of their life. That is an injustice and a scandal.

[Anonymous]

Anonymous wrote:This is why after age 65, I will not seek any life saving medical care.
I don't want to pay, nor have my relatives pay, tens of thousands of dollars for me to merely exist in a LTC facility.

Talk to us when you are 65 and tell us if you feel the same way.

[Anonymous]

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.

On my side of the family, I have a relative who paid for her in-laws with dementia to stay in their own home with round the clock aides, and she mentioned that it cost less than a nursing home. It also made them happier.

so less than $7 per hour. how generous of you.

[Anonymous]

+1 to strong family bonds. In my family / immigrant community it's very common to have a family member move in and/or hire live-in helpers from the community to handle these end of life situations with dignity and grace. Usually the care and loving connection provided far exceeds what one would receive at a facility.

[Anonymous]

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.

[Anonymous]

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.

LTC policies are also getting more and more restrictive while also more costly.

And you shouldn't need to hire lawyers to hide money away in order to qualify for less expensive care.

We purchased a LTC policy at age 50, with $100/day for max 2 years of benefits. Cost is less than $1000/year. Could have gotten $200/day for about $1800/year. That's $6K/month, and goes into effect after 90 days of needing the care (which is standard). So if you don't have enough saved for 2-3 years of care, then this plan is affordable---or you can burden your family later. BTW, added the spouse for about half the cost so for ~1400/year we have $100/day for 2 years for both of us.

[Anonymous]

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.

[Anonymous]

Anonymous wrote:I plan to self-euthanize once I can no longer live independently. I’m not going to enrich some crooked private industry because I’ve kept myself in good health. I’d rather leave money and assets to my kids at age eighty than spend $100k a year for an additinal 10-15 years to gaze out of a window being fed cafeteria food and missing my old life.

[Anonymous]

Anonymous wrote:I plan to self-euthanize once I can no longer live independently. I’m not going to enrich some crooked private industry because I’ve kept myself in good health. I’d rather leave money and assets to my kids at age eighty than spend $100k a year for an additinal 10-15 years to gaze out of a window being fed cafeteria food and missing my old life.

By the time you decide to euthanize, you are too far gone to do it.

[Anonymous]

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'm the PP that asked the question about other countries and I'm Indian. I'm aware of the in-home care available in India but that's too unstructured though. Are you saying that there are US quality nursing facilities in India? If so, can you name some? Thanks!