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Old 01-17-2018, 10:21 AM
 
Location: Paranoid State
13,047 posts, read 10,445,912 times
Reputation: 15683

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Quote:
Originally Posted by charlygal View Post
No fighting. I was just astounded how a person with assets that can be liquidated (i.e sold) would want others to foot their bills. What about personal responsibility? Our nation has a regular discourse about getting rid of those mooching off of taxpayers. One type of mooching isn't better than another.
My goodness. The Theological Place of Eternal Punishment has indeed frozen solid: I agree with everything charlygal wrote.
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Old 01-17-2018, 11:16 AM
 
13,923 posts, read 7,416,674 times
Reputation: 25430
Quote:
Originally Posted by charlygal View Post
Wow. This attitude is somewhat appalling. Why not use the assets to pay for the needed care? Instead, you want aid because of low income? You want other people to pay for wealthy people?
Quote:
Originally Posted by SportyandMisty View Post
My goodness. The Theological Place of Eternal Punishment has indeed frozen solid: I agree with everything charlygal wrote.
I clicked back to see what the kerfuffle was about. Yep. I'm 100% in agreement, too.

I've always had a huge problem with "Medicaid planning" where you shift assets 5 years in advance and make them look poor to qualify for Medicaid-funded long term care. My state taxes pay for 50% of that and 25% of my state's budget is Medicaid. My Federal income taxes pay the other 50%.

With a married elderly couple? Sure. You don't want to make one of the homeless and poor because the other has a health event that lands them in a nursing home. ...but I think it's reasonable public policy for the state to claw back that money when the other spouse dies rather than pass it on as an inheritance. The law as it's written now is unreasonable. If I have a million dollar home, $100K in the bank, and nothing coming in but Social Security, Medicaid pays for my spouse. If I rent, have $1.1 million in the bank, and nothing but Social Security, I have to pay.

My mom has dementia and is in assisted living. She has 4 years left before her brokerage account hits zero at her current burn rate. I could have done Medicaid planning tricks three years ago to make that money vanish and she'd be parked in a nursing home now with Medicaid footing the slice of the bill that her pensions & annuities didn't cover. I don't think that's ethical. If my mom runs out of money, my sister and I will step in and fund the difference. We don't want to see our mother warehoused in a low quality nursing home that takes Medicaid.
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Old 01-17-2018, 11:37 AM
 
13,923 posts, read 7,416,674 times
Reputation: 25430
Quote:
Originally Posted by runswithscissors View Post
Do you live in Canada? None of this is correct. (other than the part about many seniors not having resources)

We don't have "personal care facilities" in the USA. Especially running $6000 per month. That is called an ALF here.

The guidelines are very clearly laid out in government standards for admissions (screening done by the ALF or Expanded ALF according to their policies of what they can provide) and insurance purposes, too. IE Identifying Activities of Daily Living (ADLs).

And you NEVER "turn over all assets" to an ALF or even what you are calling "personal care facility". Choosing to live in an ALF is like choosing to check into a hotel. Until the government gets involved.

You're mixed up with Medicaid - governmental taxpayer funded SKILLED Nursing Facility. Or some ALF permutation in a few states with Medicaid waivers/expansion.
Yep. And most ALF want to keep their paying residents until the last possible moment. Incontinence? No problem. You just pay more for the service. Bathing and potty? No problem. You just pay more for the extra service. Wheelchair? No problem. You just pay more for the extra service. Dementia? No problem if they don't wander. It pretty much takes being bedridden for them to ask a resident to move to a nursing home. An empty ALF apartment generates no revenue.

My mom's ALF bill is about $6K/month. She's in an apartment big enough to hold her Steinway parlor grand piano. When she declines to the point where she can't play the piano, I'll have to think about moving her but I don't want to do that now because she's settled where she is and the wheels will fall off if I move her. The last thing you want to do with someone with dementia is move them and break their routine. Hard to predict when that will happen. One month? 6 months? 2 years? In the mean time, I hire a couple people from the outside to keep an eye on her 4 days per week, run errands, and do things like bring her to the dentist.
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Old 01-17-2018, 12:42 PM
 
Location: Cushing OK
14,547 posts, read 17,553,017 times
Reputation: 16777
One thing I know is I don't want to go to some place filled with people. I don't like crowded places, not even crowded rooms. I'm an only child and Dad left us some months after his mind. I'm just 65 but I'm always tired, but that's due to loss of parts from surgeries. When I have energy and might want other people around it ends and I just want my own space and distance from people.

I'm also bipolar, though its type 2, and the liking to be alone and what some may call withdrawn are a big part of my version.

My Millenial son got married a few years ago, and just recently bought his first home. My dauther in law's mom lives with them and will continue to. We're sort of thinking when I'm in need of company and care, that I'll move in too. He's mentioned something like tiny houses for our own space, which I think would work for me. Not sure how all those people are going to make me want to be there.

I would really like to be near my son. I'd like Grandma to be there to know my grandchildren. I miss my family and all the people I grew up with and family is important. Sometimes I think about making it sooner, but where I live alone right now is quiet and cheap and overall I am good with it. I do get bored for other people sometimes, but haven't felt the need to get overly personal with the locals.

What happens in time does worry me. Dad lost his mind, but Dad had the main blood vessel to his brain so clogged it hardly worked, and that's and that why he lost it all. It was the one plus pack a day habit, which also restricted his breathing. I avoid smokers and having discovered with more gentle herbal anti hystamines don't get stuffy to often.

My kids now are my pets. My dogs, particularly the shepard mix who sounds as big as he is, provide wonderful security, and then settle down to give my cats a gentle bath.

I'm staying here for now since its financially the least expensive I could find, even if it is isolated. But eventually I'll talk to my son. Inside me, I can feel a pull even if its not really practical now.

Its also very affordable, and makes me self supporting with a bit over 1k from social security.

My daughter in laws people don't take parents and store them in commercial Homes, and it was made quite clear to me that when its time, I'm welcome. When I get lonely, I find myself really looking forward to being part of one. After losing my parents, my ex's family took me in as part of them, and I'm still one of the family. My son wants me to be part of his. I think of the options and it doesn't sound bad at all. But if I can't take good care enough of me, then instead of a 'retirement village' or an apartment in a building stuffed full of people with amenities I'd want to be with my son. And as I hate crowded places, all the amenities would not make up for there being TOO Many people.

I don't know how all of this will settle, just turned 65, but I think its very good to have things like this thread to talk about this with multiple point of views and experience.
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Old 01-17-2018, 12:54 PM
 
4,750 posts, read 4,032,774 times
Reputation: 9952
Quote:
Originally Posted by GeoffD View Post
I clicked back to see what the kerfuffle was about. Yep. I'm 100% in agreement, too.

I've always had a huge problem with "Medicaid planning" where you shift assets 5 years in advance and make them look poor to qualify for Medicaid-funded long term care. My state taxes pay for 50% of that and 25% of my state's budget is Medicaid. My Federal income taxes pay the other 50%.

With a married elderly couple? Sure. You don't want to make one of the homeless and poor because the other has a health event that lands them in a nursing home. ...but I think it's reasonable public policy for the state to claw back that money when the other spouse dies rather than pass it on as an inheritance. The law as it's written now is unreasonable. If I have a million dollar home, $100K in the bank, and nothing coming in but Social Security, Medicaid pays for my spouse. If I rent, have $1.1 million in the bank, and nothing but Social Security, I have to pay.

My mom has dementia and is in assisted living. She has 4 years left before her brokerage account hits zero at her current burn rate. I could have done Medicaid planning tricks three years ago to make that money vanish and she'd be parked in a nursing home now with Medicaid footing the slice of the bill that her pensions & annuities didn't cover. I don't think that's ethical. If my mom runs out of money, my sister and I will step in and fund the difference. We don't want to see our mother warehoused in a low quality nursing home that takes Medicaid.
Absolutely.
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Old 01-17-2018, 01:08 PM
 
Location: Exeter, NH
5,302 posts, read 4,404,069 times
Reputation: 5698
Home care is 1,000 times better. It is MUCH, MUCH, MUCH cheaper than rest homes (which charged over $8,000 a month 10 years ago here in NH, while robbing my dying father of his desperately-needed pain meds on a daily basis). You can fire those who provide lousy care, and hire family members if possible. In any case, the rest home takes pretty much every penny you have before the so-called "Safety Net" (Medicaid) starts.

With the endless Government's War on painkillers (and an endless supply of spoiled teenage druggies is just in time for the Baby Boom to get old), family members and the elderly are intimidated into joining Hospice, just to try and minimize their end-of-life suffering. Aside from the fact that it doesn't really help since the meds STILL get stolen, a simple infection (that could be stopped with $10 worth of penicillin) will end your loved one's life days or months before it is really necessary. Theoretically you could get out of hospice, but then you're back to begging for pain meds for the dying loved one every few hours, and somehow all that money they get won't buy nearly enough staff to distribute pain meds at night!
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Old 01-17-2018, 01:18 PM
 
5,397 posts, read 6,538,749 times
Reputation: 10468
Quote:
Originally Posted by nightbird47 View Post
One thing I know is I don't want to go to some place filled with people. I don't like crowded places, not even crowded rooms. I'm an only child and Dad left us some months after his mind. I'm just 65 but I'm always tired, but that's due to loss of parts from surgeries. When I have energy and might want other people around it ends and I just want my own space and distance from people.

I'm also bipolar, though its type 2, and the liking to be alone and what some may call withdrawn are a big part of my version.

My Millenial son got married a few years ago, and just recently bought his first home. My dauther in law's mom lives with them and will continue to. We're sort of thinking when I'm in need of company and care, that I'll move in too. He's mentioned something like tiny houses for our own space, which I think would work for me. Not sure how all those people are going to make me want to be there.

I would really like to be near my son. I'd like Grandma to be there to know my grandchildren. I miss my family and all the people I grew up with and family is important. Sometimes I think about making it sooner, but where I live alone right now is quiet and cheap and overall I am good with it. I do get bored for other people sometimes, but haven't felt the need to get overly personal with the locals.

What happens in time does worry me. Dad lost his mind, but Dad had the main blood vessel to his brain so clogged it hardly worked, and that's and that why he lost it all. It was the one plus pack a day habit, which also restricted his breathing. I avoid smokers and having discovered with more gentle herbal anti hystamines don't get stuffy to often.

My kids now are my pets. My dogs, particularly the shepard mix who sounds as big as he is, provide wonderful security, and then settle down to give my cats a gentle bath.

I'm staying here for now since its financially the least expensive I could find, even if it is isolated. But eventually I'll talk to my son. Inside me, I can feel a pull even if its not really practical now.

Its also very affordable, and makes me self supporting with a bit over 1k from social security.

My daughter in laws people don't take parents and store them in commercial Homes, and it was made quite clear to me that when its time, I'm welcome. When I get lonely, I find myself really looking forward to being part of one. After losing my parents, my ex's family took me in as part of them, and I'm still one of the family. My son wants me to be part of his. I think of the options and it doesn't sound bad at all. But if I can't take good care enough of me, then instead of a 'retirement village' or an apartment in a building stuffed full of people with amenities I'd want to be with my son. And as I hate crowded places, all the amenities would not make up for there being TOO Many people.

I don't know how all of this will settle, just turned 65, but I think its very good to have things like this thread to talk about this with multiple point of views and experience.
+1. Some differences but I get the idea
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Old 01-17-2018, 02:36 PM
 
13,923 posts, read 7,416,674 times
Reputation: 25430
Quote:
Originally Posted by NHartphotog View Post
Home care is 1,000 times better. It is MUCH, MUCH, MUCH cheaper than rest homes (which charged over $8,000 a month 10 years ago here in NH, while robbing my dying father of his desperately-needed pain meds on a daily basis). You can fire those who provide lousy care, and hire family members if possible. In any case, the rest home takes pretty much every penny you have before the so-called "Safety Net" (Medicaid) starts.

With the endless Government's War on painkillers (and an endless supply of spoiled teenage druggies is just in time for the Baby Boom to get old), family members and the elderly are intimidated into joining Hospice, just to try and minimize their end-of-life suffering. Aside from the fact that it doesn't really help since the meds STILL get stolen, a simple infection (that could be stopped with $10 worth of penicillin) will end your loved one's life days or months before it is really necessary. Theoretically you could get out of hospice, but then you're back to begging for pain meds for the dying loved one every few hours, and somehow all that money they get won't buy nearly enough staff to distribute pain meds at night!
Do the math on 24x7 home care. Around me, a CNA is about $20.00 to $25.00/hour through a home care agency that handles employment taxes, health insurance, workmans comp, unemployment insurance, and the rest of the list of expenses when you have an employee. 365 24-hour days at $20/hour is $175,200. You still have to pay all the ownership costs on the house. Taxes. Insurance. Utilities. Mowing the lawn. Building maintenance. In my state, the average cost of a private room in a nursing home is $140,000.
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Old 01-17-2018, 03:09 PM
 
2,840 posts, read 4,160,782 times
Reputation: 6889
None of us knows what tomorrow will bring or if tomorrow is the day that we will have a crisis. I think most of us would like to stay in our own home as long as we are able to take care of ourselves.

If you only need a little help (cleaning, shopping, etc.) on an occasional basis I think having home care is great. Hiring part time help and being able to keep up with your own finances, etc. is relatively safe. What happens if you have a stroke or significant health crisis and can't take care of yourself? I have heard (and seen) too many horror stories of home care givers that steal; that would not be an option for me. I would absolutely not want my children to take care of me. They have their own lives, jobs, etc. and I would not put that burden on them.

Unfortunately, most senior living places will not accept you in if you are not able to take care of yourself. I hope I will be able to go to a senior living place while I am still young and healthy enough to enjoy it!
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Old 01-17-2018, 03:31 PM
 
5,429 posts, read 3,452,633 times
Reputation: 13714
From what I've observed, the people who are willing to do food provision and actual cooking of a nightly supper can be different from the people who will do bathing, help in the bathroom, helping out or into bed, incontinence help, dressing, etc.

Sometimes the people who do the bathing, helping into bed etc will do some light cleaning, but that is not a given. Heavier cleaning? Laundry?

And people who do errands and grocery shopping may not be the same people who do bathing, bathroom assistance, etc. (grocery delivery & household items delivery are good as a separate service where available)

Interested in what others have experienced about the separation of duties among employees.
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