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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?
while i don't know the answer the real question is why even think about it .
without knowing which side of the statistic you will end up on you only have two possible outcomes .
you either don't need any form of long term care or you do .
so basically what happens numbers wise means a whole lot to insurers and people in the business . but to us humans without knowing who it means little . it is either us or it isn't since it has to be someone . .
Whatever the statistics say, the wise thing is to consider and plan for the future. I knew that I had long living healthy relatives but still set up a plan to save enough so that if I WANTED to move to a nice living place, I would have the money to do so and not have to rely on Medicaid.
My dad died at 71 from pancreatic cancer and lived at home for the six months between diagnosis and death. My mom provided all care and really, he was physically self-sufficient til the end. After that, my mom did buy ltc insurance and moved into a continuing care place--independent living, then assisted living, now shes has mild/moderate dementia and is in the last stop skilled nursing unit.
I have used her ltc coverage to defray the costs of the assisted living and skilled nursing. She's in an upscale facility and ltc covers about 1/2 the $11k/month skilled nursing charges.
For some families, taking a parent into their home isn't an option. My mom never wanted to come live with us. Her mother lived with my family for many years so my mom was taking care of 4 children under the age of 6 and an elderly woman with dementia.
Everyone wants to go quickly but that doesn't always happen. I'm glad my parents prepared for any contingency.
As poster Reebo points out, living in the same home with family is not always an option for a number of reasons. My sister would have been willing to take in our mother, but our mother could no longer negotiate stairs unaided, and in my sister's home the kitchen and living room were on a level which had only a half bath, which meant for showers or bathing there would be stairs. Or conversely if my mother lived on a level with a full bathroom, stairs would have been necessary to come to meals. In addition, my sister lived about 400 miles from our mother, who knew no one in that city; so had my mother moved in with my sister, she would have been socially isolated.
Therefore, when our mother reached the point where she could no longer reliably prepare food, she reluctantly moved into an independent living facility which also had assisted living. Two meals a day were provided in the dining hall as part of the rent, as well as weekly maid service. Surprise, surprise! Our mother actually liked the place! (Meals on wheels and similar services were not an option because our stubborn mother refused to go that route. There is nothing quite like a pig-headed 90-year-old senior who is in denial and would rather forego food than to accept the concrete symbol of her decline, namely having meals delivered. It is hard to impossible to stand by and do nothing when one's mother is not eating, hence our eventually successful efforts to convince her to move into independent living.)
So there are lots of variables and lots of factors in each individual case.
The idea of taking care of a parent at home and the reality doesn't always mesh.
Our neighbors in NY took in the DH's father after his mother died. He had dementia and they slowly removed every object from his room in an effort to keep him safe. Before moving him to a nursing home, they resorted to locking him in his room at night. That was after the police found him in another neighbor's kitchen at 1 am with him insisting it was his house. They did all they could until they couldn't.
My FIL had cancer with hospice at home and died at home with DH, sister and MIL by his side. This isn't something everyone can handle though. Watching someone go through all the stages of death and die is not easy. It's understandable when some choose not be the primary caregivers at home for the end.
Not knowing how my end will be or what my family can truly handle, I don't want to put the burden or guilt on others.
Thank you for your replies. I wrote this post in the wee morning hours when I thinking about families and different choices. Then I was wondering if LTC insurance is really necessary and how many people really use it. An impossible question to really answer since no one knows until the need arises. Sorry. ...
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?
I think it's important to point out that "independent living" is quite a bit different than "assisted living". Independent living is somewhat like living in your own place. You'll have a kitchen - probably laundry facilities - and often a fair amount of square footage. My father's independent living villa also has a garage (and he still owns a car). Different places will have various amenities. Like a communal dining room where you can - but are not required to - have your meals. Some "senior" safety features. Like grab bars in various places. An emergency contact system. Transportation services. Various planned activities. Maid service perhaps once a week or so. But there really isn't anything in the way of help with ADLs (activities of daily life) - unless you pay for them separately.
Assisted living is for people who need more care - help with ADLs. Especially - at least in terms of what I've seen - people suffering from dementia. The units I've seen are on the smaller side - don't have full kitchens - laundry facilities - or similar. So - unless you pop something in a microwave or have a bowl of cold cereal - you're talking about taking all your meals in - or delivered from - a communal dining room. Assisted living also comes with various levels of care - depending on how much care a person needs when it comes to things like bathing - toileting - getting dressed/undressed - making sure someone takes his/her medications - etc. The more care you need - the more you pay.
At some point - some people will need a ton of care with ADLs and/or have complex medical needs. And then they are candidates for care in a SNF (skilled nursing facility). There isn't any "bright line" between the need for ALF care and the need for SNF care. Although it seems like a common one - especially when it comes to dementia patients - is fecal incontinence. There are also cases where people have a sudden medical event - like a bad stroke - and can go straight from living in their own houses directly to a SNF.
I think whether people wind up in any of these places depends on the person. His/her age - physical and mental health condition - etc. and needs for various types of help. There is also the issue of whether family members can help - or - more specifically - whether they can provide all the help that a particular person needs. In our case - we've had different experiences with different parents. Our mothers died at home when they were about 80. Their husbands - still alive - took care of them until the end. My late FIL had a bad stroke in his early 80's and wound up in a SNF (where he spent the last 2 1/2 years of his life). My father sold his house and moved into an independent living place near us after my mother died. He was 87 at the time. He's 97 now - and still living in the same place. Robyn
the problem with family trying to care for someone is usually what happens is when brother and sisters are involved things never end well .
one sibling steps up to the plate to care for a family member and the others tend to step backl .
that usually causes friction between everyone . if spouses are involved with those siblings it gets worse because now the family doing the carrying has the spouse asking why we are doing everything and having the expenses of caring and your brothers and sisters do nothing .
the fighting and resentment can lead to divorce .
taking care of someone 24/7 can have careers falter as well as injure the people trying to take care of the person .
i think most of the folks who have tried this will have similar war story's .
Thank you for your replies. I wrote this post in the wee morning hours when I thinking about families and different choices. Then I was wondering if LTC insurance is really necessary and how many people really use it. An impossible question to really answer since no one knows until the need arises. Sorry. ...
Long term care insurance would cover some of these options - not all. It would not have covered my father's expenses in his independent living place - but would have covered some of my late FIL's care in the SNF. Both of our mothers had home hospice at the end. Which was covered by Medicare. My late FIL also had hospice care at the end of his life in his SNF. That hospice care was covered by Medicare as well. Also - some of my late FIL's care in the SNF (a small % of the time he lived there) was covered under the rehab portion of Medicare. Robyn
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