My moms facility has a bus that takes her to appointments - necessary because she uses a power chair.

Anonymous wrote:If you lose competency the facility will often go to court to make themselves your guardian/conservator/representative payee. If you have money, that is. If you don't, they still might do it to help you get Medicaid that will pay for their care...or if the facility doesn't take Medicaid, they'll try to get you a court-appointed guardian who will move you to a facility that does. Some guardians are great. Others are neglectful or abusive.

And some facilities/guardians will ignore your "living will" directives and will keep you hooked up/drugged up as long as possible so they can still cash in on any assets or Medicare/Medicaid benefits you may have.

Money rules all. Even when death with dignity is desired.

Anonymous wrote:

Anonymous wrote:My dad was in an assisted living facility. He paid out of pocket. The facility had an in-house medical team. He would never have had to leave. When he ended up in the hospital, they worked with the hospital social worker to arrange transportation home. I was involved it it all, but it would have been pretty seamless if I hadn't been. I imagine that if he was on his own, they would probably get him to sign some sort of power of attorney before moving in.

It varies. My mom was in an assisted living facility with multiple hospitalizations and stays in rehab before she eventually transferred to a nursing home and hospice care. None of these transfers were anything close to “seamless”. My mom, too, paid out of pocket, and I was very much available, and I can’t imagine what her last years would have been like if I had not been available to do what was essentially case management— on top of spending time being her daughter.

I won’t have that, so I try not to think about it too much.

same

Anonymous wrote:If you have a lot of money there is plenty of incentive to keep you alive, but honestly, if anything I hope my kids or staff if my kids are not interested in being involved at all will respect that I only want palliative care for most illnesses once i reach a certain age. I have been to the miserable end with parents and inlaws. No way am I getting cancer treatment past a certain age. Drug me up and let me enjoy myself as I say my goodbyes.

Ditto. OP

Anonymous wrote:My dad was in an assisted living facility. He paid out of pocket. The facility had an in-house medical team. He would never have had to leave. When he ended up in the hospital, they worked with the hospital social worker to arrange transportation home. I was involved it it all, but it would have been pretty seamless if I hadn't been. I imagine that if he was on his own, they would probably get him to sign some sort of power of attorney before moving in.

It varies. My mom was in an assisted living facility with multiple hospitalizations and stays in rehab before she eventually transferred to a nursing home and hospice care. None of these transfers were anything close to “seamless”. My mom, too, paid out of pocket, and I was very much available, and I can’t imagine what her last years would have been like if I had not been available to do what was essentially case management— on top of spending time being her daughter.

I won’t have that, so I try not to think about it too much.

If you have a lot of money there is plenty of incentive to keep you alive, but honestly, if anything I hope my kids or staff if my kids are not interested in being involved at all will respect that I only want palliative care for most illnesses once i reach a certain age. I have been to the miserable end with parents and inlaws. No way am I getting cancer treatment past a certain age. Drug me up and let me enjoy myself as I say my goodbyes.

If you lose competency the facility will often go to court to make themselves your guardian/conservator/representative payee. If you have money, that is. If you don't, they still might do it to help you get Medicaid that will pay for their care...or if the facility doesn't take Medicaid, they'll try to get you a court-appointed guardian who will move you to a facility that does. Some guardians are great. Others are neglectful or abusive.

Anonymous wrote:My dad was in an assisted living facility. He paid out of pocket. The facility had an in-house medical team. He would never have had to leave. When he ended up in the hospital, they worked with the hospital social worker to arrange transportation home. I was involved it it all, but it would have been pretty seamless if I hadn't been. I imagine that if he was on his own, they would probably get him to sign some sort of power of attorney before moving in.

I’d like to see this as seamless without you but I’m dubious. I assist with a childless 90yo relative out of state. I have out of state parent dealing with multiple issues too plus health and teen issues as well. My best is checking in on this relative every other week by phone or in emergency cases. My family visits twice a year. It is not easy for us to do — my inlaws are also in another state. He lives in a major urban area. Has good money for a person his age. Unfortunately, the level of interaction for him is not there. He is cognitively fine, it is the physical he struggles with. Many other seniors are not as mentally with it as him. He complains that the services are not adequate and that much of the stuff happens because families do things tbings for their LOs (like shop) but the facility does have people to help with shopping, meds, companionship, etc. He’s in a good facility, it just seems not good enough. The independent side was also good, not perfect, but good and people seem to like it there. Moving him is not an option. Based on his opinion / outlook, lack of family is a major detriment to living in assisted living.

My dad was in an assisted living facility. He paid out of pocket. The facility had an in-house medical team. He would never have had to leave. When he ended up in the hospital, they worked with the hospital social worker to arrange transportation home. I was involved it it all, but it would have been pretty seamless if I hadn't been. I imagine that if he was on his own, they would probably get him to sign some sort of power of attorney before moving in.

Anonymous wrote:Maybe you start with family/friends but they die or become disabled themselves afterward. Who takes you to appointments? Who moves you to memory care etc? As time moves on, more people will be left alone as they get older. People have few to no children. Maybe you outlive your children. I know several older childless people (some are only children themselves) who look out for each other. At some point, they won’t be able to do much for each other.

What happens in these cases?

AI powered robotic personal assistants/nurses will soon take over elder care, childcare, home care, lawn care. I see a lot of scope for intensive work in our world that needs to be done but we don't have any takers to do it with a low pay. For example, cleaning litter, pollution, invasive weeds, sanitizing stuff etc.

Appointments are easy - Uber, public transportation, medical transport, telehealth, etc. As for moving to a higher level of care, if you don't have friends and family, then the facility staff will assist you with finding a new placement and with moving. If you don't agree and are competent, the facility will initiate eviction proceedings and in a short window of time, the court will order you to move and a sheriff or other law enforcement member will move you. Where you end up will depend on how uncooperative you are. At worst, you can end up in a shelter or on the street - but then your competency would likely be questioned if you let it get to that point. If you aren't competent, the facility will initiate guardianship proceedings and the appointed guardian will make the arrangements. If no one volunteers to be your guardian, the court will issue an order appointing one. There are paid services that do this.

As an aside, eviction will also happen if you stop paying your bill.

You hope you stay cogent enough to pay. If you aren't you might not notice.

A good CCRC in a state with strong oversight will do this.

If you can't afford that, things can get dire

Nothing? I mean this happens to most people. The staff will take care of you until you die, as long as you have enough money. If you die without a will and have assets, they will go to the state and be auctioned off/absorbed by the state.

Maybe you start with family/friends but they die or become disabled themselves afterward. Who takes you to appointments? Who moves you to memory care etc? As time moves on, more people will be left alone as they get older. People have few to no children. Maybe you outlive your children. I know several older childless people (some are only children themselves) who look out for each other. At some point, they won’t be able to do much for each other.

What happens in these cases?