My 92 year old Dad has been my 82 year old mom's caregiver for many many years (stroke and vascular dementia) but dad's automobile accident has forced us to move to the next phase. I have taken over their finances and currently have part time nursing aide help that comes into their condo for 8 hours a day in split shifts to cover the mornings and evenings.
Dad continues to decline cognitively over time, and I'm starting to look at Assisted Living facilities for the potential/eventual move that will need to happen.
The costs have been eye opening. I am in the DC metro area and AL is going to run around 130K-150K a year for the two of them. If dad predeceases mom, mom will need memory care which will run 130K a year and up just for herself.
My parents have LTC ins. that I have started tapping and still have a collective 400K balance left, and all told they have about 700K in assets (including the sale of their condo). Between my dad's pension (which includes survivor benefits) and their SS, they also have about 62K coming in per year after tax.
As it is right now, with the in-home nursing care, housing, transportation and food, they are already spending around 110K a year, so at this point the cost to go to Assisted Living would not be that much more.
If I look at the actuarial tables, they can afford to move into an Assisted Living Facility and they should be ok. But if they deteriorate rapidly, requiring much higher levels of care, or if they live longer than expected, they could run out of money.
How do you plan for this? My wife is super concerned (she's a worrier). I told my wife that if we moved forward with Assisted Living and a black swan type event happens, I would be willing to go back to work to cover their expenses (I retired 4+ years ago) but she wasn't happy with that answer.
How is everyone else dealing with all these unknowns?
I tell you all this to say.....don't worry. See the EC attorney. He'll set you straight about Medicaid in your state SHOULD the need arise for you to apply for it for long term care for mom. I had the app ready to go for my mom, and a SNF picked out too, but she passed before her funds ran out. There was NO WAY I was going back to work to fund her extreme old age in long term care, and neither should you. And with their funds, you shouldn't have to even consider it.
Take your wife with you to the attorney visit and set both of your minds at ease. No point borrowing trouble. Good luck.
From what you have shared, an AL may be a very short stop gap. Change can cause a sudden drop in ability when dementia is involved, moving your parents could very well increase their care needs.
I was faced with a similar financial situation for my dad, except, he couldn't afford to set up a Miller Trust, see a CELA or afford a nice facility and had no insurance. I looked outside the box and found board and care homes. They don't offer all the amenities and activities of large facilities but, my dad wouldn't use that stuff anyways. Some of them keep the residents through hospice, they are prepared for care needs increase, if you choose the right facility.
I would not go back to work to cover their expenses. I would look around, even into different states and find the best facility that meets their actual needs and can keep them together or as together as possible. Enrichment activities are cheaper on an as needed basis, so forget about in house, unless your parents are social butterflies and will be utilizing these services daily.
You are really fortunate that they have a decent income, insurance and some assets. You don't have to worry for years or ever, if you can find a facility even outside their area that can accommodate increased care needs, at a more reasonable price, right through hospice. (It is important to verify that ANY facility will accept hospice, not all do.) When a facility becomes a reality, location isn't as important, because their world will largely exist within the facililty and you can create excitement about new adventures outside the home.
Tell your wife that worrying won't change anything except her health, so try not to. Your parents really are positioned okay with some creative solutions.
Here's what I would do.
Consider either renting out the condo (it's a good renters market and you can get a property management company to handle the whole thing for a cut of the rent). That might bring in $2-4K a month, giving their income a boost up. Or sell the condo if the market is still good and get the money into bonds/CDs and get some income coming in with the proceeds.
Find a nice apartment where they would have no maintenance worries and where the cost is probably 5 times less than AL. Keep the home health care and just up the hours. Your parents will require someone there all the time eventually. An AL is not going to provide them with that. An AL will have maybe 50 residents with 1-3 caregivers. They won't be getting the care they need. They will with home health care. I've had to hire home health care in addition to the little support mom gets from AL, so we're moving out. An apartment and home health care is about $40-50K less a year than AL.
You look for ways to have their money make money. You also look for a ton of ways to save them money. I've been able to reduce my mom's expenses by about $1,000 a month. She doesn't need the ultra expensive diapers, and if I buy them in bulk, I save, a ton of money. We cut cable and went with streaming services that offer their same favorite programs. Coupons! It's amazing what you can do to save money.
You should not go back to work for your parents. There's ways to make that money stretch and work to cover expenses. AL is not one of them.
When my Mom needed to go into a nursing home, Dad hired 3 shifts of caregivers for himself as he couldn't live alone in his house. The caregivers were costing him $20k per month. The nursing home was costing $12k per month. Big bite out of the financial pie.
After Mom passed, Dad did the math and noticed it was quite a cost savings to move into a senior facility. He started out in Independent Living full size apartment then moved to Memory Care at the same facility.
Since I was Dad's Power of Attorney for both health and finances, I was able to see how much my parents had saved over the years. They were the children of the Great Depression so they lived well below their means. Thank goodness they did. They saved for that rainy day, and now it was pouring outside.
I, too, was always worrying if Dad would run out of money depending on how long he would live. Dad was already in his mid 90's. In the back of my mind, I knew that there was Medicaid [which is different from Medicare] if Dad should need it. I didn't know if the facility would even take Medicaid. Dad had passed a couple years later. Thankfully he and Mom had their Wills updated at my stern request, as the old Wills were older than dirt, and would have been a logistical nightmare. Plus they had prepared a current Revocable Trust. If you need an Elder Law Attorney, I can highly recommend a firm on Wiehle Ave in your area.
if you go with AL , Google care advisors. They are a realtor of sorts. Paid by the facility with placement. An invaluable service. Get someone local who will meet you for tours and arrange everything. They know the ins and outs of it. Availability, cost amenities, reputation… I used a franchise called care patrol.
absolutely do not go back to work
Remember also that any signed agreement or guarantee can be tossed out the window at the end of the lease agreement (usually a year long contract) should the facility be sold to a new owner. Yeah.... the whole picture kind of sucks.
Start researching now. I personally have found that the well established non-profit facilities sometimes offer better service than the corporate entities. While you are projecting your annual costs, don't forget to add in the annual rent increase and make sure that you find out what the annual increases have been over a 5 year period when you are taking your facility tours.
I recommend at least two visits to any facility you are interested in.... the second one unannounced. Plan your visits around lunch time or slightly before dinner time. Get a list of the planned activities and of the menu. Try to take a second set of eyes with you.
Good Luck on this journey
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