The above has info extraneous to our conversation here, but shows the difficulties in triggering. Google for other sources.

Anonymous wrote:

Anonymous wrote:This is 21:43. AARP has a good summary on LTC. https://www.aarp.org/health/health-insurance/info-06-2012/understanding-long-term-care-insurance.html

Basically, it is expensive, you can expect steep rate increases, and there are limitations on coverage, either the amount they will pay or a time limit or both. Also in the case of Alzheimer’s, like my dad, triggering the coverage can be tricky.

What do you mean that it can be tricky to trigger the coverage in the case of alzheimers? Do you mean that strategically if you only bought X years of coverage, it is hard to figure out when to start using it? or that it is hard to prove to the insurer that you need the care since the decline is so gradual? My mom was just diagnosed with Alzheimers and has 4 years of LTC coverage plus 4 years of automatic Medicaid coverage that she gets for buying LTC coverage (this is a special deal that a few states have). I was hoping this would help protect her financially, but maybe not... She has been paying crazy high premiums for 10+ years so hopefully this policy will pay out now that she needs it.

It is in the insurance company’s interest obviously not to trigger the use of LTC. Here is some info; more available for googliing:

https://www.nap411.com/financial/long-term-care-insurance/benefit-triggers

My parents moved into assisted living two months ago, mainly because of Mom's needs. (Dad is independent, albeit slow to get around.) It is $8000 a month for Mom, and an "add-on" of $1500 for Dad (mostly covering food and activities). So, $9500 for them both. It's a nice place about an hour out from DC.

Anonymous wrote:This is 21:43. AARP has a good summary on LTC. https://www.aarp.org/health/health-insurance/info-06-2012/understanding-long-term-care-insurance.html

Basically, it is expensive, you can expect steep rate increases, and there are limitations on coverage, either the amount they will pay or a time limit or both. Also in the case of Alzheimer’s, like my dad, triggering the coverage can be tricky.

What do you mean that it can be tricky to trigger the coverage in the case of alzheimers? Do you mean that strategically if you only bought X years of coverage, it is hard to figure out when to start using it? or that it is hard to prove to the insurer that you need the care since the decline is so gradual? My mom was just diagnosed with Alzheimers and has 4 years of LTC coverage plus 4 years of automatic Medicaid coverage that she gets for buying LTC coverage (this is a special deal that a few states have). I was hoping this would help protect her financially, but maybe not... She has been paying crazy high premiums for 10+ years so hopefully this policy will pay out now that she needs it.

Anonymous wrote:

Anonymous wrote:I recognize this may be an unpopular idea, but I honestly think they'll legalize assisted suicide, when faced with a huge baby boomer population that can't afford care (given the whole 401k experiment), disappearing safety nets, and living long enough to get lingering but debilitating illnesses that offer slow, difficult, and expensive deaths. I've been totally convinced assisted suicide is the more humane option since seeing my gma's demise with dementia.

I wish they would legalize it. I am watching my MIL suffer in a nursing home with minimal care and this isn't how she wants to live. She doesn't have her mind anymore and is now starving herself. She's given up and it sucks there isn't anything to do to help.

It sounds like your mother in law has dementia or Alzheimer’s. Such patients often forget how to feed themselves, and aren’t deliberately starving themselves to death. It is also common for dying people to eat less and less, it’s called failure to thrive. Despite the emotions you are attributing to her, her behavior may have medical causes.

As horrible as some nursing home may be, generally the more decentralized the care, the greater the likelihood of abuse, physical or financial. CMS does publicize ratings for all nursing homes on its website. Those owned by private equity firms (yes, this is a thing), Manorcare is one local chain, tend to be bad because they are trying to maximize profits.

The more he care takers are paid, the greater the likelihood of competent care. This remains an area where cost often correlates to quality.

Medicaid kicks in after 100 days of care in a nursing home, but there are income limits that need to be met by first running through out of pocket resources. It will not be the case that baby boomers who can’t afford it will have no access to decent care, unless we allow the republicans to underfund Medicaid, which they appear determined to do.

- a prosecutor of elder abuse cases

Anonymous wrote:

Anonymous wrote:I recognize this may be an unpopular idea, but I honestly think they'll legalize assisted suicide, when faced with a huge baby boomer population that can't afford care (given the whole 401k experiment), disappearing safety nets, and living long enough to get lingering but debilitating illnesses that offer slow, difficult, and expensive deaths. I've been totally convinced assisted suicide is the more humane option since seeing my gma's demise with dementia.

I wish they would legalize it. I am watching my MIL suffer in a nursing home with minimal care and this isn't how she wants to live. She doesn't have her mind anymore and is now starving herself. She's given up and it sucks there isn't anything to do to help.

Even if assisted suicide becomes legal, laws will NEVER allow for someone to give consent for suicide who is not mentally sound to give consent. If progressive countries in EU dont allow that, thr US wont either.

21:43 again. I’d also encourage everyone to talk to their kids or other family about what you actually want should you become ill or incapacitated. Also meet with a lawyer and draw up documents such as wills, health Care proxies, and POAs. Then talk to whoever your designated agent is honestly about your finances, where your money is, where important documents are, and if you are approaching older age, consider trying to simplify to some degree. My parents had trust issues and issues accepting the reality of their health situations and refused to do any of this despite pleading from me. Well, as I knew would happen, they got urgently sick and I found myself running around trying to sort out all of this with no actual authority to do so. I had to bring a lawyer to a hospital to get a POA and health care proxy for one of them and for the other I really need to go to court for guardianship but for now am just winging it until someone asks me for paperwork. I used huge amounts of leave from work and spend huge amounts of my own money dealing with this. It’s been an ongoing nightmare, and frankly I am extremely angry at them for being so stubborn and leaving me with such a big mess. Their philosophy was along the lines of “oh just leave us there to die and get on with your life.” Well news flash - no halfway decent person - let alone a child - is going to do that to their parents. So the least you can do is to try to get things lined up to ease the process for your caregiver.

Ok. Off my soapbox.

This is 21:43. AARP has a good summary on LTC. https://www.aarp.org/health/health-insurance/info-06-2012/understanding-long-term-care-insurance.html

Basically, it is expensive, you can expect steep rate increases, and there are limitations on coverage, either the amount they will pay or a time limit or both. Also in the case of Alzheimer’s, like my dad, triggering the coverage can be tricky.

"...I find myself wondering if people know what awaits them when they age. It is truly awful."

I feel like this should be the tagline for this forum.

Instead of asking what size house can I afford now, ask which nursing home you want to have later. If that is not incentive to save...

Thanks for your post, PP, and to OP and others.

Thank you PP, after reading this I am looking at LTC plans. Could you elaborate on your statement having its own issues?

PP - pardon all my typos!

Mother is in assisted living here in Arlington and the fees hover just under $10,000 per month. father is in assisted living in Northeast fornjust under $7,000. That doesn’t include medications or doctors co-pays or the cost of the helpers I have to hired to take them to their multitude of specialist appointments. I looked at a ton of places in both areas of the country and any that was halfway decent — emphasis on n the halfway — was around these prices. It’s also hard to get into these places as they often have only one or two openings at a time or a waitlist. The smaller group homes can be cheaper and maybe better care, but they can also be isolating as there aren’t as many people buzzing around nor as many activities. I’ve learned that the activities can be very important for QOL even for people who are very sick and can’t really participate. Just sitting among a larger group of people provides comfort.

The whole thing is insane in my view. I worry every day about running out of money for them. If you can’t addord these places, you have to apply for Medicaid. The number of Medicaid beds is extremely limited and many are in sibstandard places from what I’ve seen. Additionally, some have a requirement that you have private paid for some period of time before you can qualify for one of their Medicaid beds.

In addition, should your loved one become ill and need hospitalization, things can go south really quickly from a cost perspective. Hospitalization can do a number on an older person’s cognition and you may find yourself having to pay thousands out of pocket for a sitter to essentially stay with your loved one and ensure that he doesn’t hurt himself during a fit of hospitalmdelusion. You’ll also have to keep paying the assisted living fees for the room. This happened to us with my father and our monthly expenses were in excess of $20,000 for a three month period until he came out of the delusion.

Honestly the system is a nightmare. We have LTC insurance, which has its own problems but may be better than nothing, and are saving aggressively so as to try not to burden our children with this when we are old. We may not be able to leave them an inheritance, but at least we won’t — hopefully — burden them this way. After going through this with my parents, I often look around and find myself wondering if people know what awaits them when they age. It is truly awful.

FIL has in Home care for Dementia, 24 Hrs. /day. It runs about $150,000 per year.

Anonymous wrote:

In Florida, it was about $1,800 a month for assisted living. No buy in. My fathers S-S and vet benefits covered it.

That is because he is getting subsidized by veterans benefits. That is a different program not everyone qualifies for.