Anonymous wrote:I have a relative with 24/7 home care and they’re spending north of $350,000/year.

Yep. Sadly this is accurate. My aunt is bedridden but won’t go to a nursing home. She is of sound mind so she can’t be overruled. She has someone come in during the daytime but is alone all night because she realized her money would run out. She doesn’t qualify for any assistance. She has been lucky to afford the care she does have but her funds are dwindling and she really needs more help, not less. It makes me feel awful. I worry something will happen at night. And I worry that one day DH and I will be in the same boat. We could never afford it.

Most do realize how incredibly difficult it is to be a caregiver to a disabled adult. Especially one who needs 24/7 assistance

It ticks me off that a person can save and be smart with their money, pay off their home, have a decent retirement but they have to be impoverished with nothing to qualify for assistance. It's like what's the point of doing all the right things financially, so you can live comfortably only to be told sorry you have to be dirt broke to get the bare minimum And we're going to do extensive investigations to make sure you are dirt broke and you didn't just write a check to your children!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Hello from hell in SC! I’m reporting that my 80 year old mother with dementia in a memory care facility is currently costing 36k a month due to the need for 24/7 private aids due to lots of falls!

Maybe she should be allowed to fall. My mother was mid stage 6 , fell, fractured her pelvis, went on hospice and passed a month later on about of morphine and Ativan. It was more more in line with what she would have wanted (and articulated to me for years) than being kept barely alive while draining any remaining funds.

I know it’s not an easy decision but my mom had done a dementia directive and there wasn’t much to be done anyway.

Hindsight being 20/20 I wish I would have done what this PP did when my mom fell last summer. I fought tooth and nail for the hospital to not admit her after a fall, knowing a hospital admission would have killed her at that point. In retrospect that would have been a much more humane decision, but I really thought at the time I was doing the right thing by getting her back to her memory care where she felt comfortable. She’s been ever so slowly deteriorating (and on hospice) since then. We’re close to the end but my insistence bought her another year of suffering.

How would have a hospital admission killed her at that point?

Someone suffering from dementia, even the early stages (which she was not at this particular point) does not do well in a hospital setting. They often get delirium which is similar to but even more fun than dementia (last time my mom got it she started screaming at the top of her lungs at the woman who was evaluating her for rehab that the poor woman was just there to steal all her money- needless to say she was not found fit to go to that particular rehab). They need a sitter in their rooms, or a motion sensor for if they try to get out of bed. And the beeping and new environment and nurses coming in all the time just does a number on them. In my mom’s case it always led to them over medicating her which led to multiple additional days in the hospital which led to more overmedicating. After many days of this pattern she’d need rehab because she’d physically deteriorate. Then she’d need private one on one care in rehab due to the dementia. At this stage of the game she’d never make it out of the hospital.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I just don't understand how anyone except the super wealthy can afford even $10k month. Where are all the old poor people living that doesn't have family?

medicaid nursing homes. typically it’s more of an issue of if you have always been poor/don’t have family who can help, it’s not really a question and you are automatically put in a medicare nursing home. in a lot of ways, it’s the very poor and very wealthy that do ok at the end of life. It’s everyone in between that struggles.

Op here, I just had the convo with my MIL she has a pension which makes this all more complicated. Not enough to pay 30k a month but too much for medicaid. I guess we create a certain type of trust and put it all in their to essentially save it for the state when she dies. It's a state pension so all sort of ridiculous.

We have an elderly aunt on medicaid (luckily in a nice place). Medicaid pays the difference (minus $45) between the nursing home cost and her pension and SS. She can't have more than 2k in the bank.

Oh interesting. Will have to look into that. Probably something that varies by state. She gets 60k a year in a pension..

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I just don't understand how anyone except the super wealthy can afford even $10k month. Where are all the old poor people living that doesn't have family?

medicaid nursing homes. typically it’s more of an issue of if you have always been poor/don’t have family who can help, it’s not really a question and you are automatically put in a medicare nursing home. in a lot of ways, it’s the very poor and very wealthy that do ok at the end of life. It’s everyone in between that struggles.

Op here, I just had the convo with my MIL she has a pension which makes this all more complicated. Not enough to pay 30k a month but too much for medicaid. I guess we create a certain type of trust and put it all in their to essentially save it for the state when she dies. It's a state pension so all sort of ridiculous.

We have an elderly aunt on medicaid (luckily in a nice place). Medicaid pays the difference (minus $45) between the nursing home cost and her pension and SS. She can't have more than 2k in the bank.

Anonymous wrote:

Anonymous wrote:

Hello from hell in SC! I’m reporting that my 80 year old mother with dementia in a memory care facility is currently costing 36k a month due to the need for 24/7 private aids due to lots of falls!

Maybe she should be allowed to fall. My mother was mid stage 6 , fell, fractured her pelvis, went on hospice and passed a month later on about of morphine and Ativan. It was more more in line with what she would have wanted (and articulated to me for years) than being kept barely alive while draining any remaining funds.

I know it’s not an easy decision but my mom had done a dementia directive and there wasn’t much to be done anyway.

Hindsight being 20/20 I wish I would have done what this PP did when my mom fell last summer. I fought tooth and nail for the hospital to not admit her after a fall, knowing a hospital admission would have killed her at that point. In retrospect that would have been a much more humane decision, but I really thought at the time I was doing the right thing by getting her back to her memory care where she felt comfortable. She’s been ever so slowly deteriorating (and on hospice) since then. We’re close to the end but my insistence bought her another year of suffering.

How would have a hospital admission killed her at that point?

correction: outpaced their Social Security

Anonymous wrote:...But it’s absurd when we make societal decisions to enable people to drag this out with things like frozen property taxes and other age in place incentives while young families who are paying higher home prices also are saddled with a higher tax liability. They could tap their bloated home equity to pay taxes whereas younger buyers cannot...

How is an older person supposed to "tap their bloated home equity to pay taxes" ?
They obviously don't have cash in the bank to pay the property taxes.

Let's say the house is worth $500K (paid off) and the taxes are $12K. If they "tap" the home equity and borrow the $12K, they have to immediately start paying it back. And this would need to happen year after year. So the older person is paying back ~$1K per month year after year, to pay back the equity loan, especially when they would need loan after loan.

Which if they could afford that, they could just pay the property taxes in the first place. You can't just request $12K and agree to pay that back in 10 years when you sell the house. So for an older couple who is fine living in a paid off house but is on a limited monthly income, it would not be cost effective to them or society to have them forced out of the house and into a rental or expensive independent living, simply because property taxes have outpaced their Micare. And once they are on independent and assisted living and run out of the house profits, they go on Medicaid and the working tax payers cover their shortage. It probably would have been cheaper on the whole to the community to freeze their property taxes and let them stay independent.

Many communities have a cap on rising property taxes which allows the retired couple to stay and keep paying some property taxes (and sometimes this benefits working homeowners as well.

And a reverse mortgage is not the answer to tapping into equity. This just shifts the home equity assets to the private company instead of covering future Medicaid costs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hello from hell in SC! I’m reporting that my 80 year old mother with dementia in a memory care facility is currently costing 36k a month due to the need for 24/7 private aids due to lots of falls!

She was frugal her whole life and saved a nest egg as a teacher. A year at Clemson for one of our kids is being spent a month for her crappy care with uneducated aides who ignore her half of the time unless I argue with their supervisor.

My advice is to make sure whatever facility you place your parents in at the beginning of this journey is also qualified to accept Medicaid and has a good reputation as a Medicaid facility so that one day you can transition to that when the money runs out.

We will be moving her to a facility that requests a year of private pay before they will accept Medicaid and that is what we will need to do because she may live a lot longer, but her money is being rapidly spent down for her care

Why are you spending your college savings on this if your mother has savings? Shouldn’t you be spending down her funds that she saved for this?

I think PP is merely pointing out what an equivalent cost would be to show the magnitude, not that she is spending her kids’ college savings on her mother’s care.

Yes, I realized that that was a possibility, but the thing is, that money was saved for her mom’s care when she became old. By comparing it to a year in college, she’s implying the idea that the money would have a better use than the care of her mom, ie: paying for the son’s college tuition. Her mom saved that money- that money is meant for exactly what she’s using it for.

My partner and I are saving and investing so that we will be able to pay for our care one day. We both have some longevity genes, so we want to have enough down the road to pay for what we need as we age. We do not want to be a financial burden to our children.

Our parents did this for us. Both sets had saved enough that they never needed money from their children. That was a huge gift to us. There wasn’t a lot left when they died, but we were happy that they were always comfortable as they aged and never needed to worry about money.

DP I still think it’s a useful comparison. For the cost of keeping a person, who may not even know who their own identity and/or have any meaningful quality of life, alive for 4 months a younger person could attain an entire 4 year college degree. 1 year in a nursing home = 12 years of college (3 whole degrees). It’s just a way to filter more money to private equity for minimal return.

I would be devastated if everything I spent my life building is burned through to keep me alive with the awareness of a toddler who may not be receiving any sort of quality care. I truly do not want to live this long.

My grandma lived to 100, her own elderly kids were exhausted spending their retirement managing her care. She laid in bed watching tv most days and occasionally got wheeled around in a wheelchair. She was still with it enough to express how she wished she wasn’t still alive but there are no real options if your body does just enough to sustain basic life functions. Please just give me an “accidental” overdose of pain meds and call it a day.

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

The next generation goes into debt?

No.

They go on Medicaid and go into a home.

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."

I don’t understand this “moving the elderly” reasoning. They are living in their own houses that they pay/ paid for and invested in. Apart from cost of care, they shouldn’t be moved just to make houses available for new generations. Luckily, These are not public provided housing that the state can just move the elderly.

Clearly you’ve never had an aging parent with a neurodegenerative disease insist on staying in 5k sq ft 3 level home with tall staircases in a very car dependent sprawl area.

I do think on a macro level we should not be encouraging elderly people who cannot maintain their homes and barely use the space to stay in them, especially when they are at the end of their driving years and end up isolated in a cul de sac in some exurb.

If any individual can afford and handle being in the home and hire a driver then good luck to them. But it’s absurd when we make societal decisions to enable people to drag this out with things like frozen property taxes and other age in place incentives while young families who are paying higher home prices also are saddled with a higher tax liability. They could tap their bloated home equity to pay taxes whereas younger buyers cannot. It should not be about what any one person wants, but rather how best to allocate tax dollars and limited land.

Putting that aside though, I’ve watched my dad go through multiple falls. The house is in disrepair (not a safety hazard, but it will take a lot of work to fix and is too big to be a tear down). I work full time and have 3 kids, so I cannot drive an hour away to help with this regularly. He is still with it enough that a court will not step in until things are dire. I hope we do not get there.

DH and I have already decided we will downsize to something safer, walkable, and less maintenance as we age. Our family members who did so are doing so much better that I actually think it’s a disservice to elderly people being enabled to stay in a situation that no longer serves their abilities.

Anonymous wrote:

Anonymous wrote:None of our parents needed this kind of care for long.

My mom died at 70 after a short illness.

My father in law died at 75 after a fall and a long illness where he was at home.

My father died in hospice. He did end up in assisted living but it was largely paid for with veterans benefits.

My mother in law lived on her own on an apartment until she was 95 and had a stroke. She died within a week at a hospital.

That's because no one actually cared for old people like this before. You just let them live in their homes until they fell sick and died on their own.

We should look into this more
That’s what my plan is for my father
Even if he freaks out and demands super expensive and intense care.
He doesn’t have the money and I have no intention of giving up my life for this

Anonymous wrote:

Hello from hell in SC! I’m reporting that my 80 year old mother with dementia in a memory care facility is currently costing 36k a month due to the need for 24/7 private aids due to lots of falls!

Maybe she should be allowed to fall. My mother was mid stage 6 , fell, fractured her pelvis, went on hospice and passed a month later on about of morphine and Ativan. It was more more in line with what she would have wanted (and articulated to me for years) than being kept barely alive while draining any remaining funds.

I know it’s not an easy decision but my mom had done a dementia directive and there wasn’t much to be done anyway.

Hindsight being 20/20 I wish I would have done what this PP did when my mom fell last summer. I fought tooth and nail for the hospital to not admit her after a fall, knowing a hospital admission would have killed her at that point. In retrospect that would have been a much more humane decision, but I really thought at the time I was doing the right thing by getting her back to her memory care where she felt comfortable. She’s been ever so slowly deteriorating (and on hospice) since then. We’re close to the end but my insistence bought her another year of suffering.

Anonymous wrote:For every single poster here rallying about the cost of end of life care:

The next time our government looks at this, don't freak out about "death panels." We spend more on end of life care, that keeps people technically alive, but certainly not living, than any other country. We should be spending more on young people and poor people.

100% agree with this. There needs to be a mind shift away from "safety at all cost" to a realistic look at quality of life.