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Old 07-05-2016, 06:46 AM   #21
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Originally Posted by zesty View Post
2 words: robot servants.
"Wipe my butt and pull my pants back up, Hal."

"I'm sorry, Dave; I can't do that."

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Old 07-05-2016, 08:32 AM   #22
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Originally Posted by braumeister View Post
"Wipe my butt and pull my pants back up, Hal."

"I'm sorry, Dave; I can't do that."


Have Funds, Will Retire

...not doing anything of true substance...
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Old 07-05-2016, 09:21 AM   #23
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I havent run all the states yet but the ones I've hit show a full-up Assisted living situation is actually cheaper than a Home health Aid situation. I found that interesting since it goes against most of what I have heard
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Old 07-05-2016, 09:26 AM   #24
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We just went through this with my mother.

She was living in a "continuous care" facility in the independent living area - basically a 1200 sqft apartment where they provided meals and apartment maintenance. There were options to go into memory care or assisted living if needed; my Mom did not need either of those.

When she began needing more help, it ended up being a combination of several things. Hospice helped coordinate her truly medical needs, which ended up being oxygen and some pain medication, as well as a bath lady. My Dad and I, plus my sisters sometimes, took care of simple things like rearranging the apartment, filing, making sure bills were paid, etc. At the very end she started using "resident services" who were able to come daily and do things like make sure her oxygen was filled and that her pills were in the right place. She did investigate "home health", which was more like light nursing care.

My conclusions - YMMV obviously:

1. Having family nearby willing and able to take care of things is the best and least expensive option. Be nice to our kids is the lesson here I guess.

2. You can buy a lot of in-home nursing care for the cost of assisted living. In her case, I think the cost delta would have been about $4K / month to go to assisted living. In the last month of her life she ended up using about $100 of resident services and no nursing care.

3. There are graduations of cost - a CNA may cost $10 per hour, an RN may cost $40 per hour.

4. After watching a number of people grow old and pass away where my parent live... To be brutally honest, I think the problem is self-limiting. If you need an RN to stay with you 24/7, it is highly unlikely that you're not going to need that for more than a year or two. You'll either be dead or recovered.

5. It's good to be ahead of the curve, like W2R is. Moving into a place that has ramps and wide doors and shower grab bars and the like a few years before you end up needing those things is much easier on everyone than starting to have mobility problems and then trying to move. My parents moved into their place 10 years ago and didn't need it until maybe a few years ago, but since they were already there, there was no need for panic or rushing or pressure. It worked out well in their case.
"At times the world can seem an unfriendly and sinister place, but believe us when we say there is much more good in it than bad. All you have to do is look hard enough, and what might seem to be a series of unfortunate events, may in fact be the first steps of a journey." Violet Baudelaire.
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Old 07-05-2016, 10:06 AM   #25
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Interesting thread and information. The fly in the ointment with aging in place is Alzheimer's and dementia. My Mom was able to live her last days in the home, and her dementia had gotten to the moderate stage (confusion of her surroundings was common). If it wasn't for her COPD that severely limited her mobility, there would have no way to keep her in the home as she would have wandered off. Since DW and I have no kids, we think our plan B will be something along the lines of the 3-step retirement home. Of course, we would most certainly want to live and die at home, but this just may not be possible.
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Old 07-06-2016, 08:10 AM   #26
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Originally Posted by Options View Post
This from Genworth might be helpful in estimating long term care costs in your location, including daily, monthly, and annual estimates of home health care:

You also have the ability to calculate estimated future costs of LTC in its many forms.
Excellent website. A wake up call, and quite accurate based on my own knowledge of costs in several locations in Illinois and Florida.

Another sobering fact... 1 in 3 seniors die with Alzheimer's or Dementia. While it is possible to keep provide home care, this can well have devastating results for the caregiver. While some patients become passive and pose no emotional problems, a very high percentage strain to maintain individuality, becoming difficult to handle, or worse... to become aggressive and dangerous.

Using the Genworth Chart, a private nursing home room, 20 years from now, could cost upwards ot $170K/yr. Unless there is a change in the government's trend toward reducing public healthcare funds, this could shift the burden of care to the "at home" model, similar to to the social structure of Japan, which has dealt with this for many years.

.................................................. ..................................
Re Robots:

While I would agree there is much room for improvement in many areas, I can see little substitute for the personal emotional contact, and the physical necessities that do not lend themselves to mechanical care at present. I would suggest that two or three hours at a time, at a nursing home during visiting hours does not represent the full experience, and the breadth of the 24/7 care is far more than meets the eye. Even in the well staffed environment of the nursing home in our CCRC, the pressure of giving personal care reduces the availability of new hirees, where emotional and temperamental stability is becoming more difficult to find.

This also goes to the point of supply and demand. Those who have had to make a long and difficult search to find proper care for a loved one may attest to the wide differences between assisted living facilities and nursing homes.
Conscientious care is not just a matter of the facility, but of management of the physical and personal pieces that make up "caring". In the end, it usually comes down to the money needed to maintain standards.
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Old 07-06-2016, 08:44 AM   #27
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Originally Posted by HFWR View Post
Figuring out how to do it is easier than figuring out how to pay for it...
Originally Posted by RobbieB View Post
Where there is a demand companies will supply that demand. It's the American way -
Except that the "greedy" providers may want too much for their service (like changing diapers). I would too.
"Old age is the most unexpected of all things that can happen to a man" -- Leon Trotsky
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Old 07-06-2016, 10:29 AM   #28
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(I think ) I posted this before, but in case I hadn't, this is the best, most comprehensive planning guide I've been able to find regarding long-term care to include housing, financial, lifestyle, family, and health care considerations. Gives pro's and cons of each housing option and contains a wealth of information.

I have personally mapped out a general idea of how I want the three stages of retirement to go (euphemistically referred to as the go-go, slow-go, and no-go years). Things may not go according to plan, but to the extent that I am in a position to influence outcomes, at least I have a general idea (subject to revision based on updated circumstances and desires) what I'd like all of my retirement years to look like, up to and including end of life to the greatest extent possible.

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