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Old 02-20-2010, 12:59 PM   #41
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Have you seen the difference between private facilities and public ones? Have your
relative check them out, they might change their mind.
TJ
Can you expand on what the differences are? I am if your in bad enough shape that you can't take care of yourself, what more do you need other than a room?
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Old 02-20-2010, 01:41 PM   #42
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But IIRC Cunard and one other line had a couple of perpetual passengers. I'd think that it would start to resemble the movie Groundhog Day.
Found one of them:
snopes.com: Retirement on Cruise Ship
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Old 02-20-2010, 01:50 PM   #43
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Can you expand on what the differences are? I am if your in bad enough shape that you can't take care of yourself, what more do you need other than a room?
State of the facility and Level of neglect Quality of care.
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Old 02-20-2010, 01:57 PM   #44
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Can you expand on what the differences are? I am if your in bad enough shape that you can't take care of yourself, what more do you need other than a room?
Generally, private pay customers are a much desired commodity with NH's. A discussion with management concerning less than optimum situations involving staff, facilities, food, whatever will usually prompt corrective action for private pay folks. The NH doesn't want you moved to a competing facility. They may not be as responsive to the requests of a customer on welfare who they would probably prefer to move to a competitor's facility than have them stay.

Public facilities usually involve a shared room. Depending on your personality and your roommate's demeanor, this may be a good thing or might make you absolutely miserable. YMMV.

I'm sure the shared vs private room while on the public dole varies from state to state and situation to situation. But the choice is taken away from you if you're relying on welfare funds while living out your last days.....

Generally, the less you can count on relatives (most frequently kids), friends, whoever, to be consistent advocates for you or your loved one, the bigger advantage to being private pay where the NH wants your business and aims to keep you and your loved ones satisfied with the service/care provided.
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Old 02-20-2010, 02:44 PM   #45
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If I recall correctly, the life insurance plan will not work. My elderly aunt lived in a nursing home for many years all paid for by medicaid. When she passed away, the state required us to pass on any life insurance money over to them due to the fact that it had paid for her expenses for all those years. We gladly did so since the nursing home where she was staying treated her with great dignity and respect the last years of her life.

My mother, now 95 years old, has told me she does not plan to give away her assets to "game" the system since she thinks of it as stealing. She has done it on her own all her life and she isn't going to stop now. If she ever needs nursing home facilities, she plans to go to the place my aunt was at and pay her own way as long as possible. I agree with her decision.
I did not explain it good enough. He would be spending his own money until he ran out, then the heir would get the life insurance. Do you think 11k a year for life insurance is crazy for someone who is 74 on a 500k policy.
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Old 02-20-2010, 02:55 PM   #46
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I did not explain it good enough. He would be spending his own money until he ran out, then the heir would get the life insurance. Do you think 11k a year for life insurance is crazy for someone who is 74 on a 500k policy.
Based upon what Potto said you would have to shoot him once he ran out of money to avoid handing over at least a portion of the life insurance to the NH. It really depends on how long he lives after his money (LT care policy) runs out.
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Old 02-20-2010, 03:02 PM   #47
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I did not explain it good enough. He would be spending his own money until he ran out, then the heir would get the life insurance. Do you think 11k a year for life insurance is crazy for someone who is 74 on a 500k policy.
What potto0213 is saying is that the state may intervene and confiscate the proceeds of the LI policy as compensation for providing state welfare NH care. You might want to obtain professional advise for how the LI policy would be owned, who pays, etc. to be sure this would work. The value of a WL LI policy he owns is an asset he would have to declare to qualify for welfare.

$11k/yr for a $500k whole life policy for a 74 yr old male sounds cheap. Do you actually have a quote for that amount?
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Old 02-20-2010, 03:31 PM   #48
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Also consider the difference in types of care available with LTC - such as in home care, having someone come in to cook or cut the grass.
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Old 02-20-2010, 03:50 PM   #49
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$11k/yr for a $500k whole life policy for a 74 yr old male sounds cheap. Do you actually have a quote for that amount?
Yeah, be sure to check the fine print where it says: "insured must die in the 25th mile of a 26 mile marathon".
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Old 02-20-2010, 04:28 PM   #50
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in bad enough shape that you can't take care of yourself, what more do you need other than a room?
I will try to answer this as if it were a serious question.

The physical quality of the facility and the room can be vastly different. Just because I cannot walk or care for myself doesn't mean I am oblivous to the surroundings or their cleanliness. Likewise, the better private facilities treat the patients like guests. Asking nicely, cajoling or humoring the residents into activities or therapy that are good for them. Poorer public facilities are an assembly line with minimal defensible (usually) standards of care. Smiles and extra tme and attention are much more common in nicer private facilities.

For me the clinching argument however is about medical care. Everyone I personally know (3 family members) who has been admitted to such a facility has at some time or another had a problem with medication. A diose needed to be adjusted. A dose was adjusted poorly and needed to be reconsidered. An unexpected side effect developed. In every case it took considerable followup by family members to get the medical staff to make the needed adjustments or investigate more thoroughly. In each case, the initial pronouncement was that we should expect these kinds of abrupt declines and they were ready to move the patient to the terminal, incoherent or dementia care that would anticipate end of life in a few months at most. In all three case, the result of the considerable family pressure was changes in prescriptions and care that caused "remarkable improvement" and return to the previous quality of life and many more years of coherent intelligent (semi-assisted) life. I doubt we would have had such favorable outcomes in a public facility that had less financial incentive to address family concerns.

Personally, I would like the best care my money could buy when I am too feeble to do a lot about it. I hope my parents do the same.
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