snowbunny

I'm now in the process of looking for a place for my father to live. He needs 24/7 assistance - but not medical assistance. I'm learning what a "transfer" is - from the bed to the wheelchair, from the walker to the toilet, and so on. He is a very high fall risk which makes this necessary.

It is cost prohibitive to have someone come into my home while I'm away at work. Shuffling him back and forth to my brother's would be dangerous and confusing and we'd still have the same problem of affordability.

That leaves assisted living - well, actually a step up from that. We are very fortunate that my father has a long-term care policy that in theory will pay $3000 per month. That is, if they pay out - we haven't gotten that far yet. I've sent in my power of attorney just so I can sort that out.

In Austin, the average cost per month of a semi-private room is about $3500 per month. Depending on circumstances, it's possible that Medicare or Medicaid might pay some of the expense, but many places will not accept either - even skilled nursing homes. They like VA, but not Medicare/Medicaid.

So - if you intend to grow old here, and can qualify, get a long-term care policy. My father is lucky - he got his a while back when he was perfectly healthy and his has no lifetime cap though that will unfortunately not be an issue. There are plenty of people who can afford the $3000+ cost and you'll be competing with them. Unless you require skilled nursing care (care which can only be done by an RN or under an RN's supervision) Medicaid will pay nothing.

Jerseygirl

I'm sorry to hear about your dad SB. The risks of falling and the health complications that can arise are a huge problem for the elderly.

My mother has been through this in the last 12 months. For 8 months she was able to live at home with the help of 4 daily visits from carers. This was fully funded by UK social services. This year we had to look at care homes because she needed 24 hr care. She had no money but had property...normally the property would have to be sold to help pay the care home fees. Any pension or allowances received would also go towards the cost of the home.

My mother was assessed and was found to need continuous nursing care...therefore all costs were met by the social services/NHS. I believe this would be the case no matter how much money she had. This would be reviewed every 3 months. If at some point it was deemed she no longer needed continuous nursing care the money from the sale of her home would be used to pay for her care. If or when the money ran out the costs would be funded by the social services.

Edit: This link goes some way in explaining the UK system. The weekly cost for a private room in the care home was either just under £400 or £500...that was including 24 hr nursing care.

Englishtart

Pretty scary huh? My MIL was telling me, about a month ago, that their 'long term care' policy was about to run out, they can't afford the higher payments to renew it, so they are just having to let it go and hope they won't need it!

Rete

SB, sorry to hear about your father. It isn't easy, I know from personal experience with my father what you are talking about.

As difficult as it is growing older in the US, there are many things that must be remembered.

1. Life expectancies have increased for Americans. We are living 5 to 10 years longer than even 20 years earlier.

2. With longevity comes disease, both mentally and physically.

3. Children are no longer opting to homecare their elder parents in their homes which was the norm for our parents and their parents before them.

4. A good part of #3 above is due to high cost of living. Since two salaries are oft times needed to run a household, there is no adult at home to care for the elderly. Or, with woman's ability to pursue careers, there is no longer an adult at home to care for the elderly. Or, many adults are single when they are older and don't have the resources, i.e. apartments instead of houses, extra money, etc. to care for the elderly.

In Europe is it much better? Yes, I know about eldercare for those in the UK but in Germany it was not available for my aunt who died while sitting on the toilet at the age of 80 odd and whose body was not discovered for over a week since she never married and never had children and outlived all her friends.

Jerseygirl

I think this could happen anywhere. Sadly there are many elderly people who don't have anyone...or don't have anyone who cares.

Sally Redux

I have to say from what we have heard with my husband's family in the UK, the free care being provided is fantastic, I honestly don't know how the country can afford it. After a 'psychotic episode', an uncle is transferring home from a long hospital stay, apparently he has people coming in 4 times a day and helping him with everything. MIL (has Alzheimers) is in an interim nursing home as FIL needs a hip replacement, she will most likely need to stay somewhere long-term and no cost has been mentioned yet.

Very sorry to hear about your Dad, SB.

Rete

Oh I realize that. What struck me was the header "Growing Old in America". It isn't just America. It is a worldwide problem: How to Care For the Elderly.

Sally Redux

It is a worldwide problem, but elderly people on their own in the UK usually get free social workers/care assistants monitoring them.

snowbunny

This is especially a problem in developed countries where there's no government pay for long-term assisted living. Elsewhere, people don't tend to live as long, women are less likely to work outside the home, and families are larger, helping ease the burden.

However, I'd like to correct myself a bit. My father's illness tends to strike those in their 60s, but it can strike as young as 40 (gulp). There are single mothers caring for children with profound disabilities... how can they work to support the family?

The idea that all will be okayish so long as everyone's making an effort and working is simply not true. I've been reading up on caregiving and givers... and how much stress there is on them. If a family member, they are usually unpaid and yet cannot work. As a society, as taxpayers, do we simply turn our backs on this situation, or do we tax ourselves to help out?

I vote for the tax.

Englishtart

I know when I was the full time care giver for my Sister back in the UK, I got a monthly allowance from the benefits agency, it wasn't a lot, I think about 30 pounds a week or something, but it was better than nothing, I think that family members that stay home full time to take care of loved ones, are definitely worth paying a benefit too.

snowbunny

Yes - and there is some reimbursement for a family carer under certain circumstances. The trouble is when everyone's working, family members can't take off from work to caregive. It might be possible if you could shuffle the person in question around, but in my Dad's case this would be harmful to him.

Also, some spouses of older people are themselves limited in what they can do so can't be a carer for someone who has to be lifted, for example.

Englishtart

I understand, it is a real dilemma. We dealt with a little bit of the system here when hubbys (biological) Mom got sick, she had emphysema and needed breathing treatments, she moved into a long term care facility that took all the savings she had, plus the equity from the sale of her house. All that was left after she passed away was some cash she had managed to hide and put in envelopes for her two kids!

Definitely more support financial and medical in the UK (usually)

Dan725

Certainly makes you think. How does this long term care insurance work? Is it worth me getting now, for instance (in my 30's) - is it one of those things where if you buy a policy early, the premiums are fixed forever at a low rate, but if you buy it at say 60, its going to be verging on the unaffordable?

Yet another insurance to consider in the USA....

Steerpike

It's a worldwide problem, but as others have pointed out, there are unique challenges in the 'developed nations', and within those, the US has it's unique challenges.

As someone happy and successful here, and fully expecting to grow old here, this is not one of the better facts of life here. The recent healthcare reform is taking care (hopefully) of many issues ... Long term care is the next one I need to focus on. I don't mind buying insurance (and really should) as long as the b@stards don't try to wiggle out of delivering!

Michael

Generally hospice care (medical visits to your home if terminally sick) is covered by medicare but only 20 days in a nursing home is fully covered by medicare (an additional 80 days is partially covered if over $137.50 per day).

If you want extended nursing home coverage or assisted living care (currently not covered by medicare), you currently need to purchase that on the open market.

Generally the earlier you purchase that on the open market, the easier and cheaper it will be. However insurance policies for assisted living can be difficult since it can be hard to determine (fine print) when someone really needs assisted living.