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Old 01-17-2016, 09:05 AM
 
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My SIL husband has been having heart/health problems/surgeries for the last few years and their relationship (unfortunately) has been pretty much "gone" since I've known them (16 years now). They've been married for 49 years. Anyway, when he first started having health problems, he didn't want any help from her and she never considered herself a good nurse. She was pretty much always gone to see local daughters/grandkids and he would call her if he needed her for an emergency. So, a year or so ago, she helped him move out and into his own apartment where a healthcare pro would stop in and help him at times. Last year, she let him move back into her condo (in her name) b/c he couldn't continue to afford the apartment.

A few weeks ago, he got really sick again and had to go to the hospital. He had another "procedure" done and the doctor told him and SIL that he couldn't return to her condo b/c he needed 24 hour care......that she told the doctor she absolutely couldn't do. So, he is now living in an Assisted Living place, but she told us last week that his health is really going downhill.
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Old 01-17-2016, 10:44 AM
 
Location: Idaho
1,453 posts, read 1,153,939 times
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Quote:
Originally Posted by whocares811 View Post

Facing the Future — Long Term Care — Presented by Lincoln Financial Group

The succinct answer, according to the article is this (quote, my italics): "according to a study by the U.S. Department of Health and Human Services [snip], anyone reaching the age of 65 years has a 40 percent chance of entering a nursing home, with a 20 percent chance of staying there for at least five years." (end quote)
I don't know what data that LFC use to come up with these seemingly very high probability numbers.

In digging around, I found the total numbers and percentages breakdown of people in assisted living in 2010

Resident Profile

Quote:
Percentage Of All Residents By Age Groups:

In 2010, 54 percent of assisted living residents are 85 years or older; 27 percent are 75-84 years old; 9 percent of residents are between 65 and 74 years; and 11 percent are younger than 65 years old.

I compared these numbers with the US census bureau report in 2010

http://www.census.gov/prod/cen2010/b...c2010br-03.pdf

and Figure 5.6: Nursing home population Age 65 and over by Age and Sex from this report

https://www.census.gov/content/dam/C...mo/p23-212.pdf

and came up the following statistics:

For Assisted Living: total 735K nationwide

1. Under 65: 80.85K or 0.03% of 268,478K total age group pop.
2. 65 to 74 : 66.15K or 0.28% of 21,713K total age group pop.
3. 75 to 84 : 198.45K or 1.51% of 13,061K total age group pop.
4. Over 85 : 396.9K or 7.93% of 5493K total age group pop.

For nursing home: total 1,253K total

1. Under 65: 28.5% of nursing home pop. and 0.13% of total age group pop.
2. 65 to 74 : 0.9% of nursing home pop. and 0.05% of total age group pop.
3. 75 to 84 : 3.2 of nursing home pop. and 0.31% of total age group pop.
4. Over 85 : 67.4% of nursing home pop. and 15.36% of total age group pop.


So it is clear that the probabilities of being in assisted living or nursing home are much higher in over 85 years old group and it could be misleading just to look at the stats for ALL people over 65 years old.

It's interesting to note that even when all people over 65 years old are 'lumped' together, only 3.1% of the group is in nursing homes in 2010 so this statement:

"anyone reaching the age of 65 years has a 40 percent chance of entering a nursing home"

seems to be quite high too.

Another stat to consider is the length of the average stay

Resident Profile

Quote:
Median Length of Stay: The median length of stay for residents is about 22 months
The length of average stay in nursing home is even shorter

https://www.longtermcarelink.net/eld...rsing_home.htm

Quote:
In 2004, at any given time, only about 12.7% of nursing home residents were being covered for their stay by Medicare rehabilitation, and their average stay was only 23 days
....

Average length of stay (current resident): 835 days
Number of discharged residents: 2.5 million
Average length of stay (discharged resident): 270 days (8.90 months)
Again, not having all the details, I don't know how FLC came up with the estimate of 20% chance that a 65 years old would have to stay in a nursing home for as long as 5 years!

Last edited by BellaDL; 01-17-2016 at 11:00 AM..
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Old 01-17-2016, 11:12 AM
 
10,813 posts, read 8,061,664 times
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Quote:
Originally Posted by LoveBoating View Post
A few weeks ago, he got really sick again and had to go to the hospital. He had another "procedure" done and the doctor told him and SIL that he couldn't return to her condo b/c he needed 24 hour care......that she told the doctor she absolutely couldn't do. So, he is now living in an Assisted Living place, but she told us last week that his health is really going downhill.
If his doctor ordered 24-hour care, then his initial stay was technically considered Skilled Nursing care and covered by Medicare:
Quote:
People with Medicare are covered if they meet all of these conditions:

You have Part A and have days left in your benefit period.
You have a qualifying hospital stay.
Your doctor has decided that you need daily skilled care given by, or under the direct supervision of, skilled nursing or therapy staff. If you're in the SNF for skilled rehabilitation services only, your care is considered daily care even if these therapy services are offered just 5 or 6 days a week, as long as you need and get the therapy services each day they're offered.
Quote:
You pay:

Days 1–20: $0 for each benefit period.
Days 21–100: $161 coinsurance per day of each benefit period.
Days 101 and beyond: all costs.
Source: https://www.medicare.gov/coverage/sk...lity-care.html
There are some additional length-of-stay caveats on the website.
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Old 01-17-2016, 12:23 PM
 
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The rate of nursing home use increases with age from 1.4 percent of the young-old to 24.5 percent of the oldest-old. Almost 50 percent of those 95 and older live in nursing homes.

According to the U.S. Bureau of the Census, slightly over 5 percent of the 65+ population occupy nursing homes, congregate care, assisted living, and board-and-care homes, and about 4.2 percent are in nursing homes at any given time.

How Many Seniors Really End Up In Nursing Homes? | Nursing Home Diaries
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Old 01-17-2016, 12:40 PM
 
6,616 posts, read 3,746,469 times
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Quote:
Originally Posted by biscuitmom View Post
That's an insurance seller website and they didn't give the specific HHS source for that statistic. I went to the latest available HHS report but couldn't find that stat. The report is 107 pages long, though, so I could have missed it.
I did find a Morningstar article that included the 40% stat but their source link led to a dead end. Morningstar's length-of-stay stats were shorter than the insurance site. It also cautions against heeding stats put out by insurance providers.

The most relevant sourced statistic I could find was a Congressional Budget Office report. On page 29, it shows that in the 65+ age group now alive, approx. 2.7% are in nursing homes and 1.1% are in long term care.
It further breaks that group down into age groups and summarizes it as follows:
It defines "institutions" as

With those kind of actual current figures, it's hard to see how someone would get to a prediction that 40% of us 65+ folks will enter a nursing home or LTC, unless they're super short stays. Many people who have surgical procedures, especially orthopedic ones, do short-term Medicare paid rehab stays in LTC's. Perhaps those short stays help account for the 40%, if correct, of seniors projected to enter them?

Prudential gave us a sales pitch (called a seminar) at my workplace about 8 years ago. I think the guy said that about 20% of seniors end up needing LTC, and the avg length of stay is about 2 years.

However, averages are just averages. An average means that half stay less than 2 years, and the other half stays longer.

ALSO, I THINK that Medicare rules have been revised to allow some minimal home health care, hasn't it? So if someone needs assistance with some things, but can generally be on his own for most of the time, whereas they used to have to go to a facility, now they can get by with a home health care aid for an hour a day, or however that works. For instance, assistance w/bathing or cooking or cleaning, or making sure meds are taken, a checkup on status, etc. But I'm not sure about this. Maybe someone else knows.
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Old 01-17-2016, 01:54 PM
 
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The bottom line for me (at this point) is:
-- anyone of us -- at 45 or 85 -- could end up in a nursing home if there's no one who could take care of us. All it takes is a car accident or bad trip or fall. Plus any number of medical conditions could happen
-- at 55 and single: I don't trust that insurance companies have the underwriting straight, and don't want to put money into yet another kind of insurance policy I may not need for 30 years or ever.
-- I already know what my estate planning will be…and as of now I'll self-insure (private pay until I qualify for Medicare)

As I said, that's just the bottom line of it, as things stand right now. And of course things can change. I may indeed get a policy later. But it took a lot of research, investigation, consultations, conversations and debates to get to this decision.

When I see threads like this it reminds me of all the questions I asked and factors I had to take into consideration when I was doing my research. Sort of a been there done that…..
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Old 01-17-2016, 01:56 PM
 
4,070 posts, read 1,555,548 times
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Quote:
Originally Posted by bpollen View Post
Prudential gave us a sales pitch (called a seminar) at my workplace about 8 years ago. I think the guy said that about 20% of seniors end up needing LTC, and the avg length of stay is about 2 years.

However, averages are just averages. An average means that half stay less than 2 years, and the other half stays longer.

ALSO, I THINK that Medicare rules have been revised to allow some minimal home health care, hasn't it? So if someone needs assistance with some things, but can generally be on his own for most of the time, whereas they used to have to go to a facility, now they can get by with a home health care aid for an hour a day, or however that works. For instance, assistance w/bathing or cooking or cleaning, or making sure meds are taken, a checkup on status, etc. But I'm not sure about this. Maybe someone else knows.
That would be "median" not "average".... (Sorry, I just can't help it.)


Here's yet another link to more data:
https://www.caregiver.org/selected-l...are-statistics


My mother & step-father, both in their 90s, moved into an independent living facility at age 90, and can segue into assisted living and nursing home and hospice care when/if needed in the same facility. Of course, it cost them about $250k to move in plus about $3k a month. Clearly this is not an option for a lot of folks.
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Old 01-17-2016, 02:20 PM
 
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I've covered this ground previously but my dad had vascular dementia. He was pretty out of it by age 80 retired in his Florida condo with my stepmother looking after him. By age 83, he had become too much for my stepmother to handle. In and out of the bathtub wasn't possible. He was a safety issue wandering. He spent a couple of years in a dementia lockdown ward and his last 90 days in a nursing home. He had long term care insurance and didn't wipe out my stepmother.

My mom is 83 and has severe short-term memory loss problems that look like classic Alzheimer's symptoms. I had to move her to assisted living on July 1. She has sufficient income and assets to last 5 years at her current burn rate. I could trim the burn rate but my sister and I decided that we'd rather spend more now to make sure she has the highest quality of life while she can still appreciate it. We're paying people on the outside to come in 5 days per week to make sure she gets some exercise and social interaction. She's in a 2 bedroom apartment big enough to hold her Steinway grand piano in the living room. At some point, she'll decline to where she can't play her piano and needs to be in a secure facility. That might be 6 months. It might be 3 years. Who knows? I'm single and have tons of business travel. My sister is even more of a road warrior and lives on the west coast of Canada so I'm doing all the blocking & tackling dealing with my mother's affairs. There was no option of parking her with either of us even if we wanted to do so.

For me, I look at my parents and assume it's likely I'll end up in the same sort of situation. I'm affluent enough that I'll be able to afford it for many years. If I ever opt to remarry, I'd likely shell out the money for a long term care policy. Given the family history, my odds of ending up in assisted living and/or a dementia ward are higher than average.
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Old 01-17-2016, 02:53 PM
 
823 posts, read 564,166 times
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Quote:
Originally Posted by Robyn55 View Post
I think the wildcard for many - perhaps most - people - is dementia. There are some forms that can strike early and sometimes violently...

There seems to be at least some genetic component to Alzheimer's (there are 2 flavors - early onset - rare - and late onset - much more common - https://www.nia.nih.gov/alzheimers/p...ics-fact-sheet). So - in guessing about what may happen to you - it's a good idea to look at one's family medical history. One might even look into the possibility of genetic testing for the disease. Robyn
There was no history of Alzheimer's in my family. All four grandparents died of other causes, with their mental faculties intact. Same with my father.

Then came my mother. In her late 70s, she was in great physical condition, fiercely independent and sharp as ever. She swam laps daily, hiked most days, got down on hands and knees to scrub her kitchen and bathroom floors, headed downtown whenever she felt like it to meet friends for dinner or a movie. All her lab work was great, although she was on a garden-variety prescription for high blood pressure. She read a small stack of library books every week.

At first, she started feeling anxious in familiar situations outside her home. Panicky and not sure what was happening to her. Then she started getting confused about details of her life. Quite soon that progressed to the point where she stopped driving (she had a minor accident, the first of her life, in a parking lot, and gave up her car immediately). She couldn't shop, or cook, or clean, or get herself to appointments or to the pool or the nature preserves where she liked to hike.

First one, and then another of her children moved in with her to take care of everything she needed. But quite soon her condition progressed to the point that she could not be left alone for any length of time, in order for the child to leave for work or errands, even for a few hours. Her place had stairs, and a gas cooktop, and busy streets nearby. These were all death traps. She did not understand what was happening to her, and would make frightened phone calls, asking for help.

So we sold her place and she went into a wonderful care home, paid for by the LTC insurance which she had presciently purchased decades before through her employer. Roughly three years after she first showed symptoms of Alzheimer's, it killed her. I hadn't understood that Alzheimer's actually killed people until I saw it happen to my mother. She went so fast.

How accurate is the genetic testing for Alzheimer's? Is there a reliable test?

Last edited by josie13; 01-17-2016 at 03:27 PM..
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Old 01-17-2016, 03:19 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,927,825 times
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Quote:
Originally Posted by BellaDL View Post

Again, not having all the details, I don't know how FLC came up with the estimate of 20% chance that a 65 years old would have to stay in a nursing home for as long as 5 years!
Because - at age 68 - my life expectancy as a 68 year old female is about age 85 these days.

We are all living older - and often sicker - than people in previous generations. Robyn
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