It all depends on the level of assistance they determine the person needs.

My husband’s aunt had a heck of a time finding good home care people. It’s not that easy to find honest, competent people. She had nursing assistants who dropped her husband (this happened multiple times to her husband despite his slender, slight build). She had an assistant who stole from her and tried to set up some sort of deal where her boyfriend would look after the aunt’s house for a monthly fee (scam). She had assistants who refused to do reasonable tasks. The whole thing was a nightmare. In retrospect a nursing home would have been better.

For those advocating for in home care options as cheaper what kind of care are you talking about and what agency? Maybe if you just need an aid a few hours a day, I can see it being cheaper but if you need real full time care I certainly wasn't able to find anything that wasn't outrageously expensive.

We paid $12k base cost for skilled nursing care in Nova but it was much more than that with all of the things not covered by Medicare. For example my mother became diabetic and Medicare didn't cover shot administration but the facility is required by state law to give the shot i.e. the patient can't administer their own medications. We looked into multiple agencies and to get any sort of decent care was much more than what we paid the nursing home. Assisted living in the same facility was around $8k per month I believe (no buy-in). Independent living was less but I believe there was a buy-in. I think the buy-ins are usually if you enter at the Independent living stage not assisted or nursing.

Anonymous wrote:You can find places with no buy in. Those places are a huge scam. Assisted living in this area is about $8-12K. You are better off hiring caregivers and keeping her in her home if possible. Most aren't great. The nursing home my MIL is in is well rated and terrible.

This. Who wants to spend 10 years away from home in a nursing home and paying out of the ass to do so? It's cheaper to find your own in-home alternative.

FWIW, my grandmother's buy in 20 years ago at a very nice place 75 miles outside of NYC was $200,000 plus $3000 a month.

Anonymous wrote:I was just looking at Greenspring Villagein Springfield. They have independent living and higher level of nursing care.

At the independent living part, a large one bdrm has a buy in of $232K (you get 90% back) and a monthly service fee "starting at" $2164. I think it changes based on whether you want them to make all the meals or if you are going to make your own.

https://www.ericksonliving.com/greenspring/apartments/large-one-bedroom

My father was in another "buy-in" place that is run by Erickson in another state (the technical term I believe is continuing care retirement community.) He loved it there, and the care was excellent. His condo was about the same and I think the service fee may have been as well (it came with 2 meals per day, he would charge the other meal to his account.) Over time he also needed aides to help on a daily basis which were contracted through the facility and paid on an hourly basis. He eventually needed memory care and then skilled nursing. Fees there were much higher -- in the neighborhood of $10k per month if I'm remembering correctly. The only difference between memory care and skilled nursing was the nursing availability; SN had 24 hr nurses and cost $1k more per month.

It was an insane amount of money but worth every penny. I know the PP described this as a one-stop shop to die, but for him and for us it was wonderful. He loved the community, found a lot of friends, and then it was a relief not to have to scramble when his needs changed. I will say that I don't think they handle the 'assisted living' level in the most optimal fashion; hiring aides felt like a bit of a bandaid approach until his physical decline was so severe that we had to move him out of the independent side to the units with FT care.

Anonymous wrote:

Anonymous wrote:What happens if you don't have that kind of money?

You live with family. Or if you have no family, you get hospitalized and then somehow they will find you a medicaid nursing home. Those are extremely difficult to get into and rare.

This. there are various other options - some states have places specifically for veterans, for example, some of which will also cover their spouse.

Anonymous wrote:What happens if you don't have that kind of money?

Somebody posted something the other day about "Why is everyone so obsessive about saving for retirement"... this is a good example as to why because there are no guarantees in life.

Anonymous wrote:What happens if you don't have that kind of money?

You live with family. Or if you have no family, you get hospitalized and then somehow they will find you a medicaid nursing home. Those are extremely difficult to get into and rare.

Anonymous wrote:In Houston, my mom is in a place for about $7k a month. It's specifically for Alzheimer's/dementia care. My dad manages the payments, so I don't know if there was a buy in. I don't think so.

Same situation but in Frederick, Maryland ... It's about $8,400 a month.

Anonymous wrote:

Anonymous wrote:What's the buy-in? Is it a deposit that's eventually refunded or is it like a up-front payment that you never get to see?

Some big facilities make you buy a condo unit for several hundred thousand but you still have to pay monthly fees which are very high. When you move out, they offer different care levels so you go into their facility. They refund some when they sell the unit but you are on their time frame so if they take a year you have to wait for your money.

My grandma had a buy in of several hundred thousand. She didn't get it back as it was part of the agreement.

What happens if you don't have that kind of money?

I was just looking at Greenspring Villagein Springfield. They have independent living and higher level of nursing care.

At the independent living part, a large one bdrm has a buy in of $232K (you get 90% back) and a monthly service fee "starting at" $2164. I think it changes based on whether you want them to make all the meals or if you are going to make your own.

https://www.ericksonliving.com/greenspring/apartments/large-one-bedroom

Anonymous wrote:What's the buy-in? Is it a deposit that's eventually refunded or is it like a up-front payment that you never get to see?

Some big facilities make you buy a condo unit for several hundred thousand but you still have to pay monthly fees which are very high. When you move out, they offer different care levels so you go into their facility. They refund some when they sell the unit but you are on their time frame so if they take a year you have to wait for your money.

My mom was in dementia care in a privately-owned facility in So. CA for $6200-7000/month for the last 8 years - no buy in.