Allowance for aged care in FIRE

[FREE866]

My aunt was in a large 285 bed nursing home and it cost about $50k a year. The average stay was around 2 years. She was previously in assisted living for 7 years at $2500 per month. Meals were a blue hair convention with virtually every resident in a wheelchair. They all even looked alike.

My mother was in a new generation care facility with 24 hour help watching her. On top of social security, she was spending $110k a year. She was down to her last $5k when she passed. Getting really old is expensive.

Sorry for your loss. Yeah, this is just an awful topic for me as my dad just died a few days ago. I just hope I don't have to ever go in one of those places, but everyone probably thinks they won't have to. End of life just sucks.

 

[SumDay]

I doubt most people will be wanting to treat illnesses if they need memory care.

You'd be shocked on that one. My mother had Alzheimer's, suffered a stroke and was wheelchair bound, and my dad just couldn't let her go, so off to the nursing home she went. They went from spending almost nothing each month to $6000 a month for her memory care. The stress of watching his life savings dwindle killed him (stroke & subsequent fall). She hung on for another year and I fought with that nursing home every single day over treating her for colds, removing warts and moles, testing they wanted to do on her, physical therapy, whatever they could do to bill Medicare. One day at a care meeting I finally asked "who at this table would trade places with her?" and of course no one raised their hand. I Finally got the doctor to put her on hospice and she passed peacefully a few weeks later.

So, even though I had power of attorney and a HCD they treated every cold, refused to take her off meds she didn't need, and wouldn't let her salt her food or have sugar. At that stage, if I want chicken fried steak every d*mned meal, followed by a pack of cigarettes, who cares?

Thank you for letting me rant - didn't realize I'm still so angry about all that. I hope my kids never have to recount anything similar.

 

[audreyh1]

Do people self insure their home once the mortgage is paid off? If one has over $5M in assets why carry homeowner's insurance ( apart from liability). It's a hedge.

We did it only because we wanted to ensure a guaranteed inheritance. If you have no children....just spend down all your assets and then Medicaid pays. Of course then the state can put you wherever they want.
And if you linger for 10 years or longer in a memory care facility....it could cost millions in future dollars. I have personally seen this in my family. Plus the statistics for length of stay in nursing homes focus on averages today. 25 years from now we could see average stays in nursing homes of 10 years or longer as life expectancy increases due to the wonders of modern medicine.

I carry it for the liability. Not really comprable.

About lingering - you are on the hook whether you have LTC insurance or not. Once your $400K or whatever insurance limit is exceeded, it comes out of your pocket or you go on Medicaid. LTC policies sold today are not going to cover 10 years in an expensive memory unit.

Longer life does not necessarily mean longer stays in a nursing home. It probably means longer stays in assisted living which is far more affordable.

Anyone retiring early has better be prepared for a longer lifespan.

 

[Teacher Terry]

Sum: I am so very sorry for your experience. We have written wishes to try and prevent that type of thing. I put my friend on hospice when her cancer came back so nothing could be treated without my permission.

 

[athena53]

He also mentioned that other costs of living typically decline, and often folks have proceeds from the sale of a house. This data and thinking helped me worry less about long term care.

That's my thinking- just about every other category but healthcare goes to zero. No longer maintaining a house or a car, no travel, charitable entirely up to me. I should be able to stay in a decent place indefinitely (Midwest, LCOL area).

Someone asked about dropping homeowners insurance other than liability- first of all, I think it would be very hard to get a liability-only policy. It almost always comes as part of the package and most insurers don't want the volatility of a low-frequency, high potential severity coverage with low premiums.

My parents did drop windstorm coverage on their home one mile from the coast in North Myrtle Beach- it was expensive and they figured the land was worth more than the house. It was a good decision; Dad sold it last year after Mom died and they never had any major windstorm damage.

 

[Human]

Apologies as this is a litttle off topic from OP’s post, but it seems relevant to much of the discussion.

I was recommended this document by a friend’s father who’s a leader in the hospice movement:

“Five Wishes is a United States advance directive created by the non-profit organization Aging with Dignity. It has been described as the "living will with a heart and soul".”
https://en.m.wikipedia.org/wiki/Five_Wishes

It’s an excellent document that I’ve shared with family and friends. It’s particularly useful to get something in place (easily and compassionately) for those that don’t have a living will.

 

[razztazz]

Thanks all for the various perspectives. This also shows the differences across countries. In NZ, the elderly do stay in retirement homes for longer, I dont exactly know how long but its a few years. The issue here is that most elderly live alone in their homes till they cannot and then have to move to a retirement home. They may be in reasonable health when they move to the retirement home but they are past the point of staying alone at home as they often fall or cannot cook for themselves.

-- I detect --THREAD ENTROPY--

So, what are we talking about? Mere "retirement homes" ie Buffed-up "Seniors community" where some assists are available? I thought we were talking about "Skilled Nursing Homes"?

 

[audreyh1]

Thanks all for the various perspectives. This also shows the differences across countries. In NZ, the elderly do stay in retirement homes for longer, I dont exactly know how long but its a few years. The issue here is that most elderly live alone in their homes till they cannot and then have to move to a retirement home. They may be in reasonable health when they move to the retirement home but they are past the point of staying alone at home as they often fall or cannot cook for themselves.

We are talking about skilled nursing facilities here, not retirement homes. Something closer to a hospital ward where residents cannot care for themselves versus senior living apartments with housekeeping and daily meals and someone to occasionally look in on you.

 

[ncbill]

Apologies as this is a litttle off topic from OP’s post, but it seems relevant to much of the discussion.

I was recommended this document by a friend’s father who’s a leader in the hospice movement:

“Five Wishes is a United States advance directive created by the non-profit organization Aging with Dignity. It has been described as the "living will with a heart and soul".”
https://en.m.wikipedia.org/wiki/Five_Wishes

It’s an excellent document that I’ve shared with family and friends. It’s particularly useful to get something in place (easily and compassionately) for those that don’t have a living will.

Even better, here in the U.S. most states have their own model health care POA form(s).

You can explicitly spell out exactly what kind of treatments you want (or, more likely, don't) and pick someone to be your health care agent, who has full legal power to make health care decisions when you are incapacitated.

I've said this before, but I had a parent who developed an unusual form of dementia that typically strikes between ages 45-55.

They were diagnosed around age 50, dead around a decade later, most of that time bed-bound, requiring total care (feeding, changing, bathing, etc.)

Not surprisingly, they suffered from repeated infections. The only reason they lived so long was that I didn't put my foot down and insist they be put on Hospice instead (obviously, it wasn't a situation explicitly discussed in their health care POA)

Given the above, my health care directive is extremely restrictive, e.g. no antibiotics, period, if I have dementia.

So I'm not worried about being stuck for a decade in a nursing home.

You are in control as to your health care preferences, whether you want a full-court press or just Hospice or something in-between.

Please be as specific as possible, don't make your loved ones have to guess about your treatment preferences.