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Old 01-20-2016, 04:09 PM
 
Location: Ohio
19,895 posts, read 14,224,806 times
Reputation: 16081

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Quote:
Originally Posted by Suevee View Post
I am curious. I hear and read so much about financially preparing for these living arrangements. In my family and in my husband's family no one has used these options. All of them have lived in their homes or with family until death. All were comfortable up to the end surrounded by family. Some combined resources with other family members, some stayed independent in their own homes with family near by for support. It seems if we survive our sixties, we stick around until our mid-eighties and some beyond that.

Are we an anomaly? Or is this more common than reported?
You can dig through this study:


National Study of Long-Term Care Providers: 2012 State Web Tables


Or read this brief article:

Assisted living, HCBS growing in use, Census Bureau report finds | Long-Term Living Magazine


Quote:
Assisted living, HCBS growing in use, Census Bureau report finds

July 2, 2014
by Lois A. Bowers, Senior Editor


The report, “65+ in the United States: 2010” (PDF), highlights trends among America’s older population and documents the variations in how long people live, how well they age, their financial and educational status, their medical and long-term care (LTC) and housing costs, where they live and with whom, and other factors related to aging and health. Among its findings:
  • The share of the older population residing in SNFs declined from 4.5 percent in 2000 to 3.1 percent in 2010. The share in other LTC facilities, such as assisted living, has been increasing.
  • Medicaid funds for LTC have been shifting away from nursing homes, with HCBS funding increasing from 13 percent of total funding in 1990 to 43 percent in 2007.
Or read the Adobe file given at the link.
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Old 01-20-2016, 04:12 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,923,045 times
Reputation: 6716
Quote:
Originally Posted by johngolf View Post
This chat is very interesting but I caution everyone to be sure that other's experiences fit their model. As an example in another chat, one poster said that her and her husband told their father's that they would be more than willing to help them but they had to move close to them, which the Fathers did. While this sounds good there is no way in he!! I would move to where my children live so I have to make plans to take care of myself where I am.

Along these same lines many will tell of their experiences/plans but do those plans fit you? As an example. I am a widower thus for long range planning, I do not have anyone else (a spouse) to consider.What I need/do could be quite different than what a couple needs to do.

Bottom line is take all advice with a grain of salt as much may not fit you.
I was the person who said that. And you don't know what you might be willing - or even wanting - to do when you're 90ish - or have had an incapacitating stroke or similar physical ailment strike you in your 80's (the situations our fathers were in). And have absolutely no one where you live to help you with anything. And/or local facilities that are lousy/can't meet your needs.

We can all puff ourselves up and pride ourselves in our independence when we are younger/healthier seniors. It can easily be another story when the sh** hits the fan. Just ask yourself. Do you want to die alone and disabled at age 95 in some local crummy nursing home? Robyn
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Old 01-20-2016, 06:18 PM
 
4,070 posts, read 1,554,506 times
Reputation: 7409
Quote:
Originally Posted by Robyn55 View Post
{snip}
And have absolutely no one where you live to help you with anything. And/or local facilities that are lousy/can't meet your needs.

We can all puff ourselves up and pride ourselves in our independence when we are younger/healthier seniors. It can easily be another story when the sh** hits the fan. Just ask yourself. Do you want to die alone and disabled at age 95 in some local crummy nursing home? Robyn

I doubt if I will make it to 95, and I will probably go with a heart attack. But yes, under no circumstances do I want my son or a grandson to have to be a care giver for me. And they are the only family I have. I have instructed my son that when the time comes, find the cheapest place that will take me, kiss me good bye and never look back. And then cremation with my ashes spread in the Pacific with the ashes of my (2nd) wife and our two fur children.
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Old 01-21-2016, 04:53 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,923,045 times
Reputation: 6716
Quote:
Originally Posted by Hoot N Annie View Post
I doubt if I will make it to 95, and I will probably go with a heart attack. But yes, under no circumstances do I want my son or a grandson to have to be a care giver for me. And they are the only family I have. I have instructed my son that when the time comes, find the cheapest place that will take me, kiss me good bye and never look back. And then cremation with my ashes spread in the Pacific with the ashes of my (2nd) wife and our two fur children.
That sounds extremely sad and somewhat stupid to me. Do you really want to spend the last few years of your life in a dumpy senior place - alone? And - if so - why?

My husband and I don't have children. But we do have younger siblings and nieces and nephews scattered all around the county. We have money too. And if we get old and feeble and any of them was willing to care for me/my husband in a nice senior facility close to them - take us out to lunch or shopping or to a museum - just care for us and keep our lives interesting - well I think that would be great. For me and them too (we would rewrite our wills ).

BTW - I don't know how old you are (how old are you?) - but heart attacks are a rather ancient way of dying (except mostly for young 40ish or so old guys who get the so-called "widow maker" heart attacks). My mother had heart problems starting in her 50's - but still lived until she was 80+.

I think too many people here are too gloomy about getting old. Robyn
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Old 01-21-2016, 05:26 PM
 
Location: VT; previously MD & NJ
2,198 posts, read 1,341,203 times
Reputation: 6314
Quote:
Originally Posted by Robyn55 View Post
So I will take my *no* income tax state. Where people can save and invest the taxes they would have paid for the "privilege" of living in California and wind up with a nest egg for their old age (if you save $5k a year starting at age 25 and invest it at 3% - you'll have $377k at age 65). Robyn
Just to keep things in perspective, here are my earnings from around age 25. Not easy to save $5000 a year back then (or whatever the inflation-adjusted earnings amount would have been back then). To be fair, 1974 was when my son was born so I had some time off for that.

Most of my retirement savings/investing happened after my son left home. So while it's an excellent goal to start saving for retirement at a young age, for many people it just cannot happen.

1976
$12,726

1975
$12

1974
$5,141

1973
$10,292

1972
$6,590
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Old 01-21-2016, 05:41 PM
 
Location: Sierra Nevada Land, CA
8,393 posts, read 9,136,940 times
Reputation: 13031
Quote:
Originally Posted by Robyn55 View Post
A house - a car - no more than $3000 in assets - and income no more than about $1500/month:

Medi-Cal (for People with Medicare) | California Health Advocates

Doesn't sound very generous to me. In fact - although I am not an expert - the Florida Medicaid asset rules for spouses seem more generous than those in California:
Not so. Check out the Spousal Impoverishment act of 1988:


The expense of nursing home care which ranges from $5,000 to $8,000 a month or more can rapidly deplete the lifetime savings of elderly couples. In 1988, Congress enacted provisions to prevent what has come to be called "spousal impoverishment," leaving the spouse who is still living at home in the community with little or no income or resources. These provisions help ensure that this situation will not occur and that community spouses are able to live out their lives with independence and dignity.
Under the Medicaid spousal impoverishment provisions, a certain amount of the couple's combined resources is protected for the spouse living in the community. Depending on how much of his or her own income the community spouse actually has, a certain amount of income belonging to the spouse in the institution can also be set aside for the community spouse's use.


https://www.medicaid.gov/medicaid-ch...ment-page.html


The at home spouse can keep $3000 a month for income and almost $120,000 in nonexempt assets. A doable situation for the at home spouse
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Old 01-22-2016, 05:24 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,923,045 times
Reputation: 6716
Quote:
Originally Posted by Mr5150 View Post
Not so. Check out the Spousal Impoverishment act of 1988:

The expense of nursing home care which ranges from $5,000 to $8,000 a month or more can rapidly deplete the lifetime savings of elderly couples. In 1988, Congress enacted provisions to prevent what has come to be called "spousal impoverishment," leaving the spouse who is still living at home in the community with little or no income or resources. These provisions help ensure that this situation will not occur and that community spouses are able to live out their lives with independence and dignity.
Under the Medicaid spousal impoverishment provisions, a certain amount of the couple's combined resources is protected for the spouse living in the community. Depending on how much of his or her own income the community spouse actually has, a certain amount of income belonging to the spouse in the institution can also be set aside for the community spouse's use.

https://www.medicaid.gov/medicaid-ch...ment-page.html

The at home spouse can keep $3000 a month for income and almost $120,000 in nonexempt assets. A doable situation for the at home spouse
So - if this is a national thing - then spouses would be treated the same everywhere - yes? And they would be equally well off in California or Florida - yes? Of course - it is very common for widows and widowers to wind up in SNFs. In which case - any spousal protections wouldn't apply. I've only known 2 people in Medicaid places - a late aunt (in New Jersey) and the late father of a SIL (in Florida). Neither had 2 nickels to rub together - and both were limited in terms of the help they could accept from family (family kicked in maximum allowable amounts to pay for various things).

Note that I am hardly an expert when it comes to qualifying for Medicaid anywhere (and I hope I never have to learn!).

Overall - my thinking about Medicaid and SNFs is to try to avoid being in a situation where you need Medicaid if/when you need a SNF. No matter where you live. This means not impoverishing yourself voluntarily to qualify - and perhaps buying LTC insurance if necessary to avoid going broke as a result of long term care. Medicaid places - from what I've seen in a couple of states - aren't particularly nice places (and - in another current thread - someone in California made the same observation about Medicaid places there). Robyn
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Old 01-22-2016, 05:27 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,923,045 times
Reputation: 6716
Quote:
Originally Posted by ansible90 View Post
Just to keep things in perspective, here are my earnings from around age 25. Not easy to save $5000 a year back then (or whatever the inflation-adjusted earnings amount would have been back then). To be fair, 1974 was when my son was born so I had some time off for that.

Most of my retirement savings/investing happened after my son left home. So while it's an excellent goal to start saving for retirement at a young age, for many people it just cannot happen.

1976
$12,726

1975
$12

1974
$5,141

1973
$10,292

1972
$6,590
So you stopped working in 1976 - and the most you ever earned was $12k/year? If that's the case - then I suspect you have more to worry about than paying any kind of taxes. Robyn
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Old 01-22-2016, 08:39 AM
 
Location: Loudon, TN
5,769 posts, read 4,827,803 times
Reputation: 19395
As far as SNFs that take Medicaid in CA, I can offer my mom's case as proof of how well that worked (anecdotal, I admit). My mom was to be transferred to SNF from the hospital after the amputation of her lower leg and her subsequent decline. She was on a feeding tube, and other than her inability to eat and transport herself, was mentally healthy and well enough to be transferred out of the hospital (basically they decided they needed the bed and gave us 48 hours to find a place to send her or they would pick one). We went to look at every SNF in Sacramento that had a vacant bed to see if we liked them for her. Only one agreed to accept her on a medicaid/medicare basis. All the others refused because they said her care would be too much work for them for the amount of reimbursement they would receive. That left us the one place that I inspected and felt would NOT be acceptable to us. That's the only place that would take her. I was so defeated.

She was transferred to this place, which looked fine, but smelled horrible and was terribly understaffed, and within 3 months she passed away. I was there EVERYDAY after work to visit and had to continuously correct the mistakes that the incompetent staff made with her care. We paid extra out of our pockets to provide her with things she needed that medicaid/medicare wouldn't, like the inflatable mattress for pressure sores she developed because they weren't turning her properly, and speech therapy to assist her in learning to eat orally again. Personal property we bought for her was stolen from her room. The staff did not speak English well enough to comprehend our questions or the doctor's notes and instructions. In addition to the bedsores, she contracted pneumonia and started to have micro-seizures. It was freaking ridiculous, and a sad way for the life of a proud, strong woman to end. It is the greatest regret of my life that it ended that way and that I couldn't do more for her. Needless to say, I purchased LTC insurance for myself.
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Old 01-22-2016, 10:05 AM
 
Location: VT; previously MD & NJ
2,198 posts, read 1,341,203 times
Reputation: 6314
Quote:
Originally Posted by Robyn55 View Post
So you stopped working in 1976 - and the most you ever earned was $12k/year? If that's the case - then I suspect you have more to worry about than paying any kind of taxes. Robyn
No. My point is that when you are young and just starting out, you would be unlikely to be able to save any substantial amount for retirement. As I said before, most retirement savings didn't come early in my life - couldn't do it then.

You said a 25 year old should put away $5000 a year to benefit from 40 years of compounding. I'm saying that is probably unrealistic for most.

Luckily, even with most of my savings coming later in life/career, 20+ years of compounding worked out pretty well too.
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