Assisted Living - oh my, it's expensive.

[Laurie4b]

I wonder, can they get a roommate who is not a caregiver but who could reliably call for help if needed?

 

My inlaws were that for each other until my FIL suddenly passed away.

 

Now we are in the tough position of MIL wanting (fiercely, as most elderly folks do) to stay in her home, but not really being safe alone, but not really needing facility-based care.  It's a conundrum for sure.  Thankfully a more or less long lost relative has stepped up to stay there for weeks at a time, but she is 80ish herself, so that is not a longterm solution.  And she has a life, and can't do this continuously.  We are still figuring it all out.  (FIL died last month, so it's all pretty new.)

 

Over the years I have built up connections in the area where they lived, and I am reasonably confident that I could find her a good placement in a home that would not be outrageously expensive, but I want to respect her wishes to stay at her own place.  She can't drive or safely navigate stairs, so she is housebound unless she has help.  DH is going back there for a week in May, and I'm stopping in for some time in June as a side trip on a trip to St. Louis.  BIL is spending time there as well.  But none of us is close by.  If only we could just pop over every day and do a little shopping and cleaning, and make sure she was OK, that would be so reasonable compared to flying 2000 miles OR driving 3-4 hours each way (BIL) or 7-8 hours each way (long lost rellie.).

 

This is why, if all our children move away, our own plan is to move near one of the kids. That could enable us to live independently for longer, but if we needed assisted living, someone could check in on us to make sure we are receiving appropriate care. 

 

We are currently in the drive-7-hours-one-way-once-a-month mode, coordinating with other siblings. 

[Katy]

Assisted living in the USA is a scam.  If they need any help, they should be in a nursing home, which do accept rather independent people but also are regulated and safety inspected and require licensed nurses.  Some licensed nursing homes offer assisted living sections, those are ideal.  Someone checks on them regularly and the move to more care is much more seamless.

 

Please watch this PBS Frontline episode about the dangers of assisted living before you let anyone you care about move to an assisted living facility that is independent and not connected to a licensed nursing home with actual RN staffing.

 

http://www.pbs.org/wgbh/frontline/film/life-and-death-in-assisted-living/

[Spryte]

Wow, what happens when one spouse needs assisted living/nursing home and the other doesn't, but the healthier spouse isn't able to care for the other? Do they have to deplete their joint assets?

I'm the OP, and not as experienced as some here but from my small amount of research it's possible for one spouse to preserve some assets - up to $120K - in several states. I'm sure that varies.

 

ETA: that's if the spouse preserving assets is not applying for Medicaid. If both are, then no assets to speak of.

Edited April 23, 2017 by Spryte

[QueenCat]

Wow, what happens when one spouse needs assisted living/nursing home and the other doesn't, but the healthier spouse isn't able to care for the other?  Do they have to deplete their joint assets?

 

Not completely. From what I remember, the home is safe as long as one spouse is still living in it. And a certain percentage of any income (pensions, social security, savings, etc) is still there for the healthy spouse.

[QueenCat]

Do they need nursing care? Or would an assistant be adequate? 

 

Usually the sticking point is meds because states often regulate who can give meds---even though we all give them to ourselves and our dependents and our parents if they are around. 

 

Meds can be given in assisted living. My parents are in assisted living and someone comes to give them their meds as needed. They aren't allowed to do it themselves.

[Spryte]

Assisted living in the USA is a scam. If they need any help, they should be in a nursing home, which do accept rather independent people but also are regulated and safety inspected and require licensed nurses. Some licensed nursing homes offer assisted living sections, those are ideal. Someone checks on them regularly and the move to more care is much more seamless.

 

Please watch this PBS Frontline episode about the dangers of assisted living before you let anyone you care about move to an assisted living facility that is independent and not connected to a licensed nursing home with actual RN staffing.

 

http://www.pbs.org/wgbh/frontline/film/life-and-death-in-assisted-living/

I'll watch it. They are only looking at places that do assisted living, nursing home, and memory care. There have been Rns at each, and usually multiple docs there weekly.

[FaithManor]

Just so you no. Licensing means pretty much nothing in some states.

 

The two local nursing homes are fully kicnsed. They also abuse and neglect their patients and have hundreds of complaints against them, with charges brought by the county prosecutor.

 

Nothing gets done. Nothing. She old same old. Residents laying in body fluids, unfed, unmedicated, bed sores are the norm.

 

They yell at and slap the residents. Occasionally a lowly orderly is made a fall guy and gets fired, does 30 days in jail. But the state does not give a crap so long term, the suffering continues. Many of the residents have no family living nearby, often none even in the he state because due to the economy and lack of jobs, families have left the area and the state. With no one to watch over them and Lansing not giving a rip, they are at the mercy of their abusers.

[Carol in Cal.]

Yup. My mother's assisted living ran around $9,000/month because she was in the memory unit. She had long-term care insurance that would have covered half of that, but my sibling never filed for it.

I think it would be worthwhile to investigate whether a late filing for reimbursement could be made, on behalf of her estate.

[TechWife]

A couple close to us needs to move to assisted living. They are currently in a faculty that offers it, though they are in the independent section. But their facility will no longer offer assisted living after June 1.

 

We have been calling and visiting homes in our area, and everything is just slightly out of reach financially. It is doable, on their income, but they have some loans to repay that make it not possible. Their income is too high to qualify them for the lower income facilities. They think they won't qualify for Medicaid to get the nursing they need because of the loans. Is that true? They can pay for their current needs easily, it's when we look at the cost of assisted living that it becomes insurmountable. They could do it for a few months, maybe even a year or two, but it creates a bleed that will eventually leave them with nothing left.

 

They both need assisted living, though their actual day to day needs are vastly different. I don't know how to help them.

 

What do people do if they can't afford the care they need?

 

A suggestion we heard was to have them move in to a facility, run through their money, and then hope Medicaid kicksin. But that feels dishonest to them, like they'd be tricking the facility into thinking they can afford it when they can't. Is that really what people in this position do?

 

They will not move in with family. Their care, from a distance, is becoming difficult. They have a lot of needs, so getting them closer to someone who can help (us) would be good. Easier than 3 - 4 hours in round trip driving on top of whatever help they need every week.

 

Any experience here? We need help.

 

Their loans won't have an impact on whether or not they qualify for Medicaid. Their assets will, however. If they have money in savings, retirement plans or real estate, those assets should be liquidated, if necessary, and used to pay for their long term care. When it is exhausted and they have no other assets, they should financially qualify for Medicaid. It is not considered tricking the facility. The facility is being paid by this couple for the care they receive, then after they run out of money, the facility will continue to get paid by Medicaid. In addition, the facility will receive the funds from their social security benefit, minus a small allowance. 

 

Is there any way their loans can be restructured to lower their monthly payments? 

 

Keep in mind that qualifying medically for nursing home coverage is different than qualifying financially. There is limited coverage from Medicare for nursing homes and certain conditions must be met. Look at this booklet for information on Medicare coverage of nursing home care.

 

To find out about Medicaid eligibility, try a google search on "medicaid nursing home name of your state)." Additionally, you can call any nursing home in your state, talk to the intake coordinator and they can fill you in as well. They will also be able to point you to a state published resource with details. There will have medical qualifications that must be met. Many things people think of as nursing care are not actually nursing care and they do not always qualify for coverage. 

 

Is either person a veteran? If so, they may qualify for the VA Aid & Attendance benefit. It is for people who have served during times of war and qualify financially. If they don't qualify now, they may qualify later after their assets decrease. Qualifying dates are listed here. They do not have to be receiving a pension from the armed forces in order to qualify for this benefit. 

 

Is there a council on aging in your area or in the area where they wish to reside? They generally have the ability to educate you on different services and programs in the area.