How Much Do You Pay for Assisted Living?

[Anonymous]

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

Because your culture operates and runs the show differently; nothing to be disturbed of. Children are not caretakers of ill parents; unless you hit the lottery and are able to fully care for your parents(financially, mentally, emotionally and physically)and care for your own self, then we can have a discussion about this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

My parents don't want us to care for them. They couldn't be more clear. They don't want to live with me or be dependent on me. Should I just disregard their wishes because someone else claims I'm horrible?

No parent wants to be a burden for the children; when a parent ages and needs medical care, you must look for professional and trained senior facility to assist your loved one. Your culture is far behind, yet most people would never make such an ignorant comment!!

[Anonymous]

When should I go to nursing school? Because I will need an actual nursing degree, not the home health nurse level.

You should have planned ahead and taken care of this years ago!

I should have gotten a different education, given up the job that required me to move (hello military and private sector), and not have as many kids, as I still have 2 at home and dependent on me (classic sandwich generation problem).

Or alternately, give up everything to be near parents. Parents refuse to move out of their state, and sibling struggles also complicate where parents can go.

Life is hard. My parents never imagined this for themselves. I am doing my best to help them age with as much dignity and independence as possible, in a more safe environment than if they were in their own home with 24 hr private care.

But we need a completely different thread to address the collapse of the healthcare system, especially since the pandemic. There isn’t even reliable private care, and at least in assisted living, if someone calls out, there is a safety net of other staff who can pitch in, vs dealing with that home care aid not showing up and now you can’t leave or sleep, or you have to provide unskilled care, risking harm to yourself or your loved one, or your parents are home alone without the care they need. THIS is what keeps me up at night.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

The sad fact is that most families need two incomes to get by these days. Women are giving their labor to corporations and simply aren’t available to provide labor at home like the did in the past

I come from an immigrant family and my mother cared for two elderly relatives in our home until their last few months when they needed a higher level of care than she could provide and they went to nursing homes.

Two incomes are required to provide a very high standard of living. You could easily live off one income if you lived in a smaller house, one limited driving vacation to see family, no kids activities outside of running around the neighborhood, one car, one TV, no iPhones etc. Most people don’t think a job is so terrible that they need to live a 1950s lifestyle. Why would a woman with options want to forgo a paycheck and the resulting luxuries to provide unpaid labor to a relative? What you’re describing is simply progress and women having better options than they did in the past.

Read the Two Income Trap:
Causal factors
The authors present quantitative data to demonstrate how American middle-class families have been left in a precarious financial position by increases in fixed living expenses, increased medical expenses, escalating real estate prices, lower employment security, and the relaxation of credit regulation.[2][6] The result has been a reshaping of the American labor force, such that many families now rely on having two incomes in order to meet their expenses.[2] This situation represents a greater level of financial risk than that faced by single-income households: the inability of either adult to work, even temporarily, may result in loss of employment, and concomitant loss of medical coverage and the ability to pay bills.[6][4] This may lead to bankruptcy or being forced to move somewhere less expensive, with associated decreases in educational quality and economic opportunity.[2]

Among the expenses driving the two-income trap are child care, housing in areas with good schools, and college tuition. Warren and Tyagi conclude that having children is the "single best predictor" that a woman will go bankrupt.[7]

Warren and Tyagi call stay-at-home mothers of past generations "the most important part of the safety net", as the non-working mother could step in to earn extra income or care for sick family members when needed.[3] However, Warren and Tyagi dismiss the idea of return to stay-at-home parents, and instead propose policies to offset the loss of this form of insurance.[6]

Warren and Tyagi attempt to overturn the "overconsumption myth" that Americans' financial instabilities are the result of frivolous spending[4] – they note, for instance, that families are spending less on clothing, food (including meals out), and large appliances, when adjusted for inflation, than a generation prior.[8] They also note that dual-income households have less discretionary money than single-income households a generation prior.[6]

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

The sad fact is that most families need two incomes to get by these days. Women are giving their labor to corporations and simply aren’t available to provide labor at home like the did in the past

I come from an immigrant family and my mother cared for two elderly relatives in our home until their last few months when they needed a higher level of care than she could provide and they went to nursing homes.

Two incomes are required to provide a very high standard of living. You could easily live off one income if you lived in a smaller house, one limited driving vacation to see family, no kids activities outside of running around the neighborhood, one car, one TV, no iPhones etc. Most people don’t think a job is so terrible that they need to live a 1950s lifestyle. Why would a woman with options want to forgo a paycheck and the resulting luxuries to provide unpaid labor to a relative? What you’re describing is simply progress and women having better options than they did in the past.

Read the Two Income Trap:
Causal factors
The authors present quantitative data to demonstrate how American middle-class families have been left in a precarious financial position by increases in fixed living expenses, increased medical expenses, escalating real estate prices, lower employment security, and the relaxation of credit regulation.[2][6] The result has been a reshaping of the American labor force, such that many families now rely on having two incomes in order to meet their expenses.[2] This situation represents a greater level of financial risk than that faced by single-income households: the inability of either adult to work, even temporarily, may result in loss of employment, and concomitant loss of medical coverage and the ability to pay bills.[6][4] This may lead to bankruptcy or being forced to move somewhere less expensive, with associated decreases in educational quality and economic opportunity.[2]

Among the expenses driving the two-income trap are child care, housing in areas with good schools, and college tuition. Warren and Tyagi conclude that having children is the "single best predictor" that a woman will go bankrupt.[7]

Warren and Tyagi call stay-at-home mothers of past generations "the most important part of the safety net", as the non-working mother could step in to earn extra income or care for sick family members when needed.[3] However, Warren and Tyagi dismiss the idea of return to stay-at-home parents, and instead propose policies to offset the loss of this form of insurance.[6]

Warren and Tyagi attempt to overturn the "overconsumption myth" that Americans' financial instabilities are the result of frivolous spending[4] – they note, for instance, that families are spending less on clothing, food (including meals out), and large appliances, when adjusted for inflation, than a generation prior.[8] They also note that dual-income households have less discretionary money than single-income households a generation prior.[6]

It's kinda ridiculous that PP had to spell out what should be fairly widely known by most groups in this society. Unless one has inherited wealth or made serious bank through their work, then it pretty much takes two incomes to buy homes in good school districts and to minimize what can be the catastrophic consequences of layoffs. And don't get me started on medical expenses. This should not be a surprise to anyone living it or reading the paper.

[Anonymous]

My parents moved across the country when they were in their 60s. When they became older and infirm, I asked that they move in with us or at least closer to us so we could help more. They refused. My in laws moved to the other side of the world when in their 70s. There is little we can do now to assist them. So sometimes even when kids want to care for their parents, the parents make it impossible.

[Anonymous]

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

The great news here is that you can do whatever works for you and your family, as part of your culture. If you live in the US, great -- you can care for your aging parents or in-laws here. If you don't live in the US, even better -- because clearly you have little understanding of how it works here. What you do have, apparently, is plenty of free time to come troll in this forum and tell Americans how our culture sucks and we're doing it all wrong, because clearly we don't love our families enough. That's kind of a sad existence that you have nothing more fulfilling to do in your your real life living in your awesome culture.

[Anonymous]

Anonymous wrote:My parents moved across the country when they were in their 60s. When they became older and infirm, I asked that they move in with us or at least closer to us so we could help more. They refused. My in laws moved to the other side of the world when in their 70s. There is little we can do now to assist them. So sometimes even when kids want to care for their parents, the parents make it impossible.

Are your ILs from that side of the world? If so, that's not unusual though does it make hard for any US-based children.

Our challenge is that we are older parents. One of us will be 70 when our oldest is 30. Maybe they will have settled down, maybe not. I want to make things as easy as possible for our kids, so we will see.

[Anonymous]

Anonymous wrote:My parents moved across the country when they were in their 60s. When they became older and infirm, I asked that they move in with us or at least closer to us so we could help more. They refused. My in laws moved to the other side of the world when in their 70s. There is little we can do now to assist them. So sometimes even when kids want to care for their parents, the parents make it impossible.

The expectation is that if they need you, YOU (as the child) are supposed to drop everything and go to them.

[Anonymous]

Anonymous wrote:I have my mom in Rockville paying close to $8K a month. For a smaller non-profit AL - max 30 people in a neighborhood. She has one room with an adjoining bathroom. She gets 3 meals a day, cleaning, med management, bath twice a week, someone to help her get ready for the day and bedtime, and she has moderate dementia. We are happy with the place and they are loving and caring. I hear Sunrise is much more expensive and they charge for every service and food is not as good.

My mom is at Sunrise in Rockville. We pay $6,100 for a large room with a kitchenette (sink and refrigerator) and private bath. This includes the extra charges for medication oversight and showering 3x a week, 3 meals, housekeeping and daily activities. She has medium dementia but can get dressed on her own.

[Anonymous]

Anonymous wrote:I have my mom in Rockville paying close to $8K a month. For a smaller non-profit AL - max 30 people in a neighborhood. She has one room with an adjoining bathroom. She gets 3 meals a day, cleaning, med management, bath twice a week, someone to help her get ready for the day and bedtime, and she has moderate dementia. We are happy with the place and they are loving and caring. I hear Sunrise is much more expensive and they charge for every service and food is not as good.

If you parent is in a good place, please name it!

[Anonymous]

Anonymous wrote:Please forgive my rookie question: is any of the cost covered by insurance, Medicare, or some other sort of benefit? Is it all out-of-pocket? (These prices are terrifying!)

This is why you need longterm care insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Please forgive my rookie question: is any of the cost covered by insurance, Medicare, or some other sort of benefit? Is it all out-of-pocket? (These prices are terrifying!)

My mom is at Asbury. We pain for an independent living apartment with the sale of her house. She pays the extra with my dads pension and social security.

If she moves to assisted living they pay with the pension and social security and tgat does not giver it so they will start using the value of her apartment towards the cost.

If they run through that money she will pay with pension and social security, which does not cover the cost but since she has no money they take the loss.

NP here: In other words, Asbury is a non-profit so they will not kick her to the curb.

[Anonymous]

Anonymous wrote:
This is why it is important to consider how Long-Term Care Insurance may figure into a future health care and financial planning model. Given one month of AL at $9,000, I find it a bit incredulous that folks \, unless extremely well off, would complain that much about the monthly fees for such coverage. My parents were fortunate to have very good health and went between Cape Cod and Naples for about 28 years. It was health issue in her early 90s with a fractured hip that caused them to make the decision to go into a CCRC. They were able to qualify for Independent Living as my dad was able to care for my mother and brought in help as she had memory issues. There were five siblings in the area who kept my dad in particular (4 sons) active. The place was a buy in for a very large two-bedroom unit with a wraparound porch, and the estate actually did recoup all but 10% in the last six months with the unit's sale. Many of the models today are more rent. They made it to 96 for my mother and 99 for my dad.

I have found that the local senior center has excellent free programs for the community on aging and future planning issues which I would list as:
- Medicare 101
- Medicaid versus Medicare
- Long Term Care Insurance & Newer more flexible options with insurance providers
- Developing Your Long Term Plan of Care for as you age
- Local Providers - Who are they? What services to they provide? What are the costs? Is there a Waiting list?
- Local Agencies - Who are they? What are basic fees? What, if any, is baseline hours to schedule? What services are provided by which kind of folks: RN Nurse, CNA, Med Tech Certified, Home Health Aide, Sitter/Companion and Household Tasks person
- Legal Planning - And what about updating? Have you asked any designated person if they can do the task? Do you have successor designees?
- Financial Planning - Should your estate be reviewed on a fee basis by an appropriate financial person? Should your estate be managed by a wealth management group? (I know about age 90 that my dad shifted his financial decision-making to such a group?
- Consideration of when and if to move with plus and minus options - based on your health to perhaps be closer to family - not necessarily with the idea of direct care?

A rather blunt, but very informative woman lawyer was very clear that you need to have someone (perhaps your lawyer) read through any contract for an CCRC level because it is the contract that governs the services and fees. She has one presentation on the various levels of care and what the various main providers really offer in our area. Only one truly has the lifetime buy-in for a place to live and for medical care always or Contract A as she noted and not so with Contract B. Also getting clear information on what Medicare and Medicaid are is key because it is so easy to confuse both. The key with Medicaid protection for long term care is to realize that the rather short form has several questions in a row on whether there has been a transfer of assets in the last 5 years or 60 months. If this may be a part of a long term strategy, then you need to see the appropriate legal person to consider in your legal planning.

To be clear, I have listened as an educated, upper middleclass couple asked some presenters from various levels of care locally - how does one pay for nursing home care - as they had wrongly assumed that Medicare would cover it. They were very disturbed to hear the options of long-term care insurance, self-pay or Medicaid (which would entail the prior legal planning).

Good summary. They should also know that Medicaid homes are typically bottom of the barrel - not at all your first choice of where to live, less competent staff, etc. You don’t want to end up in a Medicaid nursing home. The best thing to do is to look for a CARFE-accredited Continuing Care Retirement Community. Make sure it is a non-profit. Major religious groups run nice ones. My mother was in McLean at a place run by retired Coast Guard. She was able to enter as a retired Veteran’s Administration nurse.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have my mom in Rockville paying close to $8K a month. For a smaller non-profit AL - max 30 people in a neighborhood. She has one room with an adjoining bathroom. She gets 3 meals a day, cleaning, med management, bath twice a week, someone to help her get ready for the day and bedtime, and she has moderate dementia. We are happy with the place and they are loving and caring. I hear Sunrise is much more expensive and they charge for every service and food is not as good.

My mom is at Sunrise in Rockville. We pay $6,100 for a large room with a kitchenette (sink and refrigerator) and private bath. This includes the extra charges for medication oversight and showering 3x a week, 3 meals, housekeeping and daily activities. She has medium dementia but can get dressed on her own.

PP was there any buy-in fee?