Agree that end of life care in the US is a racket. Intubating dementia patients etc...ridiculous and cruel.

You can do what you can in terms of DNRs, refusing interventions etc. but even then some people go on for a very long time with zero interventions. Dying is not easy and in some cases it takes several years.

Plan and protect yourself and your family. Appoint someone your medical durable power of attorney and give them financial POA as well if are comfortable with that. Talk to them and write a letter for them to keep saying that you do not want any invasive care but rather comfort measures only if you are not able to live independently or are mentally not able to safely care for self. That person has the legal right to decline care to avoid drawn out disability. You or they can execute a do not resuscitate order (DNR) and if you’re in a nursing facility you’ll be given a special bracelet to wear so CPR/EMS will not be instituted in the event of a cardiac arrest. Buy long term care insurance in your 50’s - yes, it is very expensive but it protects your partner and your family. Yes, you don’t know you’ll ever use it - that’s the nature of insurance - it’s a risk on each side you will or won’t need it.

Anonymous wrote:

Anonymous wrote:Extreme care for old people who should be just allowed to die is literally bankrupting our country. A massive cultural shift is needed.

End of life extreme medical care is unnecessarily costly, it is cruel. My father has dementia, had a stroke, and never, ever wanted to live the way he is living. I get in arguements with my brother because I now refuse to take him to any doctor besides his primary care physician if he is in pain. I refuse the flu shot for him, refuse to take him to the cardiologist and neurologist. I asked my dad if he wants to go to the doctor and he says no and becomes agitated if he goes. I let him eat whatever he wants, let him drink beer if he asks for it.

I wish someone told me sooner to refuse the flu shot. The nursing home we deal with doesn't do a lot of medical care but someone mentioned this to us recently as a way to help someone pass on. Ours would not want to live this way too and the care she receives is cruel as they are so neglectful.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most people who need long-term 24/7 care need it for 2 years or less (because they pass away) so save up enough for that.

That is a ridiculous assumption. It works out for you to believe this, but you have no idea what to expect.

No, PP is correct that the average reliance on long-term care - in-home or nursing home - is 2 years.

https://www.morningstar.com/articles/823957/75-mustknow-statistics-about-longterm-care.html

My relative that bought long term care insurance for her husband said that the cost of the long term care insurance was about break even at two years of care. So you are betting you’ll live longer than two years, and they are betting you won’t.

The more I learn about Medicaid coverage of long term care, the worse it seems. It’s literally not enough to cover the cost of care so nursing homes either won’t accept it or only accept it by gaming the system in other ways.

What are you talking about, yes medicaid LTC covers the full cost.

Read the "new old age" column in the new york times by Paula Span. She's very informative.

A lot of old people want to be allowed to die naturally but the assisted living places and nursing homes are really quick to call 911, even for those with DNR (do not resuscitate) orders. Of course, our for profit medical system profits greatly from this. My mom had great insurance and every time she had a fall they would keep her in hospital for a week and call in multiple "consults." It's a racket.

Anonymous wrote:Extreme care for old people who should be just allowed to die is literally bankrupting our country. A massive cultural shift is needed.

End of life extreme medical care is unnecessarily costly, it is cruel. My father has dementia, had a stroke, and never, ever wanted to live the way he is living. I get in arguements with my brother because I now refuse to take him to any doctor besides his primary care physician if he is in pain. I refuse the flu shot for him, refuse to take him to the cardiologist and neurologist. I asked my dad if he wants to go to the doctor and he says no and becomes agitated if he goes. I let him eat whatever he wants, let him drink beer if he asks for it.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most people who need long-term 24/7 care need it for 2 years or less (because they pass away) so save up enough for that.

That is a ridiculous assumption. It works out for you to believe this, but you have no idea what to expect.

No, PP is correct that the average reliance on long-term care - in-home or nursing home - is 2 years.

https://www.morningstar.com/articles/823957/75-mustknow-statistics-about-longterm-care.html

15 years now. He has survived event after event. You just don't know.

Anonymous wrote:There are a lot of good discussions on bogleheads money and finance forum about retirement savings, the cost of long term care, etc.

I too have made my wishes known. Once my faculties are gone, I would prefer not to keep going.

Making your wishes known does not help. Your family cannot agree to kill you. If your body is still functioning you will sit and wait (and pay) until death.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most people who need long-term 24/7 care need it for 2 years or less (because they pass away) so save up enough for that.

That is a ridiculous assumption. It works out for you to believe this, but you have no idea what to expect.

No, PP is correct that the average reliance on long-term care - in-home or nursing home - is 2 years.

https://www.morningstar.com/articles/823957/75-mustknow-statistics-about-longterm-care.html

My relative that bought long term care insurance for her husband said that the cost of the long term care insurance was about break even at two years of care. So you are betting you’ll live longer than two years, and they are betting you won’t.

The more I learn about Medicaid coverage of long term care, the worse it seems. It’s literally not enough to cover the cost of care so nursing homes either won’t accept it or only accept it by gaming the system in other ways.

Your choice really is buying long term care insurance or just hoping you don’t get something nasty like Alzheimer’s or Parkinson’s, and know that if you do get it you’ll end up on Medicaid for skilled nursing care. There really isn’t any way a regular middle class American can save enough for care for one of those diseases - my Dad’s care has cost a million already over the past 6-7 years, and he will probably live for years still (Parkinson’s). Even if he wanted to die (he doesn’t) he wouldn’t be able to manage it. You can’t just will yourself to not wake up in the morning, and all other measures take brain power or will power, things these diseases rob.

OP - some practical advice: look at the costs of long-term care policy. Look at what they cover and for how long v. pricing. Compare that against what you can earn by setting aside money for that contingency. Some life insurance policies have convertible long-term care but those are VUL or whole-life that only make sense for tax sheltering for high-wealth individuals (v. term for most everyone else).

Do you have assets such as a home that will be paid off and can be sold when the time comes? I think it is wise to set aside 25%-30% of your retirement nest egg if possible for long-term care when needed. That is, plan to live your active retirement years on about 70-75% of your annual revenue.

Anonymous wrote:Extreme care for old people who should be just allowed to die is literally bankrupting our country. A massive cultural shift is needed.

Thanks for your input, Herr Reichsführer. But don't forget there are many other "lives unworthy of life" who are costing us too much money - the handicapped, special needs kids, certain obstreperous minority groups, convicted felons, etc. With the right "cultural shift" we can arrive at a Final Solution to all these nagging, expensive problems!

Anonymous wrote:Extreme care for old people who should be just allowed to die is literally bankrupting our country. A massive cultural shift is needed.

What happens to the mind though? We say we never want to be like that, we would rather die. But someone gets to that and they cling to life! Does anyone know? I don't know any old people. I know I don't want to be one but I may end up just like them, clinging to life!

Anonymous wrote:

Anonymous wrote:Most people who need long-term 24/7 care need it for 2 years or less (because they pass away) so save up enough for that.

That is a ridiculous assumption. It works out for you to believe this, but you have no idea what to expect.

No, PP is correct that the average reliance on long-term care - in-home or nursing home - is 2 years.

https://www.morningstar.com/articles/823957/75-mustknow-statistics-about-longterm-care.html