Anonymous wrote:

Anonymous wrote:I have my mom in Rockville paying close to $8K a month. For a smaller non-profit AL - max 30 people in a neighborhood. She has one room with an adjoining bathroom. She gets 3 meals a day, cleaning, med management, bath twice a week, someone to help her get ready for the day and bedtime, and she has moderate dementia. We are happy with the place and they are loving and caring. I hear Sunrise is much more expensive and they charge for every service and food is not as good.

My mom is at Sunrise in Rockville. We pay $6,100 for a large room with a kitchenette (sink and refrigerator) and private bath. This includes the extra charges for medication oversight and showering 3x a week, 3 meals, housekeeping and daily activities. She has medium dementia but can get dressed on her own.

Anonymous wrote:
This is why it is important to consider how Long-Term Care Insurance may figure into a future health care and financial planning model. Given one month of AL at $9,000, I find it a bit incredulous that folks \, unless extremely well off, would complain that much about the monthly fees for such coverage. My parents were fortunate to have very good health and went between Cape Cod and Naples for about 28 years. It was health issue in her early 90s with a fractured hip that caused them to make the decision to go into a CCRC. They were able to qualify for Independent Living as my dad was able to care for my mother and brought in help as she had memory issues. There were five siblings in the area who kept my dad in particular (4 sons) active. The place was a buy in for a very large two-bedroom unit with a wraparound porch, and the estate actually did recoup all but 10% in the last six months with the unit's sale. Many of the models today are more rent. They made it to 96 for my mother and 99 for my dad.

I have found that the local senior center has excellent free programs for the community on aging and future planning issues which I would list as:
- Medicare 101
- Medicaid versus Medicare
- Long Term Care Insurance & Newer more flexible options with insurance providers
- Developing Your Long Term Plan of Care for as you age
- Local Providers - Who are they? What services to they provide? What are the costs? Is there a Waiting list?
- Local Agencies - Who are they? What are basic fees? What, if any, is baseline hours to schedule? What services are provided by which kind of folks: RN Nurse, CNA, Med Tech Certified, Home Health Aide, Sitter/Companion and Household Tasks person
- Legal Planning - And what about updating? Have you asked any designated person if they can do the task? Do you have successor designees?
- Financial Planning - Should your estate be reviewed on a fee basis by an appropriate financial person? Should your estate be managed by a wealth management group? (I know about age 90 that my dad shifted his financial decision-making to such a group?
- Consideration of when and if to move with plus and minus options - based on your health to perhaps be closer to family - not necessarily with the idea of direct care?

A rather blunt, but very informative woman lawyer was very clear that you need to have someone (perhaps your lawyer) read through any contract for an CCRC level because it is the contract that governs the services and fees. She has one presentation on the various levels of care and what the various main providers really offer in our area. Only one truly has the lifetime buy-in for a place to live and for medical care always or Contract A as she noted and not so with Contract B. Also getting clear information on what Medicare and Medicaid are is key because it is so easy to confuse both. The key with Medicaid protection for long term care is to realize that the rather short form has several questions in a row on whether there has been a transfer of assets in the last 5 years or 60 months. If this may be a part of a long term strategy, then you need to see the appropriate legal person to consider in your legal planning.

To be clear, I have listened as an educated, upper middleclass couple asked some presenters from various levels of care locally - how does one pay for nursing home care - as they had wrongly assumed that Medicare would cover it. They were very disturbed to hear the options of long-term care insurance, self-pay or Medicaid (which would entail the prior legal planning).

Anonymous wrote:

Anonymous wrote:Please forgive my rookie question: is any of the cost covered by insurance, Medicare, or some other sort of benefit? Is it all out-of-pocket? (These prices are terrifying!)

My mom is at Asbury. We pain for an independent living apartment with the sale of her house. She pays the extra with my dads pension and social security.

If she moves to assisted living they pay with the pension and social security and tgat does not giver it so they will start using the value of her apartment towards the cost.

If they run through that money she will pay with pension and social security, which does not cover the cost but since she has no money they take the loss.

Anonymous wrote:Please forgive my rookie question: is any of the cost covered by insurance, Medicare, or some other sort of benefit? Is it all out-of-pocket? (These prices are terrifying!)

Anonymous wrote:I have my mom in Rockville paying close to $8K a month. For a smaller non-profit AL - max 30 people in a neighborhood. She has one room with an adjoining bathroom. She gets 3 meals a day, cleaning, med management, bath twice a week, someone to help her get ready for the day and bedtime, and she has moderate dementia. We are happy with the place and they are loving and caring. I hear Sunrise is much more expensive and they charge for every service and food is not as good.

Anonymous wrote:I have my mom in Rockville paying close to $8K a month. For a smaller non-profit AL - max 30 people in a neighborhood. She has one room with an adjoining bathroom. She gets 3 meals a day, cleaning, med management, bath twice a week, someone to help her get ready for the day and bedtime, and she has moderate dementia. We are happy with the place and they are loving and caring. I hear Sunrise is much more expensive and they charge for every service and food is not as good.

Anonymous wrote:My parents moved across the country when they were in their 60s. When they became older and infirm, I asked that they move in with us or at least closer to us so we could help more. They refused. My in laws moved to the other side of the world when in their 70s. There is little we can do now to assist them. So sometimes even when kids want to care for their parents, the parents make it impossible.

Anonymous wrote:My parents moved across the country when they were in their 60s. When they became older and infirm, I asked that they move in with us or at least closer to us so we could help more. They refused. My in laws moved to the other side of the world when in their 70s. There is little we can do now to assist them. So sometimes even when kids want to care for their parents, the parents make it impossible.

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

The sad fact is that most families need two incomes to get by these days. Women are giving their labor to corporations and simply aren’t available to provide labor at home like the did in the past

I come from an immigrant family and my mother cared for two elderly relatives in our home until their last few months when they needed a higher level of care than she could provide and they went to nursing homes.

Two incomes are required to provide a very high standard of living. You could easily live off one income if you lived in a smaller house, one limited driving vacation to see family, no kids activities outside of running around the neighborhood, one car, one TV, no iPhones etc. Most people don’t think a job is so terrible that they need to live a 1950s lifestyle. Why would a woman with options want to forgo a paycheck and the resulting luxuries to provide unpaid labor to a relative? What you’re describing is simply progress and women having better options than they did in the past.

Read the Two Income Trap:
Causal factors
The authors present quantitative data to demonstrate how American middle-class families have been left in a precarious financial position by increases in fixed living expenses, increased medical expenses, escalating real estate prices, lower employment security, and the relaxation of credit regulation.[2][6] The result has been a reshaping of the American labor force, such that many families now rely on having two incomes in order to meet their expenses.[2] This situation represents a greater level of financial risk than that faced by single-income households: the inability of either adult to work, even temporarily, may result in loss of employment, and concomitant loss of medical coverage and the ability to pay bills.[6][4] This may lead to bankruptcy or being forced to move somewhere less expensive, with associated decreases in educational quality and economic opportunity.[2]

Among the expenses driving the two-income trap are child care, housing in areas with good schools, and college tuition. Warren and Tyagi conclude that having children is the "single best predictor" that a woman will go bankrupt.[7]

Warren and Tyagi call stay-at-home mothers of past generations "the most important part of the safety net", as the non-working mother could step in to earn extra income or care for sick family members when needed.[3] However, Warren and Tyagi dismiss the idea of return to stay-at-home parents, and instead propose policies to offset the loss of this form of insurance.[6]

Warren and Tyagi attempt to overturn the "overconsumption myth" that Americans' financial instabilities are the result of frivolous spending[4] – they note, for instance, that families are spending less on clothing, food (including meals out), and large appliances, when adjusted for inflation, than a generation prior.[8] They also note that dual-income households have less discretionary money than single-income households a generation prior.[6]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In my culture, children care for their aging parents except for the more serious cases. I am a bit disturbed that so many Americans leave their parents to be cared for by strangers (for decades!) and their children to be raised by strangers too (nannies). Smh.

The sad fact is that most families need two incomes to get by these days. Women are giving their labor to corporations and simply aren’t available to provide labor at home like the did in the past

I come from an immigrant family and my mother cared for two elderly relatives in our home until their last few months when they needed a higher level of care than she could provide and they went to nursing homes.

Two incomes are required to provide a very high standard of living. You could easily live off one income if you lived in a smaller house, one limited driving vacation to see family, no kids activities outside of running around the neighborhood, one car, one TV, no iPhones etc. Most people don’t think a job is so terrible that they need to live a 1950s lifestyle. Why would a woman with options want to forgo a paycheck and the resulting luxuries to provide unpaid labor to a relative? What you’re describing is simply progress and women having better options than they did in the past.