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Interesting article in the NY Times on the assisted living industry. Apparently it has grown significantly the last few years. The article points out that it is based on the hope that seniors have that they can be mostly independent with just a little assistance, but that it is hard to deliver on that promise because people often need more than just a "little" assistance.
Basically, growing old is hard. I have no idea what DW and I are going to do when we can no longer manage on our own. We have no close family, so it is all on us to figure it out.
I have seen the amount of people AND costs rise like crazy. My Aunt was in a nice one at $2,800 a month. She'd paid into a fund for 25 years. Then the costs grew and they had a cutoff so she had to move a few times. Near me is another such place, $10K a MONTH for a couple, $6500 for a single individual....Someone is sure making bank!
I have seen the amount of people AND costs rise like crazy. My Aunt was in a nice one at $2,800 a month. She'd paid into a fund for 25 years. Then the costs grew and they had a cutoff so she had to move a few times. Near me is another such place, $10K a MONTH for a couple, $6500 for a single individual....Someone is sure making bank!
I doubt that it's that easy to get rich on housing The Old and The Incontinent (maybe that's a name for a new soap opera), but without seeing the books I lack any kind of well-formed opinion.
It sure makes the idea of checking out retirement homes in Thailand sound better though.
I take my father regularly for his appointments and I can't tell you how many times I see people dropped off for appointments who truly need an advocate. The idea that shuttles can take the place of a loved one accompanying a patient is a myth.The other week there was one woman who was dropped off who could barely shuffle with her walker. The receptionist assumed I was with her and gave me her chart to fill out. I felt so bad for that poor woman. This happens all the time.
And yes, there will come a time when the "stuff hits the fan" and you need an advocate, as assistants are NOT your relatives, nor do they really have any power (or obligation) to take care of you and make the major decisions for care. If you don't make plans to arrange this the state can and will step in to do it and there are horror stores of predators taking advantage of people in these situations (even taking over their estates).
Where I work they will give them a ride to the door of the office and they have to go in on their own volition. They're in their late 80's to late 90's. Families no where to be found, working or don't want to do it. When they come back, they have no idea of what was said or anything else. Some do hire companions for 20 bucks an hour to drive them there and stay in appt and drive them back.
In my personal experience, all assisted living facilities bill for added services. If you require med management, that's extra. If you're in a wheelchair and need staff to push you around, that's extra. If you're incontinent and need Depends and someone to wipe your butt, that's extra. The base level service is cleaning your apartment weekly, doing laundry weekly, meals in the dining room, and the organized activities. Everything else requires added labor and they have to charge for it to cover their costs plus the profit on it.
The smallish (36 residents) AL where we had my MIL was all-inclusive. One cost for everything. Medication management was MANDATORY for all patients. They received their prescriptions in predosed packets from a special pharmacy and the nurses dispensed them at the required times. You did have to be mobile, with or without a walker, or able to mount/dismount and propel your own wheelchair if non-ambulatory. Bathing care, massage, dressing assistance, assistance with PT, exercise classes, all included. RN on staff 24/7, weekly rounds by a local gerontologist billed to Medicare if needed. Haircuts and manicures were extra. And we found the cost very reasonable as these places go. The facilities were nice enough, not as luxurious as some places we saw, but very clean and in good repair. Activities were limited but available (daily devotions, bingo, crafts, card games, book club, birthday/holiday parties, etc). The staff was friendly and quite communicative. All staff were locals and all fluent in English. They treated the residents like their own Grandmas and Grandpas. We were there at least weekly, often multiple times a week on an unscheduled basis, so we saw their interactions first hand, and were on a first name basis with everyone from the CNAs to the director. And the BIG bonus, it was a 10 minute drive from our home!
Everyone should have an “exit†strategy. Personally I do not understand the desire to cling to life when the quality of that life is declining and headed for a comatose state. Could it be the growth in assisted living facilities is fueled by a need to assuage guilt? Available Medicaid funds?
Everyone talks about this exit strategy but I think 99% plus of people are too cowardly or other things.
So I think we really have to consider what the millions before us did...which is usually nothing. Even when given the legal choice (some states and countries) a very tiny percentage do so.
I like to think I'd end this way....but I wonder if guilt will stop me? Society really pulls a trip on people who exist stage left.
In my personal experience, all assisted living facilities bill for added services. If you require med management, that's extra. If you're in a wheelchair and need staff to push you around, that's extra. If you're incontinent and need Depends and someone to wipe your butt, that's extra. The base level service is cleaning your apartment weekly, doing laundry weekly, meals in the dining room, and the organized activities. Everything else requires added labor and they have to charge for it to cover their costs plus the profit on it.
That's what I found too when looking for my Dad. He was actually very independent - with the exception of cooking, cleaning, and he was no longer driving. Plus, he was very lonely.
We looked at a beautiful facility where they talked up their weekly happy hours, weekly trips to the city (if you want); their great chef, etc.
It seemed like the kind of thing that I would like when I get that age - but ultimately my father was not interested.
Like you said - everything was extra. He had a woman who came daily and she did his laundry, helped him balance his checkbook, drove him wherever he wanted to go, etc. He decided he needed her more than the ALF.
Maybe the words "assisted living" differ from state to state or even within a state because the place where my relatives lived in CT had a lot of healthy people who just didn't want to cook or clean anymore. They drove their cars and my uncle even started a community garden. One of their friends was a recent widower who didn't know how to cook and was lonely. My relatives helped him and he became more and more independent and finally moved back out on his own.
My relatives eventually moved out into their own condo with a little backyard so they could have a garden. In the assisted living place there were no activities. It was mostly a very fancy, spacious apartment in a gorgeous building with a restaurant. You even had to do your own laundry down the hall. And it cost a small fortune!
Then again, I have a relative now who is in a dementia unit and it's termed "assisted living" but it's much more than that because she receives nearly constant attention, a full calendar of activities (mostly things designed to keep her mind active, but also dancing, live entertainment, gardening, outings in the van, etc.)
They do charge extra for a medication and incontinence package and there will be extra charges when she needs help bathing.
I've also had relatives who probably went to assisted living to die. They were too sick to live alone, went to assisted living, and died there. Probably a nursing home would have been better but they chose assisted living.
This was all in MA except for the relatives who moved in so they wouldn't have to cook and then moved to a condo instead. There was nothing wrong with them physically. That was in CT. Very expensive rip off.
The dementia place is EXPENSIVE but OMG, what don't they do for her! She has no idea where she is but man, oh man, is she ever HAPPY! (Who wouldn't be when they are 76 yrs old and a real live Elvis impersonator comes to entertain them and ends up crooning to her personally, takes her hand and they both stand there, arms linked and singing into the microphone, and finally he ends up dancing her around the room, with both of them laughing.) Definitely worth the money for her.
When we get past a certain age, there are far more women on dating sites than men.
I'm not talking about the sorts of dating sites oriented towards cat owners.
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