Beyond E-R

[street]

Quote:

Originally Posted by Sunset I'm amazed that you haven't had giant increases in the premium for your LTC policy. It seems many others have, to the extent that it priced them out of reach or into a reduction of benefits.

I have mine with AFLAC and took it when we were about 52 years. I had some insurance with them, and the agent told me if I waited another year those premiums would have been more to start out with. So, we got the policies and within the next few years they stopped selling the LTC policies.

No cost change yet and we have had them about 12 or so years now. My parents had their policies with them also and were very easy to work with and the checks came right to me after they were in nursing home. I than paid their monthly bill from that money.

[KarenF]

My Mom was self insured but could afford care. She fought assisted living even when she really needed it. I was still working and it really wore me down working full time and visiting her in the evenings and doing all her laundry, preparing meds, and spending time with her on the weekends. I did not mind spending time with her, but those evening trips I made because I was worried were exhausting. I will not do that to my kids. We have a reasonably good LTC policy and I have put into my long term memory that I will do whatever my kids want me (or us) to do. I have told my kids this and they think I have overreacted but they did not go through what I did. Our LTC policy covers both in home care and facility care.

[Montecfo]

We self insure. LTC is too expensive for the benefit, for which there is often no or very little payoff.

I think first-to-die paid up life insurance is a better buy. Use it to replenish funds or build them. It always pays off.

I am saddened for and in awe of folks who have cared for loved ones for years. Praise God for these angels! My parents passed at young ages and never required care, perhaps a weak homage to a quick or sudden decline. I am glad I am not forced to recall them as bedridden. My wife's folks enjoyed long lives but no LTC payout due to elimination periods.

No one in assisted living or LTC planned to be there. But we have to prepare for that eventuality.

One key issue in our plans is mental decline. My 80 year old self just might cancel that expensive LTC policy. Or might forget where I put that super secret poison recipe.

We must plan for mental decline before it grips us.

[harllee]

Quote:

Originally Posted by explanade Did she pay based on whatever the CCRC was charging when she moved in or had she contracted years earlier?

My mother had to pay a fairy large entrance fee when she moved into the CCRC at age 80. It was the fee the CCRC was charging at that time. Mother was lucky that she was in good health and able to qualify to move into the CCRC at age 80. My husband and I are not going to wait that long to move into a CCRC, I am afraid we will not qualify health wise if we wait too long.

[NoEZmoney]

I've heard many folks stand by their decision to pony up the cash for LTC premiums. And good for them as they feel the cost helps them sleep at night knowing that when (and if ) they need LTC , it will be there.
But I had an aunt and uncle (they were siblings and didn't live together) who paid a lot of $$$ for LTC premiums for years. We're talking serious cash that if they did the same and invested it in the S&P index over the same period they would've likely been covered. The aunt used less than 2 years of LTC benefit before she died. My uncle used less than a year. I did some basic research and learned that when most people need that type of skilled care, they are (on average) about <2 yrs. Reason is they had a catastrophic medical event (stroke, heart attack, pulmonary issue, etc.) and they were slowly on the spiral downward.

Now I know others who have had one family member wind up lasting a few years so there's that. Luck of the draw. But I also know people saving the would-be premiums and putting them in an interest-bearing account or saving up for an annuity. And these folks also established a trust to avoid Medicaid tapping into their savings should they need care.

As for me and DW, we're actually looking at overseas residency where we can use geographic arbitrage for cost-of-living and get excellent care. So there are options. We don't have kids to rely on and our relatives (nieces and nephews) don't instill confidence in us to ask to be our advocates when we get too old to deal with things ourselves.

Anyways...my2cents... as always each one's mileage will vary.

[BarbWire]

Quote:

Originally Posted by braumeister Exactly why a CCRC (Type A contract) is such a good idea for many people, including me.

But you've got to have someone -- anyone -- who is willing to be the "responsible party" who is contacted by the CCRC for medical and other needs.

My folks went to a CCRC for 9 months (and left because they rightly hated it). I had to be named as the "contact person" and each time there was a "reportable incident" (eg. my father with severe arthritis would sometimes fall -- "rather well" as he said -- no injury as it was more of a crumple when his knees buckled. I was called each time).

If the person has to be transported by ambulance to a hospital, or admitted to the nursing home, the responsible party takes over: the resident is just put in the ambulance with a packet of information and a wave goodbye.

The CCRC is not "in loco parentis."

So for people who are truly flying solo -- no near family or younger friends in North America -- a US CCRC isn't an option.

I worry about this ... a lot.

[BarbWire]

Quote:

Originally Posted by audreyh1 I just don’t see how anyone could expect their children to give them 24/7 care. Supervise perhaps, provided they live not too far away. But even the supervision and oversight takes a lot of work. I managed my Dad’s property and finances when he moved into an AL type facility for almost 4 years, plus another 2.5 years so far as executor. This was still a lot of work. I didn’t have to worry about supervising care until he entered hospice about a year before he died. Then it really was hands on and we essentially relocated for almost a year. You can’t be independent if someone else has to take care of you. That is not being independent! Or independence in such a situation is an illusion.

Precisely. People who dismissively waive a hand and say "we have plenty of money" don't grasp that supervision and oversight -- finances, finding and hiring 24/7 staff, dealing with medical -- is a massive undertaking that SOMEONE has to do.

I did that, single handed, for both parents for three years, and for the final year of DF's life, DM was in residential dementia care but DF was in their home and I was the solo 24/7 caretaker with hired help....when it showed up. DM outlived DF by 11 months, but I was still on call for the dementia facility while working on his estate probate. To settle first his estate and then hers took nearly 2 years. It would have taken much longer had I not managed their finances for the final 5 years.

Early when they needed care I was able to move to their town and telecommute. Then I had to quit my job -- end my career -- to take care of them. Forced ER? There was no other option that would allow me to look in the mirror each morning and know I had done the best I could for them.


I have an excellent LTC policy. I have ample resources. I do not have children, nor nieces or nephews within reasonable distance (NZ). I don't know what the heck I'm going to do for my last decade. My fear is somehow becoming a ward of the state or a predatory eldercare guardian.

[BarbWire]

Quote:

Originally Posted by NoEZmoney As for me and DW, we're actually looking at overseas residency where we can use geographic arbitrage for cost-of-living and get excellent care. So there are options. We don't have kids to rely on and our relatives (nieces and nephews) don't instill confidence in us to ask to be our advocates when we get too old to deal with things ourselves.

But no matter where you are -- low COL, excellent care (Malaysia and Philippines come to mind), who will be your advocate when you get old?

That is the bottom line, no matter where you are: someone to be your advocate and guardian angel when you are alive, and someone to "mop up" after you have died.

[street]

Kind of like home insurance do I really need it. I have paid a lot on 40 year of premiums and haven't got anything in return. It is all a gamble and many people through the years lost the farm to pay for their long years of life.

[harllee]

Quote:

Originally Posted by BarbWire But you've got to have someone -- anyone -- who is willing to be the "responsible party" who is contacted by the CCRC for medical and other needs. My folks went to a CCRC for 9 months (and left because they rightly hated it). I had to be named as the "contact person" and each time there was a "reportable incident" (eg. my father with severe arthritis would sometimes fall -- "rather well" as he said -- no injury as it was more of a crumple when his knees buckled. I was called each time). If the person has to be transported by ambulance to a hospital, or admitted to the nursing home, the responsible party takes over: the resident is just put in the ambulance with a packet of information and a wave goodbye. The CCRC is not "in loco parentis." So for people who are truly flying solo -- no near family or younger friends in North America -- a US CCRC isn't an option. I worry about this ... a lot.

The CCRC where my mother is required that she have a POA and a HCPOA when she moved in. She has fallen twice and we have been called. When we decided she needed more help (aides for 2 hours in the morning and 2 hours in the evening) all I had to do was call the CCRC and tell them what we wanted and they arranged for the aides and they started in a couple of days. Most of the aides have been excellent and they always show up. I don't have to worry about the aides, a real benefit of the CCRC.

[Montecfo]

Quote:

Originally Posted by street Kind of like home insurance do I really need it. I have paid a lot on 40 year of premiums and haven't got anything in return. It is all a gamble and many people through the years lost the farm to pay for their long years of life.

Homeowner's insurance is usually not optional. You can't tell the bank you are self-insuring.

And it is relatively cheap. Few people would choose to self insure.

[pdxgal]

Quote:

Originally Posted by Out of Steam Men caring for disabled wives seem especially prone to getting sick and dying before their partner. .

Recently learned on NextDoor of a murder-suicide nearby. Husband had been caring for wife with Alzheimer’s. Apparently they’d been devoted to one another, and it must’ve gotten too much to bear. Or maybe just most merciful for both. Very sad

[RetiredAt55.5]

Quote:

Originally Posted by Montecfo I think first-to-die paid up life insurance is a better buy. Use it to replenish funds or build them. It always pays off.

Not trying to be argumentative, but the one scenario (obviously) where that's problematic is if both spouses end up needing assisted living for some period of time.

But, that's probably not one of the more likely scenarios.

We don't have a plan ourselves to be honest, so I'm reading these posts with a lot of interest.

[Rianne]

Quote:

Originally Posted by RetiredAt55.5 Not trying to be argumentative, but the one scenario (obviously) where that's problematic is if both spouses end up needing assisted living for some period of time. But, that's probably not one of the more likely scenarios. We don't have a plan ourselves to be honest, so I'm reading these posts with a lot of interest.

Exactly. That's why I plug in combined long-term care numbers in Firecalc. Looking at $150K/year, probably on the lower side. I have to consider taxes as well. Another reason I'm following "We're entering a golden period for fixed investing" trying to get that coupon cash flow while preserving the principle.

[Montecfo]

Quote:

Originally Posted by RetiredAt55.5 Not trying to be argumentative, but the one scenario (obviously) where that's problematic is if both spouses end up needing assisted living for some period of time. But, that's probably not one of the more likely scenarios. We don't have a plan ourselves to be honest, so I'm reading these posts with a lot of interest.

That is not a problem as you can borrow against the life insurance. So it can be used as needed.

[RetiredAt55.5]

Quote:

Originally Posted by Montecfo That is not a problem as you can borrow against the life insurance. So it can be used as needed.

Thanks, I hadn't thought of that.

So, the solution would have to be life insurance that builds up a cash value? Something other than term life insurance.

[BarbWire]

Quote:

Originally Posted by harllee The CCRC where my mother is required that she have a POA and a HCPOA when she moved in. She has fallen twice and we have been called. When we decided she needed more help (aides for 2 hours in the morning and 2 hours in the evening) all I had to do was call the CCRC and tell them what we wanted and they arranged for the aides and they started in a couple of days. Most of the aides have been excellent and they always show up. I don't have to worry about the aides, a real benefit of the CCRC.

You are indeed fortunate that the aides supplied/managed by the CCRC were excellent (not the case at my parents' CCRC) and that the CCRC was responsible if one called in sick, etc. Someone managing aides for an individual at home is on the spot if they get a call that the aide isn't coming into work for the next two days; the agency may or may not send a substitute.

But you said "when we decided" -- and that is key. You made decisions about levels of care, etc. The CCRC cannot/will not do that beyond calling you or calling for an ambulance. So the resident must have a "responsible person" (RP) on call.

Suppose your mother falls and breaks her hip (God fordbid). I'm curious: how does that scenario play out? Does the CCRC call you and say they're putting her in an ambulance to St Elsewhere Hospital, and the ball is now in your court? If you're not close to the hospital, does everything then transpire by phone between you and the hospital? Does the CCRC have any responsibility for / interest in her at the hospital?


Sadly in the case of the CCRC my parents were in, the resident was simply put in an ambulance, the RP was called, and the CCRC was then out of the loop. If the RP couldn't be reached right away, it was up to the hospital, not the CCRC, to continue trying. And meanwhile the elderly resident was there at the hospital, alone without an advocate.

For anyone researching a CCRC, outlining specific "what if" scenarios is key in understanding where responsibility ends and begins, and if the RP should be nearby (1 hour?) and available 24/7 by phone. We did not ask those questions when my parents went for their 9 months in a CCRC. I wish we had.

[Montecfo]

Quote:

Originally Posted by RetiredAt55.5 Thanks, I hadn't thought of that. So, the solution would have to be life insurance that builds up a cash value? Something other than term life insurance.

Term will provide less flexibility and at some point becomes non-renewable.

[glenster]

If I ever get to the point where I am bedridden and need someone else to [mod edit] <assist with my personal hygiene >I am hoping that assisted suicide will be legal and widely used. I do NOT understand the need to simply exist without living. It was not long ago that by the time you are 50 years old it was common to die...and now its 80-90-100+

If I cannot get out of bed and enjoy the fresh air - there is no more point in living except for your loved ones not wanting to say goodbye

Thats my 2 cents...

So do not buy assisted living insurance BS products and just make a point to spend as much of it as you can while you are ALIVE and able to enjoy life!

[NoEZmoney]

Quote:

Originally Posted by BarbWire That is the bottom line, no matter where you are: someone to be your advocate and guardian angel when you are alive, and someone to "mop up" after you have died.

True. We've consulted with people who have appointed a legal trustee designated to take care of their final care issues and advocate on their behalf. My aunt and uncle had such an arrangement as they suffered severe cognitive dysfunction in their final years. Had excellent care BTW.

I suppose for us, we'd hope to arrange some legal advocate no matter where we wind up. France has excellent elder care and ombudsman services due to their healthcare laws. Maybe we could arrange and find a younger couple to be our adopted family and they'll get a settlement once we kick the bucket for having looked after our needs? Anything's possible.