Getting old is scary

[NW-Bound]

"Getting old is scary".

Yes, it surely is. And it's true whether it is going to ruin your financial or not. You just linger on, going from one drug to the next until nothing more works. Then you die in agony.

Back on Alzheimer, I wonder how other countries handle this. Do they have government-run wards where they keep patients locked up? Economy of scale? Or perhaps AZ is just an American affliction?

 

[bclover]

Why? Because elder care is so expensive here? Because elsewhere, the government picks up the tab? Because elsewhere, end-of-life care is handled differently?

Seriously, I'm curious whether, and how, it's so much different here than elsewhere.

Many many many reasons why. It's a complicated question but Yes health care in the US in general is about 2-3X's as much as the rest of the world.

the closets country to health care spending I believe is Switzerland and we still blow them out of the water.

Now as to how it's handled. first a BIG DISCLAIMER. Portugal is the only other country I lived in for an extended length of time and it was a long time ago. I AM NOT AN EXPERT and a lot of stuff has changed.

So, some big differences.
It's not just that the government picks up the tab, it also sets the price for routine things while here in the states the insurance companies charge what they want.

For example, MRI's and Xrays cost one price and one price only. Now the bad side to that is that, you don't get hospitals trying to one up each other with the latest technology. In my area of Philly you will routinely see commercials from hospitals touting their latest medical advances.

secondly and I think this is a biggie. In lisbon preventative care is pushed from cradle to grave and I mean pushed. a relative of my husbands said the country is flipping out because like many countries they are fighting an obesity epidemic.

 

[athena53]

Why? Because elder care is so expensive here? Because elsewhere, the government picks up the tab? Because elsewhere, end-of-life care is handled differently?

Seriously, I'm curious whether, and how, it's so much different here than elsewhere.

In many countries it's still part of the culture for children to take in elderly parents- one of the reasons the rate of female births to male births dropped so drastically in China after the one-child policy was introduced is that if you have a son, when he marries the daughter-in-law moves in with you and takes care of you. If you have a daughter, well, she moves in with her in-laws and you're SOL. In either Japan or N. Korea, I forget which, elderly women turn to prostitution to make ends meet (BBC podcast). I saw a presentation on accommodating workplaces for the ageing workforce and one presenter said she'd seen places in Japan where women in their 80s assembled electronic components in workstations made to accommodate wheelchairs and equipped with magnifying screens.

So, in some places it's not very pretty.

Yes, it surely is [scary]. And it's true whether it is going to ruin your financial or not. You just linger on, going from one drug to the next until nothing more works. Then you die in agony.

It doesn't have to be that way. Both my husband and my mother died quietly at home after realizing that any additional treatment (both had cancer) was more likely to just make them miserable. Hospice care made all the difference. Sometimes either the patient or their family continue to demand every last treatment and our system pays for it even when the chances of survival are slim.

 

[bmcgonig]

The stories in this thread represent the primary reason we plan to move to a CCRC in about 10 years around age 75-76. We'll invest about $300k lump sum and about $6,500 a month in a "Life Plan". This allows us to lock in those monthly expenses and stay at the same facility regardless of the level of care required.

It's not a panasea, but it does provide me with some emotional comfort and feelings of control.

Have you one picked out already? If so care to share?

 

[imoldernu]

Don't know if getting old is scary. DW and I are both 81, so I guess that qualifies us to give an opinion.
While we've both slowed down, the only thing that is really bothersome, is my own frustration with the onset of my increasing memory problems. She has become a little more frail, and what used to be 13 hours of high activity, has given way to afternoon naps.
Neither of us is much into going out to eat, except with our kids or friends, and our entertainment comes in the form of cards playing (her), and the almost daily "fun" events that are scheduled at our CCRC. We play "Trivia", and "Memories" as well as attending the once or twice a month events that are held in the main building "clubhouse". We Do associate with about 20 of the younger.. (read that "60 to 75 years olds). at "driveway" parties every week from Spring to Fall.... It's a BYOB tradition, even though DW and most of the ladies drink only flavored water, and I'm down to my single 1 1/2 oz., one to five Gin Martini.

This afternoon, we went over a few hundred pictures of our 28 years retirement, and both marveled at 1. how tall we were, and 2. the obvious level of energy... surfing at Daytona, bike riding (which I still do, but not on hills). Parties that started at 7PM, and ran until 2AM... and trips to a few dozen states as well as our one-time homes on Martha's Vineyard, and Falmouth. Some Pics of our high-top camper van and our '72 VW Westphalia. We turned on the TV, and Jeanie started watching Hallmark theater, but only lasted for about 10 minutes and fell asleep... Memories can have physical effects.

Afraid of getting older?... naw... the aches, pains, pills and discombobulation of the physical body don't outweigh the love of life. We've been through the what if's and how to handle's of whatever the future may bring. At this age, we've seen most of the downsides of being old, as well as realizing that there are only a very few of our snowbirder friends left.

By the way... the very last thing on our list is worry about money. Sure... it's possible that we could have problems that would exceed our plans, but with that, would not have changed a thing about retiring early.

Oh... one more thing... I think we laugh a lot more that most of the people we know. Life IS good.

 

[UnrealizedPotential]

America is the only one among it's peers where getting old can
can bankrupt you.

Only among certain ethnic groups. Some ethnic groups have strong family ties even into old age, so there is no need for a rest home. The children take care of their parents. All ethnic groups did that before 1950 and then things changed for some groups. I could say more but I want to tread carefully here.

 

[Car-Guy]

I was thinking about this thread today as we drove to town. It's a very small town about 15 mins down the highway. The local post office and some of the small businesses in town are pretty good about posting obits on the front doors of their business whenever someone passes on. They list the deceased persons name, a picture, dob, date of death, age and a little bit about the person. Seems like every week there are 1 to 3 new obits posted. Seems like a lot for a such a small community. In the past few months I've begun to notice that more than half of the folks that have passed away were younger than me.

Why does it seem that most of the time, the pictures in these obits were taken 20 or 30 years before. I've known many of these folks and if I hadn't read their names, I would have never recognized them by their pictures.

 

[Silver]

Have you one picked out already? If so care to share?

I'm happy to e-mail you privately with that info.

 

[Nemo2]

Why does is seem that most of the time, the pictures in these obits were taken 20 or 30 years before..

"All right, Mr. DeMille, I'm ready for my closeup."

 

[Letj]

Why? Because elder care is so expensive here? Because elsewhere, the government picks up the tab? Because elsewhere, end-of-life care is handled differently?



Seriously, I'm curious whether, and how, it's so much different here than elsewhere.

It's complex but you've hit on some of the reasons. Nursing homes are profit making ventures and are extremely expensive here. Americans on average are less healthy and tend to need more care at end of life; families are less likely to have their elderly parents living with them and off course the tab is mostly picked up by the government in the rest of the developed world.

 

[NW-Bound]

In order for the government to pay, they will have to tax more to have more money. And if workers are taxed more, they cannot save to retire early.

 

[bmcgonig]

I'm happy to e-mail you privately with that info.

I DMd you. Thanks!

 

[bmcgonig]

Only among certain ethnic groups. Some ethnic groups have strong family ties even into old age, so there is no need for a rest home. The children take care of their parents. All ethnic groups did that before 1950 and then things changed for some groups. I could say more but I want to tread carefully here.

Also the cost of nursing homes varies widely according to the area. In Alabama and Louisiana a nursing home costs in the 50/60k range. In the more expensive areas like New York or CA it can be well over 100k. Maybe the cost of nursing homes should be a consideration of where we retire.

 

[marko]

... the tab is mostly picked up by the government in the rest of the developed world.

In order for the government to pay, they will have to tax more to have more money. And if workers are taxed more, they cannot save to retire early.

IIRC my state's Medicaid pays for ~97% of all NH patients, so I think we're already there.

 

[target2019]

Things are different in the U.S., for sure. Previous generations I knew had elderly living in the same home, or close by. One grandmother lived with Mom for about 10 years, until she died. Other grandmother lived down the street in a small studio apartment, until she died. That was in the 80's and 90's.

Today, spouse's parents are in very expensive elderly community. One is advanced dementia, other is worn out thinking about it.

Clearly, care of the elderly has been monetized in the U.S. in a big way. It has happened, because we have the wealth, and people are living longer. The trend will continue. Other countries handle this differently, but the crisis is still felt globally.

A report from the WHO, with pertinent statistics:
http://www.who.int/ageing/publications/global_health.pdf

 

[Alan]

In England one is expected to fund their own care home costs until their assets are down to ~$30k, then social services will pick the costs beyond what your income will pay for. If you own a house and don't want to sell (e.g. your spouse is still living there, or you expect the stay to not be permanent) then the government will provide loans against your share of the property value to be repaid when the house is sold, either after your death or after the death both you and your spouse.

It's a tad more complicated than that but that's the crux of it. Prior to the last election the government in power promised to raise the asset threshold to ~$130,000, but that may not happen during this parliament.

I don't believe insurance companies here offer LTC insurance so self funding down to the asset limit is the only option available. Care home fees vary from ~$40 - $60k / year depending on the level of care needed and location in the country.

Care Home Fees, Cost of Care Homes | Paying For Care

 

[pacergal]

Don't know if getting old is scary. DW and I are both 81, so I guess that qualifies us to give an opinion.
While we've both slowed down, the only thing that is really bothersome, is my own frustration with the onset of my increasing memory problems. She has become a little more frail, and what used to be 13 hours of high activity, has given way to afternoon naps.
Neither of us is much into going out to eat, except with our kids or friends, and our entertainment comes in the form of cards playing (her), and the almost daily "fun" events that are scheduled at our CCRC. We play "Trivia", and "Memories" as well as attending the once or twice a month events that are held in the main building "clubhouse". We Do associate with about 20 of the younger.. (read that "60 to 75 years olds). at "driveway" parties every week from Spring to Fall.... It's a BYOB tradition, even though DW and most of the ladies drink only flavored water, and I'm down to my single 1 1/2 oz., one to five Gin Martini.

This afternoon, we went over a few hundred pictures of our 28 years retirement, and both marveled at 1. how tall we were, and 2. the obvious level of energy... surfing at Daytona, bike riding (which I still do, but not on hills). Parties that started at 7PM, and ran until 2AM... and trips to a few dozen states as well as our one-time homes on Martha's Vineyard, and Falmouth. Some Pics of our high-top camper van and our '72 VW Westphalia. We turned on the TV, and Jeanie started watching Hallmark theater, but only lasted for about 10 minutes and fell asleep... Memories can have physical effects.

Afraid of getting older?... naw... the aches, pains, pills and discombobulation of the physical body don't outweigh the love of life. We've been through the what if's and how to handle's of whatever the future may bring. At this age, we've seen most of the downsides of being old, as well as realizing that there are only a very few of our snowbirder friends left.

By the way... the very last thing on our list is worry about money. Sure... it's possible that we could have problems that would exceed our plans, but with that, would not have changed a thing about retiring early.

Oh... one more thing... I think we laugh a lot more that most of the people we know. Life IS good.

Thank you for this down to earth reality check. I, too, think, laughter is the best medicine. Yes, life is good.

 

[timo2]

This thread made me recall the 2014 article 'This Old Man' by then 93 year old Roger Angell (which won a National Magazine Award in 2015). Very rarely do we get a description of old age by such an erudite and well written individual, IMO.

https://www.newyorker.com/magazine/2014/02/17/old-man-3

From the article "I’m ninety-three, and I’m feeling great. Well, pretty great, unless I’ve forgotten to take a couple of Tylenols in the past four or five hours, in which case I’ve begun to feel some jagged little pains shooting down my left forearm and into the base of the thumb. Shingles, in 1996, with resultant nerve damage."

 

[Sunset]

In order for the government to pay, they will have to tax more to have more money. And if workers are taxed more, they cannot save to retire early.

But, the same government caps the prices charged by the NH, so the bills are less outrageous.
Example: Ontario Canada NH rate for private room is roughly $2,563 CDN per mo.

Nursing Home Rates Across Canada

 

[Teacher Terry]

In home hospice care is great but in order to use it you must have 1 healthy person in that home. YOu can not live alone.

 

[marko]

In England one is expected to fund their own care home costs until their assets are down to ~$30k, then social services will pick the costs beyond what your income will pay for. If you own a house and don't want to sell (e.g. your spouse is still living there, or you expect the stay to not be permanent) then the government will provide loans against your share of the property value to be repaid when the house is sold, either after your death or after the death both you and your spouse.

It's a tad more complicated than that but that's the crux of it. ]

I'm glad you mentioned this. Other posts implied that the US was somehow the only country requiring spend-downs.

Having lived in Europe/UK for years I was wondering if I was missing something.

 

[Teacher Terry]

This also varies widely by state. In TX you can keep a lot of your $. Other states not so much.

 

[athena53]

But, the same government caps the prices charged by the NH, so the bills are less outrageous.
Example: Ontario Canada NH rate for private room is roughly $2,563 CDN per mo.

Nursing Home Rates Across Canada

I'd be interested in how the nursing homes make this work. For about US $2000 per month, they have to pay staff, they have building and maintenance costs, they have to feed the residents, etc. It's not any cheaper to buy and maintain commercial buildings in major Canadian cities than it is in the US. Food prices aren't that different. Do they pay staff less? Do they have fewer staff? Does the government give them additional subsidies? What about people with Alzheimer's who need extra attention?

 

[Letj]

I'm glad you mentioned this. Other posts implied that the US was somehow the only country requiring spend-downs.

Having lived in Europe/UK for years I was wondering if I was missing something.

That's correct. Some places do require spend down. It doesn't make sense for the government to pick up the tab for wealthy people. However, it is true that the US is probably the only wealthy country where nursing home care can quickly bankrupt a fairy well- off person just like medical care can.

 

[ohyes]

This thread made me recall the 2014 article 'This Old Man' by then 93 year old Roger Angell (which won a National Magazine Award in 2015). Very rarely do we get a description of old age by such an erudite and well written individual, IMO.

https://www.newyorker.com/magazine/2014/02/17/old-man-3

From the article "I’m ninety-three, and I’m feeling great. Well, pretty great, unless I’ve forgotten to take a couple of Tylenols in the past four or five hours, in which case I’ve begun to feel some jagged little pains shooting down my left forearm and into the base of the thumb. Shingles, in 1996, with resultant nerve damage."

Thank you for sharing this. It made me smile-cry-laugh-cry. What a wonderful testament to read.