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Old 02-19-2013, 12:54 PM   #21
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Joe - you're lucky your dad is not in denial.

We're fighting a hard battle of denial with my MIL. We have the doctors reports, social worker reports, and psychologist reports confirming dementia... but she is in complete denial. Unfortunately, since she isn't make good decisions for herself or my FIL, we're in a legal court process now. (We were presented with the option of taking guardianship or the STATE would make them wards of the state to ensure FIL got the right care. Better family make the decisions, than a bureaucrat.) Denial and stubbornness from a strong matriarch is a challenge to family dynamics. It's an expensive and frustrating process.

I think most of us want to be left alone to make our own decisions... I respect that. But dementia can rob you of the ability to do this.
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Old 02-19-2013, 04:14 PM   #22
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I'm planning something like that, except with Hooters Girls to wait on the old guys. .
I hope I never get so old that this would sound like a bad idea!
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Old 02-19-2013, 04:25 PM   #23
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A wonderful thread. This topic worries us too since we have no children.

I'll be watching the thread closely. Thanks all for sharing your expertise in this subject.
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Old 02-19-2013, 04:57 PM   #24
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Joe - you're lucky your dad is not in denial.

We're fighting a hard battle of denial with my MIL. We have the doctors reports, social worker reports, and psychologist reports confirming dementia... but she is in complete denial.
Yes, we are lucky. Dad had a bit of denial, but very mild. It just delayed his move, and he had to push the driving to the point of getting into a minor fender bender. Some days he still tries to deny, but quickly admits his issues.

Sorry to hear about your legal problems. I honestly don't know how difficult it would have been if Dad was in complete denial. We have the legal documents that talk about what to do in the case of non-competence, with his signatures, but even then I'm sure it would have been unpleasant.

And then... there are some ugly dementias that hit early and the person has zero clue they are happening. FTD (Association for Frontotemporal Degeneration: Opening the gateway to help and a cure) is one of them. I don't want to get morbid, just want to reinforce that we all need to get our papers in order ... just in case.
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Old 02-19-2013, 06:17 PM   #25
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When my parents were in their early 80s, they bought a retirement apartment in a retirement system with 3 levels. Self sustaining, assisted care and full care.

They are still in the self care level living in their apartment without help. However, the system provides weekly house cleaning, quarterly deep cleaning and meals. They do need to check in daily to ensure they are well and have not fallen or have a medical emergency.

Part of the monthly fee included Long term care insurance which will kick in when they move into the full care unit. They purchased a cremation plan, so everything is pretty much taken care of.

The retirement center will take them to any appointments if needed, however my Dad still drives at 92. So, he takes them where they need to go.

So far nothing has cropped up that they did not anticipate and prepare for. I do live about 3 hours away, but am available if needed.. and with the 2 of them still in pretty good health, they do pretty well in their environment.
This is a great story, KB. Dad is 92 and still driving, how can you beat that. Seems like your parents have orchestrated the perfect plan and have played it out to perfection. Most of us aspire for this, but in reality, it is probably not going to happen. Good for them with their healthy life, and well planned lifestyle!
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Old 02-20-2013, 07:12 AM   #26
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This topic has been very much in the forefront of our thoughts lately. My mother moved to a CCRC in her early 70's and loved it. She had an efficiency apartment, lots of friends, activities and things to do, and lived in independent living for 11 years. The arrangement was excellent for her. She was in assisted living for only six months before she passed.

In contrast, DW's father (and DW's siblings) refused to face the realities of his advancing years and he stayed far to long in a home he could just barely afford to stay in. The only activities he had were church, the football team in season, and reading books. That was all he could afford because of the expenses of the house. I asked one SIL "Does he own the house or does the house own him?" and she had no response. And when he couldn't drive he was effectively a prisoner at home, the main social contact being DW.


When his health rapidly declined it was only by a huge ball of luck that we got him into a very good care facility and he is now shuttling back and forth between hospitals and the nursing home. There is not a shade of doubt in my mind that had he moved to the CCRC five years ago he would still be in independent living, or at least assisted living, instead of the ordeal he's going through now because staff would have picked up on the effects of diabetes and corrected it before it got out of hand.

So in the spring I want to start looking at CCRC's. We have no children, my siblings are far away, and the experiences of our respective parents has been an eye-opening awareness raiser. I am very sure that I want us to be in a CCRC no later than when I turn 70.

There are a lot of options, but the one I'm leaning toward is that you plunk down a large wad of cash, depending on the place, between $100k and $250k, (the ones with higher levels of luxury charge more, sometimes a lot more) and then you pay for routing ongoing expenses as they are incurred for an independent living apartment or single-level house. For example in one I've looked at (only online but we'll make a physical visit) has houses/cottages from one bedroom/one bath to two bedroom/two bath with den and one or two-car garages. The rent would be about $800/month and that includes all maintenance, interior and exterior. The entrance fee is prorated over a ten year period so if you moved out after five years you'd get half on that fee back.

But here's the biggie: If our resources are exhausted as may well happen if one gets dementia, they won't throw you out. In effect that huge wad of cash buys a LTC policy for both of you.

The downside of course, is this is a move we can only afford to do once which means the margin of error is zero. So we'll have an elderlaw attorney look over the contract, the finances of the organization, and probably other stuff I haven't thought of yet.

But the idea has an appeal to me.
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Old 02-20-2013, 07:29 AM   #27
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So in the spring I want to start looking at CCRC's. We have no children, my siblings are far away, and the experiences of our respective parents has been an eye-opening awareness raiser. I am very sure that I want us to be in a CCRC no later than when I turn 70.

There are a lot of options, but the one I'm leaning toward is that you plunk down a large wad of cash, depending on the place, between $100k and $250k, (the ones with higher levels of luxury charge more, sometimes a lot more) and then you pay for routing ongoing expenses as they are incurred for an independent living apartment or single-level house. For example in one I've looked at (only online but we'll make a physical visit) has houses/cottages from one bedroom/one bath to two bedroom/two bath with den and one or two-car garages. The rent would be about $800/month and that includes all maintenance, interior and exterior. The entrance fee is prorated over a ten year period so if you moved out after five years you'd get half on that fee back.

But here's the biggie: If our resources are exhausted as may well happen if one gets dementia, they won't throw you out. In effect that huge wad of cash buys a LTC policy for both of you.

The downside of course, is this is a move we can only afford to do once which means the margin of error is zero. So we'll have an elderlaw attorney look over the contract, the finances of the organization, and probably other stuff I haven't thought of yet.

But the idea has an appeal to me.
There is a catch. DW's father and step mother moved into a high end place like that managed by Riderwood. They knew my FIL was in the early stages of Alzheimer's and they had two dementia units so all seemed well. When he entered the Dementia unit he had problems and threatened a woman patient. The place concluded they could not manage him and effectively threw him out (tricked us into an outside psych eval and then refused to let him return. His wife was beside herself (she was pretty pathetic herself) and felt compelled to move back with her kids in a different state. In effect, the CCRC broke up a family by failing to live up to their promises. There are no guarantees. I liked the place and most people do fine at them. But I was shocked at the callous behavior when things got tough and would be reluctant to trust these folks.
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Old 02-20-2013, 12:51 PM   #28
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I am watching my mom (62) go through this right now with her mother (95). I flew home to basically say good bye to Gram this past weekend. My next trip home will most likely be her funeral. They have her living in her own home at the moment (after breaking her hip and being in a nursing home for 2 months). They are looking at $15k monthly for living care for her. Gram has the money luckily.




In this case, her kids are not agreeing on anything. It’s like having grown children in this case is actually a hindrance! One son says Gram is not with it enough, just put her back in the old folks home she won’t know. Another son thinks she is just fine where she is but cut back on the care (not possible). Another wants nothing to do with it and never visits or calls. It’s really just a mess! So what’s that notion that people have kids to have someone to take care of them when they age? Hmmm. Meanwhile, everyone is wondering what is going to be left of their inheritance and hesitant to spend her money on her.





We also do not plan to have children. We talked briefly about it last night. Maybe we’ll get ourselves set up in a retirement community before we’re declining. Something that has the progressive stages – assisted living then nursing home all in the same place. I hope to spell out as many details prior while we’re still with it. I will have some nieces and nephews, maybe one can be our POA.
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Old 02-20-2013, 01:30 PM   #29
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In this case, her kids are not agreeing on anything. Itís like having grown children in this case is actually a hindrance! One son says Gram is not with it enough, just put her back in the old folks home she wonít know. Another son thinks she is just fine where she is but cut back on the care (not possible). Another wants nothing to do with it and never visits or calls. Itís really just a mess! So whatís that notion that people have kids to have someone to take care of them when they age? Hmmm. Meanwhile, everyone is wondering what is going to be left of their inheritance and hesitant to spend her money on her.
Your experience echoes what some of my friends say: "Lucky you have no kids, because you won't have kid fights."

I guess that can be a real problem in some families.
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Old 02-20-2013, 01:39 PM   #30
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Your experience echoes what some of my friends say: "Lucky you have no kids, because you won't have kid fights."

I guess that can be a real problem in some families.
I've experienced both sides of this first handed. It works well when the parents involve the children a decade or two before they are needed and are very specific on who has what role. This allows for a building of trust and also makes clear what is expected. Meddling siblings are always a bother, but they don't have to be a problem.
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Old 02-20-2013, 01:43 PM   #31
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I think it can be a good plan with functional families - talking about it early, making joint decisions, etc. However, there is a LOT of dysfunction in my mom's side.
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Old 02-20-2013, 01:47 PM   #32
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I think it can be a good plan with functional families - talking about it early, making joint decisions, etc. However, there is a LOT of dysfunction in my mom's side.
I think an entire functional family is a rare thing. One functional child is enough - as long as he / she is easy to identify. But yes, dysfunction has amazing disruptive power. I'm sure we can agree involving the kids is easier said than done.
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Old 02-20-2013, 02:29 PM   #33
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My plan is to hoard some cyanide capsules. If I don't wait too long, I'll have enough sense to take them.


If I do wait too long, I won't know the difference.
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Old 02-20-2013, 02:34 PM   #34
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My plan is to hoard some cyanide capsules. If I don't wait too long, I'll have enough sense to take them.


If I do wait too long, I won't know the difference.
Just don't mix them up with your vitamins...
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Old 02-20-2013, 03:41 PM   #35
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Just don't mix them up with your vitamins...
If I start making those kind of mistakes, it is time anyway.
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Old 02-20-2013, 03:56 PM   #36
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I'm on the other side of this as the legal guardian for my 94 yo great aunt. There was really no planning on her part - she has been single all her life. While she had some relatives in the area where she lived, they proved incapable of helping her. In fact, we believed she had more in assets than she does and suspect that they may have taken advantage of her ("missing" jewelery, valuables, etc).

My aunt (her niece) was my great-aunt's POA but lived a couple thousand miles away, so she recruited me to help. We had her moved to a nursing home near to where great-aunt grew up and aunt and I lived (before aunt moved to FL).

It has worked out ok in her case as luck would have it I had retired and was able to step into the void, but the burden for helping us will likely fall to DD and DS when the time comes.
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Old 02-20-2013, 04:18 PM   #37
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I would like to know: how do you begin researching CCRCs? I think I should start doing some legwork in my community (I plan to stay here). As I understand it, CCRCs might be called CCRCs, or assisted living, or "tiered" care living--lots of titles, right? So you can't search under just one term, correct? How do you find out about licensing, etc--is there a general website with regulations on how these are to be run? Second question is, do CCRCs accept LTC insurance? I had heard that "some" do.
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Old 02-20-2013, 04:28 PM   #38
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Ah - the siblings issue. As mentioned, we're knee deep in the mess of things with my in-laws.

Large family - so lots of adult children.
A couple are responsible. And they are the ones that have been doing day-to-day help/maintenance of things, and who will be sharing conservatorship, if the court awards it.
A few more are seagull managers... Like to fly in, drop their poop opinions on what needs to be done (without necessarily offering suggestions/solutions) then fly away. But they don't obstruct, and are trying to contribute, ... when it's not inconvenient.
And the remainder are functionally useless... One has his own issues, and the other, at times, actually obstructs getting any help for his parents.

The mess has made me say more than once that I'm glad my parents were lucid and solvent when they passed away. We had our own family dysfunction on our side - but it's all resolved now.
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Old 02-20-2013, 04:37 PM   #39
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This could be an issue for anyone...who knows how one will react to the encroaching of dementia, and the fear and disorientation it causes? It's the human version of the way some elderly dogs begin to snap and bite when they start to lose their faculties. Anybody, potentially, could turn into that "can't handle them here, get rid of them" patient. I guess the way some places deal with it is to medicate patients. Scary.

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When he entered the Dementia unit he had problems and threatened a woman patient. The place concluded they could not manage him and effectively threw him out ....I was shocked at the callous behavior when things got tough and would be reluctant to trust these folks.
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Old 02-20-2013, 08:44 PM   #40
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I would like to know: how do you begin researching CCRCs? I think I should start doing some legwork in my community (I plan to stay here). As I understand it, CCRCs might be called CCRCs, or assisted living, or "tiered" care living--lots of titles, right? So you can't search under just one term, correct? How do you find out about licensing, etc--is there a general website with regulations on how these are to be run? Second question is, do CCRCs accept LTC insurance? I had heard that "some" do.
Marita, I'm not expert. But perhaps I can shed some light.

First of all, you can do a search like "senior living city" (with city being your specific city name). This will return a general list of various communities in your area. But it will include everything from independent living to assisted to memory, etc. Make sure to page down. The bigger named companies will likely be at the top. Some of the independents might be down a little.

Read up. Read their FAQs. Learn as much as you can on the web. You'll also see "aggregator" sites that try to do the searching for you. I didn't use those. I don't know anything about them, but I'd guess there is some advertising involved. Just guessing. You'll see in your searches that some up front call themselves a CCRC. Some don't but are, you just have to start reading.

After you web research, visit. You may want to visit a few styles too just to compare and contrast. That is, contrast an independent/assisted living only place to a CCRC. It is interesting.

There are all kinds of payment models out there, some CCRCs even have multiple methods. Big upfront with big promises. Small upfront with few promises. Big monthlies with promises, etc. In the case of you having LTC, they may structure a contract with smaller monthly fees because you have LTC. It is a wide open world out there. I got so confused at the one CCRC we visited for my dad that my head was spinning.

Also, be aware... In my dad's area, the CCRCs require you to pay real estate tax. This was NOT insignificant. Read the fine print.

We didn't get a hard sell in our ventures. We did get on mailing lists though. I found most of the marketing people to be informative and kind, with no pressure. Your mileage may vary. I guess I'm saying if you visit and don't want to jump now, I wouldn't worry about it. They'll take you back. The nature of the business is... that they need new people all the time. Kind of grim, but that's the reality.

We had some friends who funded their "vacations" visiting these places out of town. Apparently, they'll let you stay a day or two at their respite rooms if you are from out of town. Just a suggestion.

In the end, a CCRC was not for dad. He's too far along in age. The one place had some creative payment contracts for older folk, but I didn't like it. Still too much upfront for a near 90 year old.

Dad ended up an independent/assisted living place run by one of the big companies. He seems pretty happy with it. He is close to his home, which is what he wanted.

My aunt had alzheimers and my cousins got her in a CCRC by signing a "blood contract" of some sort that basically charged her a huge rate per month in order to draw down her assets. When she reached zero, they'd take medicaid assignment. It was a nice place, a non-profit run by a church group. Sadly, my aunt passed just before they got to 0. She didn't last long.

For DW and I, we're not eligible yet. The legwork with searching for my father opened my eyes. I'm still too young to know for sure if I want this. Having lived with my dad for a few days in the independent living place, I have an idea of how that would be. But they draw an older crowd, most 85 and up, with the youngsters usually having issues like MS, bad vision or the like. At 50, I could not relate. I'd like to eventually do a serious visit to a CCRC, some of which will accept you as early as 55. Perhaps we will in a few years.
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