I didn't fully comprehend the cost of eldercare

[Anonymous]

Anonymous wrote:Yeah what do families do when the money runs out?

The next generation goes into debt?

Medicaid if Trump does not cut it.

Or live on street.

[Anonymous]

Anonymous wrote:I know it's painful, but this is what retirement money is for. It's not meant to be passed down to heirs or fancy trips (although those are nice if you save a lot!), it's meant to provide care for you when you can't care for yourself.

And medicaid nursing homes are a lot cheaper than this. I have two relatives in one. They are 3 beds to a room and they basically never get to leave their bed. They aren't helped to the bathroom and they only wear diapers.

I have been pricing memory care. 134,000 to 200,000+ with annual 5% increases.

That is not how I want my money spent. I want to die before I have to live in a wheelchair unable to speak or feed myself.

[Anonymous]

Anonymous wrote:

Anonymous wrote:These costs seem inflated. I know people who care for people who need help that make nowhere near that.

Right. I think the difference is whether the caretakers have medial training--like a nurse in your house 24-7 or just a person who can help you walk, use the bathroom, bathe, prepare food for you, etc., but not providing actual medical care.

When we were in this situation a few years ago, the cost in our HCOL was $35/hr with an agency, and around $30 if you hired independently (which I didn't have the bandwidth for). It was definitely in the $20k/month range. The carers were not nurses and did not have medical training. They did do difficult work--bed transfers, bathing, assistance with bathroom needs. Where I live, even a college-aged babysitter charges $25 an hour. You can't find care for the elderly for less.

[Anonymous]

Advice I was given some years ago is patients typically do not go beyond 2 yrs needing 24/7 care. I think this is where palliative care only, that decision needs to be made.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:LTC might help if you are considering buying it for yourself. As the PP said, it's too late for your dad.

You definitely need to talk to your dad and fully understand his finances. How long can he pay for full time care? What are his issues? Some progress much faster than others.

You might try at home care and see if he can realistically reduce hours. If not, then he has to be made aware that if he runs out of money he will have to find a Medicaid bed if he qualifies.

We've had to repeatedly talk to our parents about the reality.

Yeah my brother keeps saying he has the money but I realized my brother doesn't fully understand how much money my dad has. My relationship with my dad is so weird since my mom died this all sucks

True, it does suck for everyone. You'll need to wrap your head around that. End of life is hard and it triggers all sorts of past issues. You need to have a detailed discussion with your brother before you talk to your dad so you're on the same page. And he needs to truly understand how much At Home care is. You also need to know how much different types of facility living is. That's not cheap either, but people can sell their homes to pay for that, in many cases.

If I were you, I'd call using your name and the generic "my parent" might need care. And ask about pricing. Find out about the assisted living places close to your brother, including pricing. Find at home care companies and pricing. Get a sense of your dad's options. Then present all of this to your brother, then your dad.

I said this upthread, but these decisions also vary depending on what is wrong with him. Did he have a heart episode? A stroke? Broke something? How likely is it that he will fully recover?

Sorry. I missed the question before. He has aFib and COPD. He was in heart failure but didn't know it because he thought his chest hurt from COPD so he kept taking his steroid which worsened heart issue and put him into kidney failure. He only notified my brother because his legs were too swollen to walk.

He will never but have the Afib but it's otherwise "stable" just with very limited mobility. No stroke. Nothing broken.

He needs the care for mobility issues, self care, meals, driving to appointments, etc.

With that assortment of issues, he probably doesn't have that much longer given that he's 90. At some point he will be too weak to do anything, if he doesn't have a stroke first from the aFib. Find out how much money he has to pay for care. Then, as I've said, have a realistic conversation about the realities of what he can afford. I had to do this and I thought it would be terrible. I put it off and put it off. Then it wasn't that bad. I felt tremendous relief afterwards. The guessing and catastrophizing makes the stress worse.

This also might be a phase 1 and 2 kind of thing. He has in home care until he can become more independent again. And if not, then he has to go into a care facility.

[Anonymous]

My father lingered, mostly bed bound and mute with primary progressive aphasia (basically locked in syndrome) for an agonizingly long 8 months in a very expensive private skilled nursing facility.

My hot take in retrospect: we/I took too long to get him into hospice care. I really think that once a patient gets a dire diagnosis (dementia) the family needs to take a hard look at outcomes and what they want their loved ones last years -months-days to look like.

Put a Do Not Resuscitate order in place - have a copy of the order out on display and every family member needs to keep a copy. Stop all meds - my mom insisted my dad keep taking his BP meds (this prolonged his life). Initiate palliative care and transition to hospice.

My dad died 15 days into hospice care.

[Anonymous]

^ this

[Anonymous]

What do most people spend on their parents? My in-laws literally have nothing saved. They are living off Social Security, and we supplement them. And they are divorced. So I am afraid of what the next 15 years will look like.

[Anonymous]

"against medical advice" is an important phrase to know. To speak. It may need to be spoken or signature on a hospital form. Physicians may offer-up life extending actions/procedures that the patient or family does not want. You do not have to say yes. It does have to be documented, though. They don't want to be sued.

[Anonymous]

Anonymous wrote:What do most people spend on their parents? My in-laws literally have nothing saved. They are living off Social Security, and we supplement them. And they are divorced. So I am afraid of what the next 15 years will look like.

If they need care and have no/minimal assets, then this is a Medicaid situation. If either have a house and don't have a spouse, then the house can be sold for care. If they go into a private pay nursing home, there are a good many that will then take Medicaid payments for the remaining time. But you have to get the person into the private pay situation first. Private pay will look at the person's assets, determine how much they have compared to how long they think they'll live. And do not sign anything that says you will be responsible for paying for anything.

[Anonymous]

$32 - $35 per hour in a poor county in Maryland.

[Anonymous]

op here: blessing in disguise is that his caused me to reach out to my in-laws regarding their plan. They dont qualify for medicaid due to pensions but dont make nearly enough for this kind of care. They didnt realize medicare didn't cover it. So I guess good thing we found out now at 75 😞

This all gives me so much anxiety. I am going to be working until I am 105

[Anonymous]

Anonymous wrote:

Anonymous wrote:Yeah what do families do when the money runs out?

The next generation goes into debt?

The elderly person goes on Medicaid and into a Medicaid bed in a nursing home.

Are you going to a continuous care neighborhood that everybody makes fun of and they don’t kick you out.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm sorry.
You'll here half the population saying "shouldn't an old person be able to just stay in their own home" vs. the other half that will say "this is how you move the elderly out and make homes available for new generations."

It's not even about making those houses available (which is pretty gross). It's about a realistic approach to making sure people get the medical, personal, and social attention they need

Yes. My widowed mom lived in a very cold climate in a state where winter can begin in November and end in March and we mentioned being concerned about it falls on ice etc. and she was like “Well I can just stay inside for six months of the year and people can bring me things like groceries.” WE tried teaching her to use insta cart but it was beyond her. no hibernating while people fly in from across the country to go to the grocery store for you is not realistic.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Yeah what do families do when the money runs out?

The next generation goes into debt?

Medicaid if Trump does not cut it.

Or live on street.

Some states have filial responsibility laws and can force adult children to pay.