Cost—yikes!

[Anonymous]

Anonymous wrote:Having been through 2 parents need of LTC, we have opted to pay for LTC insurance. It isn't nearly as good as it used to be, but better than full private pay. We don't want our kids having to shoulder the bill as we did for our parents.

NW: 7m
LTC cost/year (for now): 6K/year

Interesting. I've wanted to do this and financial advisor told us to skip. Our net worth is higher than this, but we may now have unexpected expenses with one of our DCs over the arc of their life.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Was there a point to your father sharing this with you? As in, is he worried he might run out of money? Is he hoping you might help?

There are government homes, OP, but a lot of them are not pleasant. There are waitlists, and they do a thorough check of assets, including a look back period of several years, to make sure you haven't squirreled wealth away somewhere.

Hmm, there are not government homes, but nursing homes that take Medicaid for residents. Yes, you complete forms and dissolve your assets (not all if one of the couple is not a resident - "community spouse").

Just FYI -- the "community spouse" can keep $100,000. All other assets need to be spent before Medicaid will kick in.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, make sure you see if the CCRC has any sort of safety net for when people run out of money. I was looking into a few options for my parents, and the communities had a special fund for exactly that. It's one of the reasons I plan on buying into a CCRC when I'm older. I don't want my kids to have to worry about moving me if I outlive my money.

My parents CcRC functions like that. The huge entry fee covers you if you “outlive” your money. You live for free and they don’t include ss in it.

You aren't living there for free. You are prepaying.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I mean at some point you need to decide if the cost benefit is worth it. Is your mom really living? But yes, it’s insanely expensive and most people who choose to go with this much care spend down principal.

What’s the other option? You don’t just die when you decide to die.

I really wish you could decide in advance you don't want to live being "mostly incapacitated". It is ridiculous that you can't. I don't see the point in spending all that money. I would much rather my children and grandchildren had that money. I am hoping that in 25-30 years when I reach 80 there will be that option.

My mom had a stroke and spent 12 years in assisted living. She was incapacitated enough that she had to be there - needed help bathing, dressing, eating, and she couldn't walk. Yet she got to spend those years interacting with me, and she got to see her grandchildren grow up. That was the "point" of spending hundreds of thousands of dollars. I'm sure she wouldn't have chosen suicide over that.

There are lots of people in assisted living in a similar situation - incapacitated enough that they need professional help, too incapacitated to live alone or with their families, but not so incapacitated that their life "isn't worth living".

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Was there a point to your father sharing this with you? As in, is he worried he might run out of money? Is he hoping you might help?

There are government homes, OP, but a lot of them are not pleasant. There are waitlists, and they do a thorough check of assets, including a look back period of several years, to make sure you haven't squirreled wealth away somewhere.

Hmm, there are not government homes, but nursing homes that take Medicaid for residents. Yes, you complete forms and dissolve your assets (not all if one of the couple is not a resident - "community spouse").

Just FYI -- the "community spouse" can keep $100,000. All other assets need to be spent before Medicaid will kick in.

I believe the community spouse asset amount is now around 140K, perhaps higher. If the community spouse then needs to move to a nursing home, those assets will then be spent down.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Having been through 2 parents need of LTC, we have opted to pay for LTC insurance. It isn't nearly as good as it used to be, but better than full private pay. We don't want our kids having to shoulder the bill as we did for our parents.

NW: 7m
LTC cost/year (for now): 6K/year

Interesting. I've wanted to do this and financial advisor told us to skip. Our net worth is higher than this, but we may now have unexpected expenses with one of our DCs over the arc of their life.

If you have a higher net worth, it typically is NOT worth it to pay for LTC. We have enough to generate $400-500K/year for the next 40 years and barely touch the Principal. Kids would get $25M with that. Figure once we need a Nursing home/advanced care we wont be traveling/living in 2 homes/having cars, so the 400-500K we expect to spend yearly will just transition to paying for care. And it could likely be paid for in our condo or we can go to a CCRC situation.

But it's typically much better to just plan to invest and self pay. Why? Because LTC policies now are typically for at most 36 months and if you are higher net worth, you can afford that care for 36 months easily, and if you invest the $5-10K/year you'd be paying for it, will most likely come out ahead. And after 36 months, you would be spending your own money anyhow

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, make sure you see if the CCRC has any sort of safety net for when people run out of money. I was looking into a few options for my parents, and the communities had a special fund for exactly that. It's one of the reasons I plan on buying into a CCRC when I'm older. I don't want my kids to have to worry about moving me if I outlive my money.

My parents CcRC functions like that. The huge entry fee covers you if you “outlive” your money. You live for free and they don’t include ss in it.

You aren't living there for free. You are prepaying.

Yes, you are "prepaying" for higher level care. However, my parents are in a "luxury CCRC" and have the plan paid for where they do NOT pay anymore for care above Ind Living (except for 3 meals a day versus 1 currently). So currently they pay about $7K total for the 2 of them to have 1-1.5 meals a day and a 2bed/2bath apartment with cleaning, utilities, all maintenance included. If one goes to "advanced care" they only pay for the extra 2 meals per day. The other gets to stay in that apartment (or can downgrade, but not required). If both go to "advanced care of anytype" they will still only pay for the extra meals per day (so $300-500/month). Once they are both determined to be in advanced care and not moving back (ie not nursing care after a surgery or fall), then they have to give up the apartment.

And if they "run out of money", they will get to live there for free (and run out means spend down your investments---they won't touch your SS payouts, so you use that for medical expenses and basic living expenses (hair cuts, toiletries, etc). And if you have LTC insurance, they are not forced to "pay that to the CCRC" that is their own money. (my parents both have a 24 month policy with about $250/day payout.)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I mean at some point you need to decide if the cost benefit is worth it. Is your mom really living? But yes, it’s insanely expensive and most people who choose to go with this much care spend down principal.

What’s the other option? You don’t just die when you decide to die.

I really wish you could decide in advance you don't want to live being "mostly incapacitated". It is ridiculous that you can't. I don't see the point in spending all that money. I would much rather my children and grandchildren had that money. I am hoping that in 25-30 years when I reach 80 there will be that option.

My mom had a stroke and spent 12 years in assisted living. She was incapacitated enough that she had to be there - needed help bathing, dressing, eating, and she couldn't walk. Yet she got to spend those years interacting with me, and she got to see her grandchildren grow up. That was the "point" of spending hundreds of thousands of dollars. I'm sure she wouldn't have chosen suicide over that.

There are lots of people in assisted living in a similar situation - incapacitated enough that they need professional help, too incapacitated to live alone or with their families, but not so incapacitated that their life "isn't worth living".

I think (IMO) it's only people who end up in memory care that feel "life isn't worth living". When you talk to your parents and 5 min in they don't know who they are talking to and their memory really only exists from when they were 2-10 yo, it can be frustrating. But many many people have minor strokes/HA/health issues that require assisted living but they are still mentally 100% all there (or as all there as an 85-95 yo without dementia can be) and yes they would get great joy from living their life to it's fullest. Who cares if you require assistance for bathing, toileting and eating.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I mean at some point you need to decide if the cost benefit is worth it. Is your mom really living? But yes, it’s insanely expensive and most people who choose to go with this much care spend down principal.

What’s the other option? You don’t just die when you decide to die.

I really wish you could decide in advance you don't want to live being "mostly incapacitated". It is ridiculous that you can't. I don't see the point in spending all that money. I would much rather my children and grandchildren had that money. I am hoping that in 25-30 years when I reach 80 there will be that option.

My mom had a stroke and spent 12 years in assisted living. She was incapacitated enough that she had to be there - needed help bathing, dressing, eating, and she couldn't walk. Yet she got to spend those years interacting with me, and she got to see her grandchildren grow up. That was the "point" of spending hundreds of thousands of dollars. I'm sure she wouldn't have chosen suicide over that.

There are lots of people in assisted living in a similar situation - incapacitated enough that they need professional help, too incapacitated to live alone or with their families, but not so incapacitated that their life "isn't worth living".

I think (IMO) it's only people who end up in memory care that feel "life isn't worth living". When you talk to your parents and 5 min in they don't know who they are talking to and their memory really only exists from when they were 2-10 yo, it can be frustrating. But many many people have minor strokes/HA/health issues that require assisted living but they are still mentally 100% all there (or as all there as an 85-95 yo without dementia can be) and yes they would get great joy from living their life to it's fullest. Who cares if you require assistance for bathing, toileting and eating.

My mom ended up in memory care. Her short term memory was shot, yet she remembered all of us when we visited. Sometimes she momentarily confused her daughters for her sisters, but she usually caught herself soon after. She always remembered our kids as well as DH. She was much happier in memory care than at home where she was largely alone. Dementia is largely terrible, but not everyone has the exact same symptoms and may exhibit contentment, even happiness, every day.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, make sure you see if the CCRC has any sort of safety net for when people run out of money. I was looking into a few options for my parents, and the communities had a special fund for exactly that. It's one of the reasons I plan on buying into a CCRC when I'm older. I don't want my kids to have to worry about moving me if I outlive my money.

My parents CcRC functions like that. The huge entry fee covers you if you “outlive” your money. You live for free and they don’t include ss in it.

You aren't living there for free. You are prepaying.

Yes, you are "prepaying" for higher level care. However, my parents are in a "luxury CCRC" and have the plan paid for where they do NOT pay anymore for care above Ind Living (except for 3 meals a day versus 1 currently). So currently they pay about $7K total for the 2 of them to have 1-1.5 meals a day and a 2bed/2bath apartment with cleaning, utilities, all maintenance included. If one goes to "advanced care" they only pay for the extra 2 meals per day. The other gets to stay in that apartment (or can downgrade, but not required). If both go to "advanced care of anytype" they will still only pay for the extra meals per day (so $300-500/month). Once they are both determined to be in advanced care and not moving back (ie not nursing care after a surgery or fall), then they have to give up the apartment.

And if they "run out of money", they will get to live there for free (and run out means spend down your investments---they won't touch your SS payouts, so you use that for medical expenses and basic living expenses (hair cuts, toiletries, etc). And if you have LTC insurance, they are not forced to "pay that to the CCRC" that is their own money. (my parents both have a 24 month policy with about $250/day payout.)

How does that LTC payout work if not going to a third party vendor?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, make sure you see if the CCRC has any sort of safety net for when people run out of money. I was looking into a few options for my parents, and the communities had a special fund for exactly that. It's one of the reasons I plan on buying into a CCRC when I'm older. I don't want my kids to have to worry about moving me if I outlive my money.

My parents CcRC functions like that. The huge entry fee covers you if you “outlive” your money. You live for free and they don’t include ss in it.

You aren't living there for free. You are prepaying.

Yes, you are "prepaying" for higher level care. However, my parents are in a "luxury CCRC" and have the plan paid for where they do NOT pay anymore for care above Ind Living (except for 3 meals a day versus 1 currently). So currently they pay about $7K total for the 2 of them to have 1-1.5 meals a day and a 2bed/2bath apartment with cleaning, utilities, all maintenance included. If one goes to "advanced care" they only pay for the extra 2 meals per day. The other gets to stay in that apartment (or can downgrade, but not required). If both go to "advanced care of anytype" they will still only pay for the extra meals per day (so $300-500/month). Once they are both determined to be in advanced care and not moving back (ie not nursing care after a surgery or fall), then they have to give up the apartment.

And if they "run out of money", they will get to live there for free (and run out means spend down your investments---they won't touch your SS payouts, so you use that for medical expenses and basic living expenses (hair cuts, toiletries, etc). And if you have LTC insurance, they are not forced to "pay that to the CCRC" that is their own money. (my parents both have a 24 month policy with about $250/day payout.)

How much did they prepay in advanced? It had to be a huge chunk of money so if they are paying $7K on top of that for one meal and an apartment that's not a great deal.

[Anonymous]

I've never heard of someone having CNAs on top of skilled nursing. That's a cost most people would not pay for

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Was there a point to your father sharing this with you? As in, is he worried he might run out of money? Is he hoping you might help?

There are government homes, OP, but a lot of them are not pleasant. There are waitlists, and they do a thorough check of assets, including a look back period of several years, to make sure you haven't squirreled wealth away somewhere.

Hmm, there are not government homes, but nursing homes that take Medicaid for residents. Yes, you complete forms and dissolve your assets (not all if one of the couple is not a resident - "community spouse").

Thanks for the clarification. I can never remember if it's Medicare or Medicaid!

I would think it’s Medicare. Medicare is for the elderly. Medicare is for the poor or disabled.

Medicaid is what pays for nursing care when you’re out of money. And Medicaid nursing homes are generally not well regarded.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I mean at some point you need to decide if the cost benefit is worth it. Is your mom really living? But yes, it’s insanely expensive and most people who choose to go with this much care spend down principal.

What’s the other option? You don’t just die when you decide to die.

I really wish you could decide in advance you don't want to live being "mostly incapacitated". It is ridiculous that you can't. I don't see the point in spending all that money. I would much rather my children and grandchildren had that money. I am hoping that in 25-30 years when I reach 80 there will be that option.

My mom had a stroke and spent 12 years in assisted living. She was incapacitated enough that she had to be there - needed help bathing, dressing, eating, and she couldn't walk. Yet she got to spend those years interacting with me, and she got to see her grandchildren grow up. That was the "point" of spending hundreds of thousands of dollars. I'm sure she wouldn't have chosen suicide over that.

There are lots of people in assisted living in a similar situation - incapacitated enough that they need professional help, too incapacitated to live alone or with their families, but not so incapacitated that their life "isn't worth living".

I think (IMO) it's only people who end up in memory care that feel "life isn't worth living". When you talk to your parents and 5 min in they don't know who they are talking to and their memory really only exists from when they were 2-10 yo, it can be frustrating. But many many people have minor strokes/HA/health issues that require assisted living but they are still mentally 100% all there (or as all there as an 85-95 yo without dementia can be) and yes they would get great joy from living their life to it's fullest. Who cares if you require assistance for bathing, toileting and eating.

My mom ended up in memory care. Her short term memory was shot, yet she remembered all of us when we visited. Sometimes she momentarily confused her daughters for her sisters, but she usually caught herself soon after. She always remembered our kids as well as DH. She was much happier in memory care than at home where she was largely alone. Dementia is largely terrible, but not everyone has the exact same symptoms and may exhibit contentment, even happiness, every day.

Dementia is a terrible disease. So sorry you are dealing with this. However, when well managed, many patients are much happier in care. I have an aunt who asked to go to memory care 6 years ago. She didn't feel safe at home anymore. Took a bit to get meds managed but she is much happier there. Obviously she has progressed and it is challenging, but she has good days and bad. For her, the childhood memories are stronger now. But she recognizes many people or gathers they are their sibling/cousin/etc someone who they look like/close in age. Or she will just ask who you are and say "I know I should know who you are but I can't recall right now", which indicates she has an inkling.

She is much happier in memory care and has been from the start. Then again, if you didn't feel safe at home because of your memory issues then it's a given that you would do much better in a facility under constant care where you don't have to worry you will leave the stove on and burn down the house or that you have voices in your head (the proper medication and moving to memory care helped iwht that).
But we anticipate the coming years will be more challenging as you can only stave off progression for so long

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, make sure you see if the CCRC has any sort of safety net for when people run out of money. I was looking into a few options for my parents, and the communities had a special fund for exactly that. It's one of the reasons I plan on buying into a CCRC when I'm older. I don't want my kids to have to worry about moving me if I outlive my money.

My parents CcRC functions like that. The huge entry fee covers you if you “outlive” your money. You live for free and they don’t include ss in it.

You aren't living there for free. You are prepaying.

Yes, you are "prepaying" for higher level care. However, my parents are in a "luxury CCRC" and have the plan paid for where they do NOT pay anymore for care above Ind Living (except for 3 meals a day versus 1 currently). So currently they pay about $7K total for the 2 of them to have 1-1.5 meals a day and a 2bed/2bath apartment with cleaning, utilities, all maintenance included. If one goes to "advanced care" they only pay for the extra 2 meals per day. The other gets to stay in that apartment (or can downgrade, but not required). If both go to "advanced care of anytype" they will still only pay for the extra meals per day (so $300-500/month). Once they are both determined to be in advanced care and not moving back (ie not nursing care after a surgery or fall), then they have to give up the apartment.

And if they "run out of money", they will get to live there for free (and run out means spend down your investments---they won't touch your SS payouts, so you use that for medical expenses and basic living expenses (hair cuts, toiletries, etc). And if you have LTC insurance, they are not forced to "pay that to the CCRC" that is their own money. (my parents both have a 24 month policy with about $250/day payout.)

How does that LTC payout work if not going to a third party vendor?

The payout comes to you, with documentation that you are in LTC for the specified number of days. Have not had to use it yet, but that is what the documentation indicates. You just have to provide documentation that you are actually in a facility getting LTC, and then it kicks in after the waiting period (either 45 or 60 days for my parents). So if one of them ends up in LTC once their policy kicks in, right now it would just about pay for their entire IL fees for both of them.

I will ensure they get the LTC payout if they are eligible, because the money does not have to go to the CCRC. Technically if they get it, they could gift it to me/pay me back for the CCRC entry fee (right now the estate plan says I get paid back "with interest" after creditors, so basically after their minimal Credit cards each month and any medical bills, I will be getting the rest of their estate up to the entry fee+ interest. Then the rest is split between me and my other siblings (but there most likely wont be much left for them if anything at all). We don't need the money so I'll leave it in their estate as long as they are alive