Aging in Place

[imoldernu]

Periodically, I go back to the newspaper in the town where I grew up, to check obits, or to reflect on changes that have occurred since I left after high school in 1954. This article that points to the coming problems of an aging population caught my eye. It details some of the high governmental expenses that will be necessary to support the rapidly growing percentage of the senior population, particularly in Rhode Island, but existing in most states.

WEISS: Aging report is ‘Rhode map’ for change | Opinion | pawtuckettimes.com

Googling "Aging in Place" brings up many organizations that deal with this. While each of us has our own plan for the future, the sheer numbers of the growing elderly population point to more attention to the idea that assisted living and nursing homes may not be there in the future, as they are now... and that older people will likely be more responsible for their own future, than they are today. That a geometric increase in the older age groups will not be accompanied by a younger generation, with enough time, money and ability to maintain the standards of today.

So, yes... though you have planned your own future, the resources for your age group may well change, and accordingly affect what may be available when you reach 70, 80, 90, or older. Thus.. the emphasis and hard look at "Aging in Place"... staying in your own home and having access to those things that we take for granted today.

One website of many that address this growing concern.
Age In Place | The National Aging In Place Council

Where you live, the type of housing, and more importantly the facilities... shopping, healthcare, transportation and social... may well be as important or maybe critically important to your later years... even more so than money.

Think this through.

 

[braumeister]

Excellent point, and something everyone should consider seriously.

 

[RobbieB]

Got it covered.

Internet groceries delivered to the door
In home care
Taxi

All are available here and verified because I used them to care for my wife and my father.

 

[HFWR]

Figuring out how to do it is easier than figuring out how to pay for it...

 

[W2R]

Googling "Aging in Place" brings up many organizations that deal with this. While each of us has our own plan for the future, the sheer numbers of the growing elderly population point to more attention to the idea that assisted living and nursing homes may not be there in the future, as they are now... and that older people will likely be more responsible for their own future, than they are today.

I completely agree and I am trying to prepare for that. It is hard to prepare for the unknown, but sometimes in life we have to do that. I am planning to age in place if it is at all possible.

Where you live, the type of housing, and more importantly the facilities... shopping, healthcare, transportation and social... may well be as important or maybe critically important to your later years... even more so than money.

Along these lines, my Dream Home is a single level and already modified to be suitable for an elderly/disabled person (as the last owner was both). Shopping, the best health care, transportation, and anything else I could ever possibly need is available within a mile or two of my house. So, I think I am pretty well set as far as the physical environment. As my dear departed mother would have said, "This wasn't entirely accidental."

Perhaps caregivers will be hard to find and hire once we Baby Boomers move into our 80's and 90's. People said in another thread that it's hard even now to get a teenager to mow a lawn for spending money. So I am thinking that the same problem may appear when Baby Boomers start looking for a caregiver, 15-20 years in the future.

 

[RobbieB]

Where there is a demand companies will supply that demand. It's the American way -

 

[imoldernu]

Coming back with some thoughts about the actual $$$ involved, and the other items that may not be there in the future.

First... simple companion care, no experience begins at a low $10/hour, which would add up to $88K/yr. for 24/7 care. That may be very low. In our lower cost area, the minimum is $15/hr for 2 hours or less. Home aides with some experience are $30/hour here. This is has been going up by 10%/year for the past 5 years, and at present, the Home Care Companies are out straight, with a waiting list.

I mention these costs, because when we moved here in 2004, live-in companions were available privately for about $20K/yr plus the room/board/transportation for that person. Obviously major changes. Those people are not there any more. The common suggestion for expense control is companion living... finding someone to share costs and support. Not an easy thing to accomplish.

At present, we have local government funded transportation (buses) for in-town cost of $5 and county-wide costs of $15. Since this is tax supported, the likelihood of that continuing for ten years, is nil. Some door to door delivery may be available, but transportation? Current grocery delivery price... going up fast... Free for $100 order, $15 otherwise. As the demand increases, despite logic, costs do not go down.

What RobbieB wrote:

Got it covered.

Internet groceries delivered to the door
In home care
Taxi

All are available here and verified because I used them to care for my wife and my father.

Yes!.. Excellent... The right way to go. My concern is for you and me... and where we may be 10 years from now, given the rapid increase of the aging population.

Being independently wealthy may well make these concerns unnecessary, but for many, an hour well spent, in looking ahead for those "golden " years.

 

[RobbieB]

The Co. in my link charged $20/hr with 2 hour minimum, but that was 3 years ago.

Cooking, light house keeping, assist with dressing, personal grooming, getting in/out of bed. Some of their staff were very good and others I had to call to say "never send that person here again, I'll take the day off"

 

[zesty]

2 words: robot servants.

 

[ejman]

2 words: robot servants.

Agree. Although I think the immediate future (next 5-10 years) will present challenges in finding people willing to do this difficult work, I think that beyond that time period robotics will progress sufficiently to the point where this won't be nearly as much of a problem.

 

[razztazz]

Agree. Although I think the immediate future (next 5-10 years) will present challenges in finding people willing to do this difficult work, I think that beyond that time period robotics will progress sufficiently to the point where this won't be nearly as much of a problem.

This is encouraging. I turn 59 end of this Summer. I figure that's young enough to avoid something major and expensive and non-lethal for another 5-10 years.

So, now my question is, what makes you say that after a 5 to 10 year window affordable robots will be available to handle these tasks?

I'm not trying to stir anything up. I'd just like the good news characterized. Are you working in that field or have some other insight into the current stage of development?

 

[growing_older]

In home care

This is a great idea and the demand is likely to keep growing. Already this can be a lot harder to arrange suitable care than you might expect. Even using a well established service, we had difficulty getting providers to reliably show up as promised. Prices are likely to rise as demand increases.

 

[bclover]

Where there is a demand companies will supply that demand. It's the American way -

I was thinking the same thing. I'm assuming if our population is aging, companies, manufacturers, service providers will all follow the money trail.

Case in point, I live in the Philadelphia area and attend the womens business development center. a non profit designed to help women entrepreneurs already we've had an increase in popular senior services offered by small businesses. I recently met a women who started a business called "your other daughter".
Seniors who wish to stay in there houses longer hire her to do "light" needs. cooking meals, running errands, checking on your elderly parents etc etc. met another gal who started her own "uber" for the elderly.

I really do think that the emphasis in my area is moving away from "nursing home, senior citizen centers" to more small individualized service providers.

 

[razztazz]

Quote:
Originally Posted by RobbieB View Post
Where there is a demand companies will supply that demand. It's the American way -

I was thinking the same thing. I'm assuming if our population is aging, companies, manufacturers, service providers will all follow the money trail.

The potential problem I see is/will be: where's the money? While these services are cheaper than going into "The Big House' I suspect they'd still be kind of spendy for an average person over several years at a time. At least in a nursing home there's some government funding after a certain point.

The well-off can spring for it but the larger population (the one everybody's worried about) either won't be able to afford it or will flame out after a while without some level of Government program back-filling. That's the kind of money that will facilitate the demand to create the business push. If they're just expecting folks to pay for it like they'd pay for anything else they want to buy, I don't think there's that much bread

 

[ejman]

This is encouraging. I turn 59 end of this Summer. I figure that's young enough to avoid something major and expensive and non-lethal for another 5-10 years.

So, now my question is, what makes you say that after a 5 to 10 year window affordable robots will be available to handle these tasks?

I'm not trying to stir anything up. I'd just like the good news characterized. Are you working in that field or have some other insight into the current stage of development?

No special knowledge other than very interested in the topic from family experience with disability and elder care A quick search shows that there is a great deal of research effort going on in this area, particularly in Japan where the demographics are particularly pressing. Some interesting work
Toyota Develops Human Support Robot For Elder Care | Digital Trends
https://www.good.is/articles/robots-elder-care-pepper-exoskeletons-japan
https://www.beaconreader.com/jenna-...t-homes-and-other-aging-in-place-technologies

 

[Htown Harry]

An increased role for family members would certainly figure into the macroeconomic elasticity equation.

There's no economic reason that the decades-long trend of more seniors living apart from the next generation must continue.

 

[razztazz]

An increased role for family members would certainly figure into the macroeconomic elasticity equation.

There's no economic reason that the decades-long trend of more seniors living apart from the next generation must continue.

But their children can't afford then either. (Not intended to take this in another direction)

 

[Options]

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:

https://www.genworth.com/about-us/industry-expertise/cost-of-care.html

You also have the ability to calculate estimated future costs of LTC in its many forms.

The Genworth Cost of Care Survey has been the foundation for long term care planning since 2004. Knowing the costs of different types of care - whether the care is provided at home or in a facility - can help you plan for these expenses. The 2016 survey, conducted by Carescout®, one of the most comprehensive of its kind, covering 440 regions across the U.S. and based on data collected from more than 15,000 completed surveys.

 

[Amethyst]

Human beings have choices in what they do for a living.

If we want people to be willing to take care of us, we'd better not turn into nasty old people, or they will refuse.

That means behavior modification for old people...no more cantankerous curmudgeons allowed.

Until those robots show up, anyway.

 

[donheff]

I have been a member of Capitol Hill Village since it's inception about ten years ago. CHV is a non-profit dedicated to helping its members age in place in our homes in DC's Capitol Hill neighborhood. It was modeled after Boston's Beacon Hill Village which was the first organization in the "village" movement. CHV is a leader in using volunteers to achieve its goals -- 70% of our services are performed by volunteers and 30% be vetted service organizations. That ratio is reversed in many villages. The types of services offered are broad, varying from simple matters like transportation up to complex health care advocacy as well as a wide variety of social activities (book clubs, dinners, fitness, etc). I am one of a few CHV volunteers who help the old folks with computer problems. It has been a great way to meet some fascinating people in the neighborhood. My only worry is that we won't be able to keep the energy up and when I need the services there won't be a full house of volunteers. It takes a Village.

 

[braumeister]

2 words: robot servants.

"Wipe my butt and pull my pants back up, Hal."

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

 

[HFWR]

"Wipe my butt and pull my pants back up, Hal."



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

LMAO

 

[razztazz]

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

 

[SecondCor521]

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.

 

[ExFlyBoy5]

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.