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Are You Ready for the Cost of Senior Care?
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Has Achieved Nirvana
Picture of jodi
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My in-laws live in a retirement community - one that you have to qualify for/but once you are in, they take care of you forever even if you run out of money (and you cannot transfer your money to your kids after you are in). It’s really nice. They currently live in a house in a neighborhood that feels like a regular neighborhood, lots of places to walk, right up against a park with hiking trails. The facilities are fantastic, and there are apartments and assisted living areas and nursing care and memory care units that they can easily move to if they need to. I would like to live someplace like that in 10 or 15 years. It would be nice to be settled into someplace where it wouldn’t be so stressful on my family (or me) if my mind decides to leave me before my body does.


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Smiler Jodi

 
Posts: 20501 | Registered: 20 April 2005Reply With QuoteReport This Post
Minor Deity
Picture of Mikhailoh
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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
Yes. It would be good idea for all of us to understand the Medicaid spend-down regulations. That way you can start gifting in years before you will need it (assuming you trust your kids).

We just went through it last year, and while it's not entirely opaque, it's complicated, what with Miller Trusts and such.


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"A mob is a place where people go to get away from their conscience" Atticus Finch

 
Posts: 13590 | Registered: 20 April 2005Reply With QuoteReport This Post
Minor Deity
Picture of Mikhailoh
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A good read.

https://smartasset.com/retirem...caid-5-year-lookback


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"A mob is a place where people go to get away from their conscience" Atticus Finch

 
Posts: 13590 | Registered: 20 April 2005Reply With QuoteReport This Post
knitterati
Beatification Candidate
Picture of AdagioM
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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.


Yes, and what does that LTC insurance cover? Mom-in-law had a policy (she and Dad bought in a long time ago). It pays out over 3 years, and then I think that’s the end of it. Those three years run out this year.


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http://pdxknitterati.com

 
Posts: 9822 | Location: Oregon | Registered: 06 June 2005Reply With QuoteReport This Post
Minor Deity
Picture of Amanda
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quote:
Originally posted by wtg:
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.


Will check them out - wondering if they are all run by the same organization, also if they are non/for-profit.

quote:
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.


MANY thanks wtg for providing the various models of SR. There are SO many different kinds, sometimes I'm afraid I'm already too old cognitively (Frowner ) to weigh all the different options - that especially includes visiting a few. Ha! Don't even know how I'd dare fly, considering the need for stop-overs from here with stop-overs . Worst fear is that a flight would be cancelled or have a long layover. (When it's happened in the past I've slept on benches when benches but my back issues would make that impossible now.)

I'm also seriously confused about the differences between LTC arrangements - to name but a few, Adagio's and Jodi's comparative LTC descriptions. First, the vast difference between the LTC policies which are used up in a matter of a few years and the communities one signs on to (if qualifying) which keep you to the bitter end, with no remaining assets.

And other variations. (Wondering too if I'd qualify for certain kinds of residences with medical requirements.)

I've been following ever since they began to be thought of, the "Aging in Place" arrangements - the first publicized, in Boston (Beacon Hill), the second, New Canaan CT where I grew up. The idea they developed was residents to help each other. Not to do the physical work themselves, but to form cooperatives which would work out agreements with maintenance companies for members' repair, snow removal, anything as needed.
Also for members to help each other like (remember, the old days?) neighbors when they have medical emergencies and need help. Also, they'd stay in touch - checking on each others' needs - supporting each other, pretty much anything, apart from heavy duty physical work.

Note that as it must be clear, those first two Aging in Place arrangements apply to extremely affluent sub-groups - older couples or widow/ers who want to stay in their long time family homes even though their nests are long empty. That way they hope to be able to remain in the old family home thanks to the cooperative arrangements they're putting together - and to do so, at the same or even lower cost than senior residential care at whatever level of care. I mention them as examples, not because I'm contemplating either neighborhood there or elsewhere. After all, one of the main ideas is to allow long term neighbors to help each other.

Anyhow, now those original Aging in Place movements have expanded hugely, including third party firms offering their services to similar homeowners who want to stay put, with the difference being that the firms initiate the services.

One service is to help aging homeowners stay in place acting on their behalf basically as "property managers" (similar to those helping out of town landlords).
2)a second service provided is to provide medical and organizational help to seniors living alone.

Billing themselves as "Senior care" experts, one son has been nagging me for years to sign up for a one woman firm at his expense, to relieve his mind about me. (I've refused owing to the high cost and the complete loss of autonomy/privacy it would entail.) Her calendar is already full, though, owing to the large number of worried adult children living at great distances who have signed on for her services. There's certainly a great need and it's a great business model.

There are increasingly other permutations of Aging in Place services which sound like excellent ideas (including both volunteer and paid services). They look after elders to varying degrees - some to provide company and light housework others more in-depth (e.g. "Home InStead" - it may be nation-wide by now). The Senior "Experts" (or hired assistances) are also available in medical emergencies in addition to monthly home visits.

They also hire from secondary agencies - home nursing/care aids, errands and cleaning and more. Together, it costs quite a lot to fill the elders' needs, adding secondary and tertiary agencies' fees to that of the hourly workers' (Need I say, they are underpaid, but at least bonded and can be available as needed!).

And all the same, such master agencies, working together with subsidiary agents, still come to much less than an Assisted Living facility.

So many things to consider!

Will look up the services you were kind enough to post, wtg!

Adding one caveat I almost forgot. I hope to be able to live near one or both sons eventually. That adds much confusion, because their plans are so uncertain.

Neither is married and neither has a permanent job - that is, neither has a job they are certain to want to stay with it. Moving is a big deal, and I don't want to move without knowing it's permanent or semi-permanent - especially for a singleton. Meanwhile, there's so much uncertainty to do with the lives of all three of us - especially financial And there is also a great deal of uncertainty to do with mine and theirs - especially financial and health (overlapping, of course).

One digression, however, to interject is that I can't see myself living in Quimper Village (or any similar) - that pleasant community you described in WA. That's because, alas, I wouldn't qualify as a worthy member. Unless I misunderstand, all members of the co-op would help maintaining the physical set-up and meals.

That spine business, remember! It's been a long time since I've been able to take care of my own present home and yard (and more, to do with added medical issues).

Now I have to make myself to get to the gym (it's getting increasingly hard to stay with it, but reminding myself of the endorphins helps.


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The most dangerous word in the language is "obvious"

 
Posts: 14392 | Location: PA | Registered: 20 April 2005Reply With QuoteReport This Post
Has Achieved Nirvana
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I didn't think Quimper would be your cup of tea; it wouldn't be mine either. I just think it's an interesting model. I think part of the process is understanding what is available and then eliminating the ones that don't appeal at all.

The link I provided earlier has a video of FV if you want to see what the facilities look like. And as I think I mentioned there, it is a non-profit.

LTC insurance is sold by insurance companies. As I understand it, when you buy LTC insurance, it typically pays out when needed at some $X/day for a period of time. My mom signed up for LTC and dropped it after a couple of years. Her policy would have paid $100/day for up to three years. At least those are the kinds of plans that were being sold 20 years ago. I think there are different kinds of plans being offered today. And there are a lot fewer insurers in the market.

For the various communities like FV with life plans, you pay an entrance fee up front and then also pay each month. One can kind of think of it as LTC insurance, but you are buying it from the community rather than an insurance company, and the coverage is guaranteed for your life rather than ending in three years.

The up front fee is based on what level you come in at (independent, assisted, skilled), the size of the apartment you will be living in (studio, 1BR, 2BR), your age, and your income (SS, pensions, LTC insurance). The monthly fee is based on the level of care you are using (independent vs assisted vs skilled).

An example...

In 2007, my father-in-law had $185K in assets after he sold his townhouse, not a lot of money even in 2007.. His only income was SS; he had no pension or LTC insurance. He was 81 years old.

Friendship Village came back with a $140K entrance fee, which left him with only $45K plus his SS to pay his monthly rental. He only qualified for a studio apartment; he couldn't afford a one bedroom.

I don't remember exactly what the rent was, but I think it was in the $2K+/month range. that included linen service for towels and sheets, once a week room cleaning, and a $450 card for food.

He could get a sandwich plate in for $7.50, or could go to either the cafeteria style restaurant or the fancy white tablecloth restaurant. Those meals were $15. He used to have breakfast in his apartment, have a big lunch in the cafeteria, and then have soup or something else for dinner in his room. There were also a couple of casual bar-type dining places, sort of sports bars. The food card covered his one big meal a day and he paid for the food he ate in his room out of his monthly SS.

There was a laundry room down the hall where he could wash his clothes. Fitness center, indoor pool, billiard tables and pianos (well, maybe PSOs) in various atrium areas. There were garden plots for people who wanted to plant veggies or flowers. If you had a first floor unit you could have a dog. All included in his monthly fees.

Their actuarial calculation was that he would be in independent living for 7 years, assisted living for 2 years, and skilled nursing for a year.

He was in independent living for about three years and had just gone through almost all of his $45K in assets when his health failed somewhat suddenly. He was transferred to skilled nursing and died six months later.

The life plan that he had chosen and paid $140K up front worked like this...

1) FV kept 2% of his entrance fee for the first 24 months, which basically meant that they were taking half of it.

2) At the time of his death, he basically had $70K of his entrance fee left and it was returned to his estate to be divided among his heirs.

Different communities have different plans. You might put up less up front if there is no provision to return something to your heirs at your death. And so on...

I don't know what prices look like these days; Dad was there more than 15 years ago. We were very surprised when he qualified to get into FV with his modest assets without additional assistance from the family. You just have to start reaching out to places you might be considering and see what they have to say.


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We are all visitors to this time, this place. We are just passing through. Our purpose here is to observe, to learn, to grow, to love… and then we return home. - Australian Aboriginal proverb

Bazootiehead-in-training



 
Posts: 38086 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
Has Achieved Nirvana
Picture of Steve Miller
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I think we’re set up OK for long term care and I have little to contribute. The way we’ve done it won’t work for most people.

I will say that Sharon has made a career of doing collections for nursing homes and she says it’s very difficult to get removed from one whether the money runs our not. Her experience is in CA, other states differ, check local laws. In CA a facility pretty much has to keep you whether you can pay or not.

Might pay to get in early.

Meanwhile, the best advice out there comes from that sage-of-our-age, Kenny Rodgers:

“The best you can hope for is to die in your sleep.”


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Life is short. Play with your dog.

 
Posts: 35033 | Location: Hooterville, OH | Registered: 23 April 2005Reply With QuoteReport This Post
Minor Deity
Picture of Jack Frost
posted Hide Post
quote:
Originally posted by piqué:
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?


It depends. Many estate planning attorneys do not know Medicaid planning well. I practiced estate planning but always referred out elder law matters to a specialist.


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Be calm, be brave, it'll be okay.

 
Posts: 17694 | Location: Maine | Registered: 20 April 2005Reply With QuoteReport This Post
Has Achieved Nirvana
Picture of jodi
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quote:
Originally posted by AdagioM:
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.


Yes, and what does that LTC insurance cover? Mom-in-law had a policy (she and Dad bought in a long time ago). It pays out over 3 years, and then I think that’s the end of it. Those three years run out this year.


Yes, this is where I’m stuck. I’m wondering if it might be smarter money wise to get into a community like my in-laws are in than to rely on long term care insurance. But who knows what those communities will look like/cost down the road when we need them.


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Smiler Jodi

 
Posts: 20501 | Registered: 20 April 2005Reply With QuoteReport This Post
czarina
Has Achieved Nirvana
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I looked hard at LTC insurance when I was in my 50s and concluded it made no sense, for many reasons. Put the premiums into a safer investment set aside for LTC and you'll likely be in a better position than if you buy LTC insurance.

That intentional community in Port Townsend (a wonderful small city, btw) sounds appealing to me and so does Friendship Village. The only problem is I find most people's ideas of community stifling. Too many extroverts in those places. I need to find a community of grumpy introverts who are definitely NOT chirpy morning people.


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fear is the thief of dreams

 
Posts: 21396 | Registered: 18 May 2005Reply With QuoteReport This Post
czarina
Has Achieved Nirvana
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I did run the calculator for FV and they said I qualify for a 2 br2 bth with a garage and front and back porches. I wasnt crazy about the floor plan--kitchen/LR/dining all one room--but would work if it was just me and I could bring the dogs. Just need a sign for the front door that says "go away"


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fear is the thief of dreams

 
Posts: 21396 | Registered: 18 May 2005Reply With QuoteReport This Post
Has Achieved Nirvana
Picture of wtg
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quote:
Originally posted by piqué:
That intentional community in Port Townsend (a wonderful small city, btw) sounds appealing to me and so does Friendship Village. The only problem is I find most people's ideas of community stifling. Too many extroverts in those places. I need to find a community of grumpy introverts who are definitely NOT chirpy morning people.


Pat loves going over to Port Townsend.

"Too many extroverts and chirpy morning people" ROTFLMAO

Where's the calculator for FV? I didn't see it.


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We are all visitors to this time, this place. We are just passing through. Our purpose here is to observe, to learn, to grow, to love… and then we return home. - Australian Aboriginal proverb

Bazootiehead-in-training



 
Posts: 38086 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
czarina
Has Achieved Nirvana
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on their home page. I looked at the one in Tempe, AZ. Maybe not all locations have it.


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fear is the thief of dreams

 
Posts: 21396 | Registered: 18 May 2005Reply With QuoteReport This Post
czarina
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I need one that has a boarding barn and riding trails.


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fear is the thief of dreams

 
Posts: 21396 | Registered: 18 May 2005Reply With QuoteReport This Post
Has Achieved Nirvana
Picture of CHAS
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quote:
That intentional community in Port Townsend (a wonderful small city, btw) sounds appealing to me and so does Friendship Village. The only problem is I find most people's ideas of community stifling. Too many extroverts in those places. I need to find a community of grumpy introverts who are definitely NOT chirpy morning people.


Let me know what you find. Big Grin

I expect no problems with a nursing home. I fully expect to be shot by a jealous wife long before that time comes. Smiler


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Several people have eaten my cooking and survived.

 
Posts: 25758 | Location: Still living at 9000 feet in the High Rockies of Colorado | Registered: 20 April 2005Reply With QuoteReport This Post
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