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Old 09-15-2017, 03:27 PM
 
Location: WA
5,394 posts, read 21,393,457 times
Reputation: 5892

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Quote:
Originally Posted by ocnjgirl View Post
Regardless of their past infractions (all nursing homes have infractions, every one), I am not convinced these deaths are totally the fault of the home or even more their fault than the county.
...
I am inclined to go easy on this situation. Every nursing home I am familiar with finds dead bodies regularly even with the AC running. Old feeble people die at a higher rate than the rest of us.
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Old 09-15-2017, 04:10 PM
 
20,552 posts, read 16,625,375 times
Reputation: 38585
Quote:
Originally Posted by runswithscissors View Post


Why are you defending "the system" again and dismissing the member's story about the difficulties finding a place that WILL take those patients and the horrendous care his mother received.

What happened? She didn't get her leg amputated with the right timing or something? She "waited" too long?
I'm not defending anything, I am explaining how it works and telling people how to do it so that they do have choices. I have been stating facts and explaining the process my mom dealt with, not offering opinions. I do defend to some degree though the home in the original story. Family members who are there on a daily basis stated their parents had good care there, and many confirmed that the home and family members called Power department begging to be made a priority multiple times to no avail.


I will add though, not everyone can be "fixed" medically, (or they'd not be in a home). Many people have wounds that won't heal regardless what they try. Many diabetics can't keep their blood sugar below 200 or even 300 even with meds, and those people will likely end up with amputations. You can't go by that to know if care is good. People are in long term care because their conditions are not going to get better, most are going to get worse, get amputations and have strokes and break hips no matter how good the home is.

Last edited by ocnjgirl; 09-15-2017 at 04:41 PM..
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Old 09-15-2017, 04:23 PM
 
Location: Sierra County
271 posts, read 116,788 times
Reputation: 371
Quote:
Originally Posted by yellowsnow View Post
By the time I am in bad enough shape to require a nursing home, I want to be in the one that will kill me the quickest.
Then you'd be a liability.
So don't count on it
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Old 09-15-2017, 04:50 PM
 
Location: East of Seattle since 1992, originally from SF Bay Area
29,781 posts, read 54,440,540 times
Reputation: 31078
Quote:
Originally Posted by mathjak107 View Post
medicare pays for a very limited time under certain conditions . nor do they pay for assisted living .
They pay for post-surgery convalescence homes for a week or two, but Medicaid is state, not federal.
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Old 09-15-2017, 04:53 PM
 
71,531 posts, read 71,712,424 times
Reputation: 49115
medicaid is a joint federal/state combo .certain things are mandated by the fed and other things are left up to the states .

"Medicaid
Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home care and personal care services."
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Old 09-15-2017, 05:00 PM
 
3,086 posts, read 820,707 times
Reputation: 1734
A number of posters seem to imply that because have purchased LTCi, they now have a full LTC plan in place. Surely, that is only one piece of the admittedly difficult planning? True enough that in the past many policies covered an unlimited period but today due to increasing costs the average benefit period is likely to be for three-years only down from the 5-year periods commonly purchased even a few years back.

Three-years doesn't BEGIN to address a worst-case scenario. From what I can see all that really is being protected are the assets that would have been expended during that benefit period minus the policy cost - particularly for the unmarried. And any actual dollar-cost benefits have to be offset against the burden on families attempting to manage and collect on policies at a time of peak demand 20 years from now.

No argument that much care provided by families is NOT reflected in the relatively short-duration nursing home stay stats. But how much of that care could, practically, be offset by LTCi?

For example, my grandmother had multiple nurses for a few years in her 80s. Would SHE have qualified for care under a policy? Doubtful. Sure, she used nurses to dress her for outside activities but that was only because my grandmother chose girdles and formal clothing with jewelry and the like. There were a few nighttime accidents with required clean-up due to procrastination (compounded by diuretics) but no Depends nor incontinence. And she was quite mentally sharp, spending her evenings and nights alone. For HER, the money invested outside of an LTCi policy (even with a much lesser overall potential return) proved wise.

She needed cooks and drivers and housecleaners and folks to steady her on steps (but NOT to or from bed, or into wheelchairs). And maybe a weekly nurse visit to consult on meds or accompany her to the doctor and take blood pressure and the like. (No family members lived local and she outlived her good friends.)

In my case, I can easily self-insure for a number of years. In a worst-case scenario, would adding another 3-years of insurance coverage onto that number make a meaningful difference in any outcome? Doubtful.

If you have children (I have one, no spouse though), the reality is that this IS a family-based decision - if only to involve offspring in (best scenario) managing your future care or assets and/or (worst-case scenario) directly providing hands-on care or financial support. My daughter still is in college (interested in gerontology), unmarried but in a long-term relationship (who knows). The probability is high that she will continue to remain local in our close-in location to an economically-vibrant city. My health is excellent.

It's time to start planning for various scenarios but it's too soon (for us) to predict the likelihood of the assorted outcomes and implement steps. Many of my peers (single mothers, with assets and children) have the ability to pay for services but the extent to which they do so may well depend on the preference of their kids depending on the situation at hand.

The danger here - that I've already seen among friends - is the reluctance of the elderly to spend money they have on needed care or the inability of their children to recognize that parents can no longer adequately cope. So, yes, communication and planning early-on is important - for all scenarios.

LTCi is just too much of a gamble with it's own sets of problems. And for "just" 3-years?

Our current condo (location, transportation options, walkability, stores, restaurants, sports facilities) replicates an excellent CCC - at a much cheaper cost. The condo itself is "little old lady friendly" - and if need be can be made more so with a chair-lift on the stairs and a handicapped shower. In still in my early 60s - I'm too "old" for cheap LTCi (I've been evaluating it for years, always with a negative result) but too "young" with a kid in college living at home to make "senior" decisions. Depending on health and my daughter's preferences as her adult life forms I may stay here OR perhaps choose a CCC, which is another form of LTCi.

And, yes, a worst-case scenario could depending on future health costs result in a Medicaid "spend down." Plenty of assets or not. But absent a couple of million dollars, that's just reality.
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Old 09-15-2017, 05:04 PM
 
71,531 posts, read 71,712,424 times
Reputation: 49115
we bought our partnership plan for the benefits after the 3 years coverage is up , not the 3 years coverage .

once the insurance is up we have 100% asset protection , no look back ,no spend down , stay at home spouse's income has no limits . we just pass the bills over to a special version of medicaid to pay as part of our deal .

while NY and Indiana have 100% asset protection , other states offer limited asset protection plans . if they spend 500k in care 500k in assets is protected .

Last edited by mathjak107; 09-15-2017 at 05:18 PM..
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Old 09-15-2017, 05:46 PM
 
Location: Coastal Georgia
37,103 posts, read 45,622,935 times
Reputation: 61718
I do not even need to read all the posts to know I don't want to go to assisted living. I belong to a service club and was roped into delivering holiday cards to two local facilities. One was upscale and very nice. One was not.
Even in the upscale facility, the patient's had no privacy. Those who still had a few marbles could interact and participate in activities, but they still had to do so among others who were out in the ozone. In the lower scale facility, the patients were well cared for, but it was dismal.

It is my hope to age in place, near to, but not dependent on my kids. Alas, I guess all the poor old loonies felt the same.
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Old 09-15-2017, 05:50 PM
 
3,086 posts, read 820,707 times
Reputation: 1734
Quote:
Originally Posted by mathjak107 View Post
we bought our partnership plan for the benefits after the 3 years coverage is up , not the 3 years coverage .

once the insurance is up we have 100% asset protection , no look back ,no spend down , stay at home spouse's income has no limits . we just pass the bills over to a special version of medicaid to pay as part of our deal .

while NY and Indiana have 100% asset protection , other states offer limited asset protection plans . if they spend 500k in care 500k in assets is protected .
Yeah, but mathjak, living in NY you have an unusual situation - best-case scenario. Just like most local retirement programs don't begin to offer the benefits that NYPD receives (another post on the forum!), most states don't begin to offer what NY does.

Last weekend, I was helping a friend evaluate long-term care for her disabled daughter. So much comes down to the State - in her case, tragically so.

I'm single. What does our state's limited asset protection plan (dollar for dollar) really DO for me? Practically? Sure I can protect the asset amount equal to that covered by LTCi (minus, of course, what I spent) before qualifying for Medicaid. But what good are those assets at that point in my life? For I'm now in a nursing home on Medicaid, probably pretty much incapacitated given the pre-nursing home care I would have separately funded.

Sure, it's money that would eventually pass my heir. But if my main concern is her future, I'm far more interested in setting up a trust that would survive me - and provide future protection against lawsuits, divorce etc. for her. The trust would primarily be for *that* benefit not to protect assets for Medicaid - since I'd still have a substantial amount for future care and (admittedly) am rolling the dice that I won't need an "excessive" amount.

It's all a gamble. The key is to figure out for YOUR situation (both familial and monetary and the state you reside in) what makes the most sense. Not easy.

Edited to add - Not having investigated this, I've no idea what access my heir would have to the protected assets during my lifetime. Not a spousal-situation with joint accounts. Assuming say a worst-case scenario of 10 years, I'd want her to access these protected assets to perhaps buy a home etc.

But I'm now totally incapacitated, won't be able to myself use the assets in the nursing home, but presumably absent future planning not be competent to transmit them to the heir? I assume this issue would be worked out prior to committing to one of the a limited asset protection plans ... Maybe it's possible to transmit them somehow once the LTCi amount is finished up and Medicaid approved. Still, though, my guess is that I'd feel "safer" with a trust set up prior to my having become incapacitated.

Last edited by EveryLady; 09-15-2017 at 06:40 PM..
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Old 09-16-2017, 04:45 AM
 
1,137 posts, read 569,984 times
Reputation: 4370
Quote:
Originally Posted by Crashj007 View Post
That's possible only if you hire your own hitman.
Other ways too. You haven't tasted my cooking.
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