Retiring on a literal shoestring: support group (celebration, 55, grandparents)

[MotleyCrew]

Originally Posted by newenglandgirl

I am already checking out affordable alterntives to nursing homes, though I am not near the time. The average decent nursing home is 4 grand a month. This is ridiculous. and some even at this rate are found to be negligent in some way.

I think that a smart boomer would buy a 10 bedrm house in a college town and have several nursing students live there for free in exchange for looking out for them with a registered nurse coming by once a week for meds, bp, routine checkps on the residents. Maybe a college student live-in as a cook, making very simple vegetarian meals (much of the nursing home food is questionable at best). Each resident or their family would kick in maybe $1500/mo incluing all property costs and food. The elders if qualified could perhaps get food assistance. They could have a living room for visits. They could be near a senior center for activities.

That way they (we) could age in place, without the outrageous costs. The boomers are going to be flooding nursing homes and driving up the costs. It's going to be a really tough situation. Also when aging boomers try to sell our houses to pay for nursing homes there will be a glut of housing on the market and if we can't sell we;ll be forced to forego nursng home care anyway! AARP and other elder organizations had better take notice and think up some smart plans about keeping old folks in regular residences with drop-in or live-in medical assistance.

The assisted living centers in AZ run between $2,100 to $2,800 a month and that includes a little studio apt, 3 meals served in a restaruant type dwelling and health checks 24/7, as well as transportation. The ones on the lower end of the spectrum are private homes that take in elderly. If you need more assistence, like memory care, then the room starts at $3,800 for a private studio and a little less if you have a roommate. I still think this will be out of our reach when we are at that point. I think we will just kindly get off the planet early and out of the way. In my humble opinion, AARP is worthless.
Your ideas on the 10 room house are good ones, but sadly I think that the liability issues keep many good hearted investors out of the loop. I would think the insurance would be prohibitive in many cases. You would need a licensed RN 24/7 to keep tabs on the residents and that gets pretty expensive.

[livecontent]

Actually there really is no substitute for nursing home care for some residents who require extensive care, as my mother. The minimal rate for the nursing home, she is at, is $218 a day for semi-private room. If you break it down by the hour, it comes to $9.00 a hour. You can never provide that level of care, at home, with 24 hours of RN services and other additional specialty medical and non-medical staff with very expensive equipment to maintain a seriously ill resident. Now this nursing home is in the upper tier of facilities but you can find nursing homes for about $160 a day. Our cost is $255 a day because it is a private suite. I think that is terribly expensive but there were no single rooms at $230 a day--the waiting list was years. We were lucky to even get the suite, which is just a bigger room with a private bath. There are suites in the area that are about $400-450 a day--think about that.

There are already exist alternatives for patients who do not need full extensive care which provides care at home--such as the PACE program
Medicare.gov - Program of All Inclusive Care for the Elderly (PACE)

The issue is not whether you will have care because if you have money, you can pay. If you do not have the funds then you will be taken care under Medicaid. The big issue is that we need to fund and build more nursing home facilities so you can easily find a bed when it is necessary. Also, with more beds, there may be more competitive rates.

The Feds do fund nursing homes through low interest loans and grants and consequently requires acceptance of Medicaid patients. We need to have more funds available and we need to look at the thresholds of acceptance to Medicaid, so that people can maintain more assets and still have care. Obviously, we have to better fund Medicaid instead of bonuses to the greedy New York Bankers.

In addition, I think that we need to move to build nursing homes with single rooms and allow Medicaid to fund that option, where today only semi-private rooms are paid. Many hospitals are moving to single smaller rooms and those patients are mostly temporary. To expect elderly people to share a room, long term for the rest of their lives, is just not a good policy.

You will find when you start looking for nursing home care that competition for single rooms is brutal and you better have money to coerce or bribe--because that is what it takes. Do you really think that the the pampered, spoiled baby boom generation will want to live with a roommate in a dorm nursing room--it is going to get much, much worse.

Just to add, the care of the nursing home that we selected is excellent. The facility is new and bright, on one level with patios and gardens. It has a good staff to patient load. In addition to Long Term Care (LTC), It has a very extensive rehab facility as it provides a Skilled Nursing Faciilty (SNF) care under Medicare. The contract with Kaiser Permanente is big, so that the Physicians and Nurse Practitioners have their own office and they are there everyday. Not all nursing homes are the same; you have to real conscious of what you are selecting.

Livecontent

[MotleyCrew]

Originally Posted by livecontent

Actually there really is no substitute for nursing home care for some residents who require extensive care, as my mother. The minimal rate for the nursing home, she is at, is $218 a day for semi-private room. If you break it down by the hour, it comes to $9.00 a hour. You can never provide that level of care, at home, with 24 hours of RN services and other additional specialty medical and non-medical staff with very expensive equipment to maintain a seriously ill resident. Now this nursing home is in the upper tier of facilities but you can find nursing homes for about $160 a day. Our cost is $255 a day because it is a private suite. I think that is terribly expensive but there were no single rooms at $230 a day--the waiting list was years. We were lucky to even get the suite, which is just a bigger room with a private bath. There are suites in the area that are about $400-450 a day--think about that.

There are already exist alternatives for patients who do not need full extensive care which provides care at home--such as the PACE program
Medicare.gov - Program of All Inclusive Care for the Elderly (PACE)

The issue is not whether you will have care because if you have money, you can pay. If you do not have the funds then you will be taken care under Medicaid. The big issue is that we need to fund and build more nursing home facilities so you can easily find a bed when it is necessary. Also, with more beds, there may be more competitive rates.

The Feds do fund nursing homes through low interest loans and grants and consequently requires acceptance of Medicaid patients. We need to have more funds available and we need to look at the thresholds of acceptance to Medicaid, so that people can maintain more assets and still have care. Obviously, we have to better fund Medicaid instead of bonuses to the greedy New York Bankers.

In addition, I think that we need to move to build nursing homes with single rooms and allow Medicaid to fund that option, where today only semi-private rooms are paid. Many hospitals are moving to single smaller rooms and those patients are mostly temporary. To expect elderly people to share a room, long term for the rest of their lives, is just not a good policy.

You will find when you start looking for nursing home care that competition for single rooms is brutal and you better have money to coerce or bribe--because that is what it takes. Do you really think that the the pampered, spoiled baby boom generation will want to live with a roommate in a dorm nursing room--it is going to get much, much worse.

Just to add, the care of the nursing home that we selected is excellent. The facility is new and bright, on one level with patios and gardens. It has a good staff to patient load. In addition to Long Term Care (LTC), It has a very extensive rehab facility as it provides a Skilled Nursing Faciilty (SNF) care under Medicare. The contract with Kaiser Permanente is big, so that the Physicians and Nurse Practitioners have their own office and they are there everyday. Not all nursing homes are the same; you have to real conscious of what you are selecting.

Livecontent

I brought my 94 year old mom home for a while, until we can figure out a place for her. Home health care seems to be just as expensive as the facility, if not more so. Medicare will pick up the tab if it is doctors orders for thearapy and such, but if you are a private payer, then ouch. My husband and I will probably draw up some "end of life" instructions for our kids to take the guilt off their shoulders when we come to that road. I will not go to a skilled nursing center or memory care. Alz units can run up into the $7,000 range so I see a system now in place for only the uber rich or the very poor. Glad you have your mom in a good facility LiveContent.

[mzfroggez]

Originally Posted by MotleyCrew

I brought my 94 year old mom home for a while, until we can figure out a place for her. Home health care seems to be just as expensive as the facility, if not more so. Medicare will pick up the tab if it is doctors orders for thearapy and such, but if you are a private payer, then ouch. My husband and I will probably draw up some "end of life" instructions for our kids to take the guilt off their shoulders when we come to that road. I will not go to a skilled nursing center or memory care. Alz units can run up into the $7,000 range so I see a system now in place for only the uber rich or the very poor. Glad you have your mom in a good facility LiveContent.

A similar line of thought was expressed by a pretty young guy (maybe 22 years old) on the retirement thread - I believe he said he didn't want to live to be "old" and it caused quite a ruckus. Others either in that thread or in another talked about the bleak outlook for aging and why they didn't want to go there, based on either the media hype today or what they were witnessing with parents and/or grandparents. I actually can relate to much of what they were saying.

I am thinking of aging and the subsequent issues that arise maybe with a pollyanna mentality but the alternative is......???????? When I read about the cost of nursing homes, assisted living, memory care units etc, well, I'm not going to think on those things and I'd agree with Motley Crew's approach/I'm going to draw up something as well as talk seriously to my kids (we've already had some of these conversations) about quality of life and all that stuff.

I spent this time last year working with an aunt (my mother's youngest sister), figuring out places she could go as living in her apt appeared not to be an option any longer. In the process, we discovered she was living like a pauper but needn't have. She had sufficient funds and I arranged, at her request, to get her into an independent living situation. I'm assuming she went down hill or something because things got very weird after that and I bowed out, turning the situation over to "her favored niece" and saving my poor mom the agony of hearing about how I was botching everything up (no good deed goes unpunished).

But I got a glimpse of the various stages of institutional aging for the well-off as well as for the not-so-well-off and frankly, it offended my sensabilities at the incredible cost if you could afford it as well as the inequity of decent living conditions for those who were less-financially set. Perhaps one could say that there will always be disparity in what people have but it should offend us when we see elderly people warehoused. It should offend us when we see any age group warehoused. It is exceptionally pitiful to think that that is where a life of living can end.

So with that said, I'm not going to blow what I have saved but I'm also not going to fret about what is to come - I can't "redo" my life now to have enough to put away to insure myself against what might happen. I wasn't totally frivelous by any means but made some good decisions and some bad, and then of course, life happens and throws you a few curves.

Actually, after having owned homes and figuring that nest egg, I got caught in the downturn of the economy and lost that/suddenly, there is no "paid off home" so expenses will naturally increase though my available cash likely will not. While home ownership is a pain in the neck in many ways, the idea of a more fixed debit side of life could be comforting (I'm trying to feel better by figuring in the issues of property tax/homeowner's ins/things that break and go bump in the night, all of which are less insidious when renting although in time, they do pass over to the renters by the landlord's need to make a profit on investment)

I'm enough of a "boomer" to say something is not right with this picture. I hope that there are enough of my generation to be bothered by it that maybe we institute some changes in what appears to be the coming state of affairs.

This is lengthy but honestly, I think when quality of life is dictating that my children go bankrupt in order for me to receive humane care or I have to go into a totally spartan existance for the next 15/20/30 years in order to be treated decently for the following 10, well, I'll just opt to not take medications that are keeping me alive and just close my eyes. I have to figure that a natural event would follow such an approach in due time. If this is a worse alternative than what I'm hearing on this board, I don't see it.

[Umbria]

Originally Posted by triciajeanne

A similar line of thought was expressed by a pretty young guy (maybe 22 years old) on the retirement thread - I believe he said he didn't want to live to be "old" and it caused quite a ruckus. Others either in that thread or in another talked about the bleak outlook for aging and why they didn't want to go there, based on either the media hype today or what they were witnessing with parents and/or grandparents. I actually can relate to much of what they were saying.

I am thinking of aging and the subsequent issues that arise maybe with a pollyanna mentality but the alternative is......???????? When I read about the cost of nursing homes, assisted living, memory care units etc, well, I'm not going to think on those things and I'd agree with Motley Crew's approach/I'm going to draw up something as well as talk seriously to my kids (we've already had some of these conversations) about quality of life and all that stuff.

I spent this time last year working with an aunt (my mother's youngest sister), figuring out places she could go as living in her apt appeared not to be an option any longer. In the process, we discovered she was living like a pauper but needn't have. She had sufficient funds and I arranged, at her request, to get her into an independent living situation. I'm assuming she went down hill or something because things got very weird after that and I bowed out, turning the situation over to "her favored niece" and saving my poor mom the agony of hearing about how I was botching everything up (no good deed goes unpunished).

But I got a glimpse of the various stages of institutional aging for the well-off as well as for the not-so-well-off and frankly, it offended my sensabilities at the incredible cost if you could afford it as well as the inequity of decent living conditions for those who were less-financially set. Perhaps one could say that there will always be disparity in what people have but it should offend us when we see elderly people warehoused. It should offend us when we see any age group warehoused. It is exceptionally pitiful to think that that is where a life of living can end.

So with that said, I'm not going to blow what I have saved but I'm also not going to fret about what is to come - I can't "redo" my life now to have enough to put away to insure myself against what might happen. I wasn't totally frivelous by any means but made some good decisions and some bad, and then of course, life happens and throws you a few curves.

Actually, after having owned homes and figuring that nest egg, I got caught in the downturn of the economy and lost that/suddenly, there is no "paid off home" so expenses will naturally increase though my available cash likely will not. While home ownership is a pain in the neck in many ways, the idea of a more fixed debit side of life could be comforting (I'm trying to feel better by figuring in the issues of property tax/homeowner's ins/things that break and go bump in the night, all of which are less insidious when renting although in time, they do pass over to the renters by the landlord's need to make a profit on investment)

I'm enough of a "boomer" to say something is not right with this picture. I hope that there are enough of my generation to be bothered by it that maybe we institute some changes in what appears to be the coming state of affairs.

This is lengthy but honestly, I think when quality of life is dictating that my children go bankrupt in order for me to receive humane care or I have to go into a totally spartan existance for the next 15/20/30 years in order to be treated decently for the following 10, well, I'll just opt to not take medications that are keeping me alive and just close my eyes. I have to figure that a natural event would follow such an approach in due time. If this is a worse alternative than what I'm hearing on this board, I don't see it.

Excellent post!! I often wonder what I'm going to do with no kids to keep on eye on things if I end up in such a warehouse. That isn't living. I saw a documentary once about both elderly people and those with terminal diseases. This group (a hugh group) of people had been planning how and when they would each leave this world. It wasn't a bunch of crazies, but very calm people that had thought this all through. Living their final months/days in pure hell wasn't going to be an option for them. I have to say, I agree with this thinking.

[Minervah]

Originally Posted by MN2CO

Excellent post!! I often wonder what I'm going to do with no kids to keep on eye on things if I end up in such a warehouse. That isn't living. I saw a documentary once about both elderly people and those with terminal diseases. This group (a hugh group) of people had been planning how and when they would each leave this world. It wasn't a bunch of crazies, but very calm people that had thought this all through. Living their final months/days in pure hell wasn't going to be an option for them. I have to say, I agree with this thinking.

Same here as far as the "no kids" thing. I do have two sisters but I don't know if I could depend upon them for help. One thing good about Oregon that I will miss is they have assisted suicide. I have known a couple of people who signed up for it and of others who know people who have used it.

It makes sense to me. We humanely put our pets down when they are on their way out so they will not suffer. Why not extend that dignity to all humans?

[Minervah]

Originally Posted by livecontent

You are my kind of woman. I love figure skating. Keep in mind that the Headquarters of the Olympics is in Colorado Springs Colorado Springs Olympic Training Ctr | Team USA and the Headquarters of the US Figure Skating Association http://www.usfsa.org/About.asp is located at this site with a national museum and hall of fame.

Livecontent

Wow, that is great. Now I have to pay a visit to Denver.

[SCBaker]

Originally Posted by MN2CO

Excellent post!! I often wonder what I'm going to do with no kids to keep on eye on things if I end up in such a warehouse. That isn't living. I saw a documentary once about both elderly people and those with terminal diseases. This group (a hugh group) of people had been planning how and when they would each leave this world. It wasn't a bunch of crazies, but very calm people that had thought this all through. Living their final months/days in pure hell wasn't going to be an option for them. I have to say, I agree with this thinking.

Excellent posts from all of you. I had this same conversation with my new neighbor just the other day.

The brutal reality is we are on our own. Yes, AARP is a joke. Endorsing worthless overpriced products to line their pockets with cash. The final blow, endorsing the President's health care plan which was going to cut medicare.

No middle or upper middle class person is ever going to be able to afford, in home care, assisted care or nursing home care. Working for a company for 40 yrs. and walking away with a nice sized pension has been gone for many years. Even if we have caring children, I don't think they are going to be able to help much in the future. One day soon, the politicians are going to have to stop worrying about getting re-elected and make the tough choices in order for our country to survive. Significant cuts in social programs, SS, medicare, medicaid and such. Just my opinion.

In order to qualify for medicaid you can not have more than $200.00 or $250.00 in assets. They will not take your home if your spouse needs it to live in. Maybe we should all pray for a terminal illness, with no more than 6 months to live. Then we can go into hospice care for free.

[brightdoglover]

Speaking strictly for myself, I have always assumed I will rationally suicide if and when my circumstances don't work for me. I have no religious issues with it. I have worked with demented patients and there is no point *in my mind for me* with living into anything remotely like that. I have advance directives, have spoken to my lawyer, told my health care proxy (an old friend) "if in doubt, pull the plug." That refers to any terrible compromise before old age, and into old age, if I should get there. (Genetics would suggest I will).
I say this for myself only. I am not trying to say that old or compromised old people's lives are not worthwhile. I am only saying my own wouldn't be worthwhile to me under some circumstances.

[Bideshi]

Is this really what we have come to in America? Is this the reward for hard work all of our lives? Suicide so we're not a burden on society?