LTC - I have none. Betting on an alternative.

[tn3sport]

In the planning for my FIRE (5 years away from trigger pull) I think I have most major categories covered except Long Term Care (LTC).

I have no LTC plan. I don't plan to buy a LTC policy.

Instead, I hope to live out my final years at my home. I'm going all-in that the autonomous vehicle will provide that freedom.

Hopefully, I'm 25 years away from needing any type of LTC. That should give the automated car industry plenty of time to develop and stabilize.

Here's how I see the autonomous vehicle playing a part in my LTC:
- DR. visits: Easy, jump in the car and tell it to take me there.
- Groceries: shop online and auto delivered.
- gym or recreation: jump in car and tell it to take me there.
- socialization: jump in car and tell it to take me there (community center, church, park, etc)
- travel: jump in car, tell it to take me to airport, cruiseport, and return itself home.
- Major surgery: might be a problem. Would likely have to call one of the kids to help. But, who knows, maybe out-patient care will provide an automated ride home.
- Memory health support: This is a tough one. Have not figured this out yet. If I get a memory decease, I'll need 3rd party help. Might be able to afford in-home care for a while, but ultimately will need to be institutionalized. Which sucks.
- What am I missing?


That's the gist of my question. If you want to know why I came to this alternative idea, read on:

I have two aunts. Let's call them Aunt Ant and Ant grasshopper.

Aunt Ant: married, stayed married, worked, and invested for retirement. Husband long gone, she lives in a high-cotton retirement community. One bedroom apartment that has all kinds of social programs and well trained personnel available at her beckon call. To give you an idea of the place, her neighbors are an ex-governor and several other prominent citizens in Florida. But, its still a retirement home/community. Its just dressed up nicely and is quiet and peaceful. She has a LTC policy that will last 5 years and allow her to spend her final years in this nice facility with excellent care.

Aunt Grasshopper: married, divorced, and partied most of her life, jumping from short term job to short term job. Never remarried. Never saved for retirement. She now lives in a retirement facility on government financial support. She has nothing. She is 100% dependent on the government. The facility is a POS. Its a room, with a roommate that is noisy. The climate control is never set right. There are other residents constantly standing or sitting in the hall ways. The door alarms go off constantly (memory care patients set them off when they walk through them). The workers are unskilled and low wage workers that could careless about the residents or even keeping the place clean. The place is an absolute nightmare. She has no LTC policy. This nightmare of a facility is the last place she will live when the light go dim for her. Depressing.

My problem: I don't like either situation. Yeah, Aunt Ant is in a nicer place with first class support; and, Aunt Grasshopper reaped what she failed to sow. Neither are the way I want to spend my final years.

BTW, I didn't make up this story. I really do have two aunts that lived polar opposite lives. I've visited both numerous times and don't like either one's situation.

I want to live out my final years in my house, by the lake, in peace. I'm not invested in LTC or a LTC policy. Instead, I'll put that money into an autonomous car when the time is right, and maybe save some cash for limited in-home care. I'll hope it provides me with an opportunity to finish out my final years on my terms, where I want to.
What do you think?

 

[Big_Hitter]

who is going to get you out of your bed and/or clean your bedpan and feed you?

 

[samclem]

How is the autonomous car going to help you get to the toilet and "clean you up" when you are done there? Will the autonomous car put out the house fire when you leave the stove on by mistake?
A LTC policy normally starts paying for assistance when you can't do 2 of the activities of daily living.

1. Personal hygiene - bathing, grooming and oral care
2. Dressing - the ability to make appropriate clothing decisions and physically dress oneself
3. Eating - the ability to feed oneself though not necessarily to prepare food
4. Maintaining continence - both the mental and physical ability to use a restroom
5. Transferring - moving oneself from seated to standing and get in and out of bed

I don't think an autonomous car is going to solve these problems. Maybe some sort of robot attendant or other automation would be more helpful.

 

[Bryan Barnfellow]

"- Memory health support: This is a tough one. Have not figured this out yet. If I get a memory decease, I'll need 3rd party help. Might be able to afford in-home care for a while, but ultimately will need to be institutionalized. Which sucks.
- What am I missing"

By that time memory augmentation via brain plug-n-play hardware will be common place, no doubt. Or is it already? I forget...

-BB

 

[W2R]

I hope you are missing nothing. It's so hard to think of everything. I agree with BB that memory care is a very difficult issue.

I am 68, and recently bought and moved into the house next door to my long time dear companion, Frank. We plan to age in place, and take care of one another as best we can. I am not counting on autonomous vehicles, but almost everything we could need is very close by.

Whichever one of us lives the longest, will have to figure out what to do without the other there to help him or her. I plan to "self insure" for LTC, and pay for whatever I may need as the need arises. I'd rather not live in a facility at all, if possible. But, who knows.

 

[cathy63]

For most of the items on your list, you could live in a city and rely on public transit today. You don't really need to rely on autonomous vehicles to make that possible. My in-laws live in San Francisco with a bus stop outside their door. They haven't had a car in over 10 years, relying on muni to get around the city and BART to go farther afield. An autonomous car just makes it possible to have that same lifestyle in a rural location.

FIL died in September at age 92, after 8 months of in-home hospice care, with no LTC policy. Kaiser insurance covered most of the costs, and they self-paid the rest. MIL is still quite active at age 87 and seems to enjoy living alone (for the first time in her life!) I expect she'll need a live-in caregiver at some point in the future, but odds are it won't be for more than a few months at her end-of-life and it's an expense she can afford if needed.

The real sticking point in your plan is if you develop unexpected physical or memory issues in your 60s or early 70s. You could need constant care for 20 years or more, and you might not be able to afford that in your rural lakeside home. The odds are in your favor though as the majority of people don't fall into that situation.

 

[tn3sport]

who is going to get you out of your bed and/or clean your bedpan and feed you?

Monday is hard enough. You had to bring up a valid point of view...Albeit, its a disturbing reality...

The autonomous vehicle or anything robotic will likely never address the issue you identified. That would require in-home care, assuming I don't move to a facility. In-home care would require funding. I imagine its not cheap paying someone to come to my house, drag my fat ass out of bed, brush my teeth, and wash my soiled clothing... Is the solution to save money or buy a policy

However, I do think autonomous cars and home automation will be able to provide meals. Heck, using the Echo and Rhoomba, I can practically do that already. So, its not likely I will starve. But, personal hygiene is something that would require 3rd party help.

 

[Huston55]

At the risk of being too blunt...you're missing the central challenge to living in your own house (or anywhere really) until demise; that challenge is the ever increasing need for assistance & care. A self-driving car is not going to solve that problem for you; it won't feed you, give you meds, help you use the bathroom, take a shower, dress, etc.

I've experienced this first hand with mine and DW's families, and most of our relatives also planned with the hope they could live the rest of their life in their own home with "just a little help." In our experience, it simply doesn't work or more accurately, it works until it doesn't, which is almost never until the end of life. It's usually until the first serious fall, until memory degrades beyond self-sufficiency, until the first kitchen fire, or the like.

For the record, I have decided to NOT buy a LTC policy, the rationale for which is the subject of another thread. My advice (which is but one person's opinion) is that you should consider a CCRC (Continuing Care Retirement Community) and/or assisted living/nursing facility. Do the research now (or as soon as you know where you'll be in late life - Chattanooga or Florida); have a solid plan. If you don't like these types of facilities, have a plan that minimizes your time in one BUT, a plan that has you walking into one versus being transported to one.

I suggested a CCRC because, it addresses whatever may happen regarding the level of care you might need plus, it can work somewhat like LTC regarding protecting your assets. Our plan is to use a CCRC, likely a Life Care facility, in lieu of LTC.

PS: I really like Chattanooga & eastern TN; have had family there for 40+ years.

 

[tn3sport]

For most of the items on your list, you could live in a city and rely on public transit today. You don't really need to rely on autonomous vehicles to make that possible. My in-laws live in San Francisco with a bus stop outside their door. They haven't had a car in over 10 years, relying on muni to get around the city and BART to go farther afield. An autonomous car just makes it possible to have that same lifestyle in a rural location.

FIL died in September at age 92, after 8 months of in-home hospice care, with no LTC policy. Kaiser insurance covered most of the costs, and they self-paid the rest. MIL is still quite active at age 87 and seems to enjoy living alone (for the first time in her life!) I expect she'll need a live-in caregiver at some point in the future, but odds are it won't be for more than a few months at her end-of-life and it's an expense she can afford if needed.

The real sticking point in your plan is if you develop unexpected physical or memory issues in your 60s or early 70s. You could need constant care for 20 years or more, and you might not be able to afford that in your rural lakeside home. The odds are in your favor though as the majority of people don't fall into that situation.

Great points. My retirement home is St Augustine. It's in a rural location today, but its Florida, and the city is coming out to greet me whether I like it or not. Live-in or in-home care is likely something I'll need to plan for. Memory or physical issue in 60 or 70 would be bad luck and alter any well laid plans... thx

 

[Fedup]

My MIL had slight dementia, she kept asking my husband to repeat things multiple time. She died at home at age 87. No LTC. She did have a nurse come in to her house 3 times a day, breakfast, lunch, dinner. The purpose of the nurse visits is to make sure she took her medicine and heated ready made food for her. But she made tea on her own.
I plan to age in place too. But I bought LTC just in case, but it's only for 3 years max.

 

[tn3sport]

I hope you are missing nothing. It's so hard to think of everything. I agree with BB that memory care is a very difficult issue.

I am 68, and recently bought and moved into the house next door to my long time dear companion, Frank. We plan to age in place, and take care of one another as best we can. I am not counting on autonomous vehicles, but almost everything we could need is very close by.

Whichever one of us lives the longest, will have to figure out what to do without the other there to help him or her. I plan to "self insure" for LTC, and pay for whatever I may need as the need arises. I'd rather not live in a facility at all, if possible. But, who knows.

I'm building a MIL suite on my retirement home for that very reason: That one day, I might get a housemate that I can depend on to grow old with.

But, your post reminds me of something I would love to see come back:
The Tontine retirement plan. Its illegal now, but I bet it could really work given the volume of retired persons today.

 

[kaudrey]

Monday is hard enough. You had to bring up a valid point of view...Albeit, its a disturbing reality...

The autonomous vehicle or anything robotic will likely never address the issue you identified. That would require in-home care, assuming I don't move to a facility. In-home care would require funding. I imagine its not cheap paying someone to come to my house, drag my fat ass out of bed, brush my teeth, and wash my soiled clothing... Is the solution to save money or buy a policy

My uncle died last fall at age 86 after suffering from Alzheimer's for about 8 years. My aunt didn't want to put him in a home, so slowly increased the amount of home care he had, until it was 24/7. It cost about $70K a year in the last 3 years. The money came out of savings. For me, that is part of what I am saving money for when I retire....

 

[tn3sport]

At the risk of being too blunt...you're missing the central challenge to living in your own house (or anywhere really) until demise; that challenge is the ever increasing need for assistance & care. A self-driving car is not going to solve that problem for you; it won't feed you, give you meds, help you use the bathroom, take a shower, dress, etc.

I've experienced this first hand with mine and DW's families, and most of our relatives also planned with the hope they could live the rest of their life in their own home with "just a little help." In our experience, it simply doesn't work or more accurately, it works until it doesn't, which is almost never until the end of life. It's usually until the first serious fall, until memory degrades beyond self-sufficiency, until the first kitchen fire, or the like.

For the record, I have decided to NOT buy a LTC policy, the rationale for which is the subject of another thread. My advice (which is but one person's opinion) is that you should consider a CCRC (Continuing Care Retirement Community) and/or assisted living/nursing facility. Do the research now (or as soon as you know where you'll be in late life - Chattanooga or Florida); have a solid plan. If you don't like these types of facilities, have a plan that minimizes your time in one BUT, a plan that has you walking into one versus being transported to one.

I suggested a CCRC because, it addresses whatever may happen regarding the level of care you might need plus, it can work somewhat like LTC regarding protecting your assets. Our plan is to use a CCRC, likely a Life Care facility, in lieu of LTC.

PS: I really like Chattanooga & eastern TN; have had family there for 40+ years.

Spot on and thx for the tip on CCRC. Will look into it or look into some hybrid approach that allows me to have a couple roommates at the river house in FL by using a management company to protect my assets and keep the lights on, while pooling resources for dependent care.

 

[imoldernu]

We would not buy LTC policy again, but we will not cancel what we have. Details:
DW had a stroke in 1995. Scary, but survived after some excellent surgery.
We purchased policies that covered $100/day for three years, w/o inflation plan. Policies also covered home care instead of nursing home.
Policies cost $1,000/yr and have only gone up to $1,200/yr now.
Thus far each policy has cost a total of about $19,000.
Potential payout for each year in nursing home $36,000.

In 1995, the average cost for nursing home care (private room) was about $50,000. In our area the current average cost is $75,000. In our CCRC, somewhat higher.

This website gives current average costs for your location. A reality check.

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

 

[Mdlerth]

I rearranged your quotes.

I don't plan to buy a LTC policy.

This topic generates some controversy, but certainly there are cogent points in favor of your viewpoint. If you have enough assets, there is no pressing need for it since you can self-insure.

I have no LTC plan.

It sounds like you do have a plan. But it may be improved with some additional thought. Consider that transportation is just a tiny sliver of the spectrum of services you might want.

 

[donheff]

Whether you will need third party care in your final years is a crapshoot. If you become physically unable to eat and go to the toilet you need help. Autonomous cars are not going to wipe your butt. If you have family willing and able to deliver the help, you may be OK. If not, you have to hire someone. Seems like there are three choices to address that possibility: a good LTC policy; savings that can replace an LTC policy; or draw-down to Medicaid eligibility. Of course, the later gets you the party girl aunt's solution the quality of which varies widely from location to loacation.

 

[Fedup]

I'm counting on robots to wipe my butt. If they can serve as employees in a hotel in Japan, then why can't they do that in the future. Think positive thoughts.

 

[donheff]

I'm counting on robots to wipe my butt. If they can serve as employees in a hotel in Japan, then why can't they do that in the future. Think positive thoughts.

Next we will be talking about sex bots and the thread will be axed. Oh, hell, I went there.

 

[Huston55]

I'm counting on robots to wipe my butt. If they can serve as employees in a hotel in Japan, then why can't they do that in the future. Think positive thoughts.

Next we will be talking about sex bots and the thread will be axed. Oh, hell, I went there.

Looks like we have a ways to go before bots can handle these sorts of needs.

I'm also a bit put off by all the sharp corners of WeeBee. I'd hope to have a caregiver with smoother surfaces & rounder shapes.

https://vimeo.com/groups/gamesandinteraction/videos/152088984

 

[athena53]

I'm counting on robots to wipe my butt. If they can serve as employees in a hotel in Japan, then why can't they do that in the future. Think positive thoughts.

If you can actually get to the bathroom and use the toilet, there are some pretty fancy bidets that will do the job with sprays of water followed by warm air.

Having said that- being with DH in his last months drove home to me how much work it can be to care for someone who can't walk without help, can't always control their bodily functions and who's constantly at risk of falling. Having picked DH up off the floor more times than I care to count, "Help! I've fallen and I can't get up!" isn't very amusing to me. I cleaned his messes up off the floor a couple of times, too. I'm grateful it wasn't more than that. (And yes, he did resort to Depends after that.)

There are good in-home care agencies that will do all this- I used one in DH's last days and they were $22/hour. That adds up if it goes on for years, but they tell me they have some clients who are in their 90s and staying at home. I spoke with DS about this because he keeps saying he and DDIL could take me in- if I'm that frail I'd want to at least fund someone to come in part of the day and when they want to vacation so they aren't trapped taking care of me 24/7. DDIL's parents may end up needing help and they're not as financially secure as I am, so I keep that in mind, too.

Hopefully this will be many years down the road since I'm "only" 64. For the record, I have no LTC coverage and the fancy Monte Carlo simulation I just got from my financial advisor shows that I have a greater-than-90% chance of not outliving my savings, even with the scary Nursing Home scenario. I'll update it annually but can always stop buying plane tickets and cut charitable donations if things start to look bad.

 

[exnavynuke]

I'm counting on robots to wipe my butt. If they can serve as employees in a hotel in Japan, then why can't they do that in the future. Think positive thoughts.

Well, an electric bidet can take care of that for you today (wash and dry). You can even get seats that lift up to help you get off the seat if you're muscles no longer work properly. With enough money, you can motorize many of life's necessities.

That said, there are still some things a person may need help with such as feeding themselves, clothing themselves, taking care of things that require a mental capacity they no longer possess, etc.

 

[Just_Steve]

You could always add a euthanasia component to the plan.

Euthanasia is illegal in most of the United States. Physician aid in dying (PAD), or assisted suicide, is legal in the states of Washington DC, California, Colorado, Oregon, Vermont, and Washington; its status is disputed in Montana.

https://en.wikipedia.org/wiki/Euthanasia_in_the_United_States

 

[LARS]

As many have pointed out, there is much more to Assisted Living then simply getting around town. That having been said, it is certainly likely that one will be able to age in place longer, which in turn means, if you're lucky, not needing LTC for as long as otherwise would be needed without autonomous driving vehicles.

I certainly see (hope) autonomous driving vehicles will allow me more flexibility in where, and how, I age.

 

[imoldernu]

"Life Care" has been mentioned in the above posts.

For those who have not gotten into CCRC costs this is a serious subject that should be well understood, before the time comes to decide on Continuous Care Retirement Communities.

This article describes "Life Care" options in California, but similar facilities are located in every state.
Continuing Care & Life Care Retirement Communities

Here's the difference as I see it. Please correct this as if your understanding is different.

In our CCRC, the continuum of care includes:
80 Regular homes (where we live now)
65 Apartments
50 Assisted living units
69 Nursing home units
40 Memory Care units.

We are not in a "Life Care" CCRC.
We do not pay Endowment charges for continuous care guaranteed for life.
The current charge for a 2BR apartment is $26K/year for one person and an additional $6K for a second person. This includes two meals (lunch and dinner) per day and all other costs... TV and internet, all utilities, transportation for shopping, doctors and some social events, with no charges except for telephone.
The only other charge is a refundable one month security deposit.
Assisted Living begins at $42K for a shared room. and Nursing Home care about $70K.

That said, "Life Care" is different. The ones I am familiar with involve complexes with Condominiums and the associated care units, where you pay an endowment fee upfront to guarantee lifetime care through whatever facilities are necessary. Usually involves a contract that specifies the involved terms for rebates at the end of life to the estate. One Florida case that I'm familiar with involved a $350K upfront cost with a monthly charge while living in the condo.

YMMV

 

[LARS]

"Life Care" has been mentioned in the above posts.

For those who have not gotten into CCRC costs this is a serious subject that should be well understood, before the time comes to decide on Continuous Care Retirement Communities.

This article describes "Life Care" options in California, but similar facilities are located in every state.
Continuing Care & Life Care Retirement Communities

Here's the difference as I see it. Please correct this as if your understanding is different.

In our CCRC, the continuum of care includes:
80 Regular homes (where we live now)
65 Apartments
50 Assisted living units
69 Nursing home units
40 Memory Care units.

We are not in a "Life Care" CCRC.
We do not pay Endowment charges for continuous care guaranteed for life.
The current charge for a 2BR apartment is $26K/year for one person and an additional $6K for a second person. This includes two meals (lunch and dinner) per day and all other costs... TV and internet, all utilities, transportation for shopping, doctors and some social events, with no charges except for telephone.
The only other charge is a refundable one month security deposit.
Assisted Living begins at $42K for a shared room. and Nursing Home care about $70K.

That said, "Life Care" is different. The ones I am familiar with involve complexes with Condominiums and the associated care units, where you pay an endowment fee upfront to guarantee lifetime care through whatever facilities are necessary. Usually involves a contract that specifies the involved terms for rebates at the end of life to the estate. One Florida case that I'm familiar with involved a $350K upfront cost with a monthly charge while living in the condo.

YMMV

Thank you for the link. When finally getting serious about assisted living, in its various forms, it is very important to use the terms correctly to make sure you understand what you're getting.