No.

probably, but only because I live by myself.

if I can’t stay at home, that means I don’t need the house, the sale of which would cover a few years of care. If I then run out of money, I presumably qualify for Medicaid. The risk there would just be that my estate that I was hoping would pass to my kids would be gone.

Sort of. We think. Maybe.

We would like to stay in our home as long as possible, but of course one never knows where life will lead you.

I looked at LTC insurance twenty plus years ago when my Mom was considering it. It didn't seem like a good option, and her accountant recommended against it. He predicted, correctly, that a lot of insurers would get out of the LTC market; it was already sorting itself out back then. I don't think that's where I would put my money.

We are familiar with several very good organizations in the area that provide a wide range of living arrangements if you can no longer manage at home. All of them guarantee lifetime care, as long as you can meet their entrance requirements, which is an issue for many.

One requires a minimum net worth to get in but there is no upfront payment; you pay as you go. They look at pensions and SS income that would continue even if you've run out of cash. Their monthly fees are higher than some other places and you're basically paying your entrance fee over time. Medicaid and their foundation cover the costs if you outlive your money.

Two other places have various plans that require varying amounts of money up front and monthly payments while you are alive. They also accept Medicaid and have foundations to support care for people who have exhausted their assets. They have various plans that allow some portion of the entrance fee to be refunded to your estate when you die.

My FIL lived at one of these and was able to afford it even though his financial resources were pretty limited. It worked out really well. He loved living life independently rather than moving in with one of the kids (two of them offered). And he didn't have to worry about running out of money.

Lifetime guarantees at retirement communities are only as good as their financial situation is strong. While the three organizations that I referenced seem to be OK right now, I also know that they are facing a lot of challenges. All three are faith-based and non-profit, so they don't have the same pressures regarding expectations for profitability as ones that are managed by for-profit corporations. They just need to stay solvent.

As the article says, a lot of people aren't thinking about this. Or they are severely constrained by their financial situations and don't have good options.

quote:

Originally posted by Doug:
If I then run out of money, I presumably qualify for Medicaid.

Yeah, except what you can afford with Medicaid may be pretty depressing.

quote:

The risk there would just be that my estate that I was hoping would pass to my kids would be gone.

My kids know that I hope to die the day I spend my last penny. They’ll both graduate from college and grad school with no debt. I can’t guarantee more than that.

quote:

Originally posted by QuirtEvans:

quote:

Originally posted by Doug:
If I then run out of money, I presumably qualify for Medicaid.

Yeah, except what you can afford with Medicaid may be pretty depressing.


.

True, if it happens in the next several years. However, I was being a bit pessimistic since for me I would probably be well into my nineties and have been in full-time medical care for 15-20 years. At which point I don’t give a crap.

I’ve actually managed or overseen this financial process for both my parents and my mother-in-law. For the somewhat middle class or a bit better, the math can be at least a little less dire.

For my parents, a lot of what I paid for care in their last years qualified as deductible expenses. Meaning that effectively what I took out of their IRA lasted a lot longer because we didn’t pay taxes on it. that, plus the fact that vacation expenses, restaurant expenses, other travel and entertainment, and eventually, rent, went away really made the savings last much better than the forecasts my Dad had made.

For my mother-in-law, who’s been in memory care for 18 years, obviously, it’s a tougher story. She has had three six-month+ stints in hospice, but keeps out-surviving it. The family will be able to keep her in a reasonably nice facility, but in her shoes, I’m not sure it would really matter to me anymore. She hasn’t recognized anyone in years, and has no idea where she is. She is not suffering, but has nothing to live for.

quote:

Originally posted by Doug:
probably, but only because I live by myself.

if I can’t stay at home, that means I don’t need the house, the sale of which would cover a few years of care. If I then run out of money, I presumably qualify for Medicaid. The risk there would just be that my estate that I was hoping would pass to my kids would be gone.

Consult an Elder Law attorney about how to transfer assets to your kids while minimizing the Medicaid transfer penalty.

J

Both my parents have required memory care. My mom just got moved in couple of weeks ago. It’s expensive. She had long term care insurance, and we are trying to decide if it’s something we should get. Dementia is such an awful way to go.

quote:

Originally posted by Jack Frost:

quote:

Originally posted by Doug:
probably, but only because I live by myself.

if I can’t stay at home, that means I don’t need the house, the sale of which would cover a few years of care. If I then run out of money, I presumably qualify for Medicaid. The risk there would just be that my estate that I was hoping would pass to my kids would be gone.

Consult an Elder Law attorney about how to transfer assets to your kids while minimizing the Medicaid transfer penalty.

J

We went through a rigorous round of financial planning with an excellent fee-only planner before Mr. Pique retired. We are still thinking about and exploring strategies for very late old age, but haven't come up with anything definitive.

I personally would not want to end up in a Medicaid nursing home. There was a scary article in the NYT (?) recently about what that day-to-day reality is like. Some of the people in that article were in their 60s and the reason they ended up on Medicaid was they had a bad fall. Apparently, that's all it takes.

My long-term care insurance for now is to do my physical therapy every day, and get weight-bearing and balance challenging exercise in several times a week. Also, barn chores help keep you fit.

Keep on assessing strength and balance and if they aren't up to par, do something about it.

Jack, our next stop in our long term planning is to contact the estate attorney our CFP recommended to us. Do we need an elder-law attorney consult as well?

Very good facilities accept Medicaid. So do ones that you probably wouldn't want to live in. Which type you end up in depends largely at what point you are trying to get in to the facility.

If you've been living at home, have pretty much run out of money, and then go looking, then the choices are dismal.

If you're willing to move into a place that offers a range of support (independent, assisted, memory care, skilled) and has a life care guarantee, and pay the entrance fee or meet their net worth requirements, you can be in a place that is very nice, and in some cases almost like living in a resort. It's no different than living in a condo or apartment at the beginning, and then downsizing your activities as your world gets smaller. What you get is easy access to the services you need rather than trying to figure it all on your own.

The place my FIL moved to, with his very limited financial resources, was like that. He moved there after MIL died, and he kept saying he wished they had investigated Friendship Village when she was alive. She would have loved it. He lived a rich, full life on his terms and didn't worry about ending up in a nursing home like *his* mother did. It was one of the ones you wouldn't want to live in.

Clearly there are tradeoffs and this isn't for everyone. It all comes down to your tolerance for risk, what you're willing to give up, and the depth of your pocketbook.

One thing I will note based on going through this process with half a dozen family members and friends is that even if you do everything to stay healthy and fit, life can turn in a heartbeat and you can go from living independently to needing significant assistance.

quote:

Originally posted by jodi:
Both my parents have required memory care. My mom just got moved in couple of weeks ago. It’s expensive. She had long term care insurance, and we are trying to decide if it’s something we should get. Dementia is such an awful way to go.

Decide sooner rather than later. Mr. Nina and I both applied, he was accepted but in the intervening time between my application and acceptance I got a diagnosis that meant they denied my application. A few weeks earlier, no problem.

I don't see the cost of health care going down anytime soon, if at all.

quote:

Originally posted by wtg:
One thing I will note based on going through this process with half a dozen family members and friends is that even if you do everything to stay healthy and fit, life can turn in a heartbeat and you can go from living independently to needing significant assistance.

Amen, sister.

Big Al

quote:

Originally posted by wtg:
Very good facilities accept Medicaid. So do ones that you probably wouldn't want to live in. Which type you end up in depends largely at what point you are trying to get in to the facility.

If you've been living at home, have pretty much run out of money, and then go looking, then the choices are dismal.

If you're willing to move into a place that offers a range of support (independent, assisted, memory care, skilled) and has a life care guarantee, and pay the entrance fee or meet their net worth requirements, you can be in a place that is very nice, and in some cases almost like living in a resort. It's no different than living in a condo or apartment at the beginning, and then downsizing your activities as your world gets smaller. What you get is easy access to the services you need rather than trying to figure it all on your own.

The place my FIL moved to, with his very limited financial resources, was like that. He moved there after MIL died, and he kept saying he wished they had investigated Friendship Village when she was alive. She would have loved it. He lived a rich, full life on his terms and didn't worry about ending up in a nursing home like *his* mother did. It was one of the ones you wouldn't want to live in.

Clearly there are tradeoffs and this isn't for everyone. It all comes down to your tolerance for risk, what you're willing to give up, and the depth of your pocketbook.

One thing I will note based on going through this process with half a dozen family members and friends is that even if you do everything to stay healthy and fit, life can turn in a heartbeat and you can go from living independently to needing significant assistance.

That's great advice. My brother's mother (half brother) and her husband went this route in Chicago several years ago. They are both gone now, but bro reported they were very happy and in a very nice facility and then they went from that to assisted living and nursing care.

We will have to figure this out.

Several of you have mentioned something called "Friendship Village". What IS that and is it a franchise?

I wonder if it's like some types of my "eventual housing" arrangements, I've hoped for (some of which are idiosyncratic to my tastes).

For example, I'd like a development or housing with a well-appointed gym with ample hours (I prefer gyms here , open 24/7 but I'm sure they would be hard to find, especially owing to liability concerns - how to insure the residents are protected that many hours?). I'd have preferred an indoor lap pool (a lucky brother and SIL have their own indoor pool) - also, ample storage.

I guess I need to acknowledge my ever increasing needs for third party help with yard, repair and cleaning help, unexpectedly hard owing to spinal issues. I'd welcome the availability of transportation to basics like grocery shopping and medical care (I prefer to choose my own foods, also simple meals I'd mostly prepare myself.)

Also prefer to live in a community of congenial neighbors, ideally with mixed generations and availability to cultural activities both for recreation and shared facilities (studios, classes, shared interest groups).

I'm afraid I couldn't afford to buy into such a community, though - one beginning with independent housing (ideally, no shared walls) and gradually moving to one with more assistance as I require it. From what I've heard, the entrance fees are already high (a minimum of several hundred thou $) besides which I'd need to pay the equivalent of high rent on the private market to cover utilities, maintenance, taxes, cleaning, and X number of prepared meals/week including numerous add-ons depending on the facility).

Worse, though, there are significant increases of monthly "rent" for inflation and perhaps (depending on the fine print) add-ons for ones increased needs. Those required assistances are tacked on as a function of what the facility deems necessary (not discretionary, and not at according to my notions of comfort or privacy.

I think I'm the one who mentioned Friendship Village . I was referring to the specific community where my FIL lived. There seem to be places called Friendship Village all over the country. I don't know for certain but I don't think it is a franchise.

From what you describe as your requirements, it doesn't seem like the kind of place that would meet your needs.

There are a number of models for senior living. I'll pass along a few articles about the basics so you can get a sense for what is out there, and pursue investigating further those options that might work for you.

Overview from a builder/developer perspective: https://www.probuilder.com/agi...odels-senior-housing

That article mentions a cohousing community called Quimper Village, located in Port Townsend, WA. It's sort of a neat model, and it happens to be located fairly close to where my best friend Pat lives.

https://www.quimpervillage.com/

A recent article on Aging in Community. Tons of references and links with more information.

https://journals.sagepub.com/d...=cr_pub%20%200pubmed