Preparing to Age in Place

I´m so sorry for your loss. Hard to lose a best friend you´ve had for so many years. Joan

I've been working on that. When my husband loses mobility, I will be stuck. We remodeled for ADA access some years ago and can safely age here, for the most part. Our income producing annuities can have additional (excess distributions) taken out, but the income will not last as long. Selling the house would put us into a rental situation (uncertain costs) or assisted living ($3-4K/month), which would not last long. The math does not really work for us to move. And, short of a reverse mortgage, there is not enough income to cover caregiving. Here's one article from AARP, which is following this issue. Lisa Ling Explores Caregiving in New CBS Special (aarp.org)

Any chance of family helping?
We are in much the same boat along with many, many others.
How about shared housing with friends where you all pitch in for caregiver help? What a dilemma for us all and scary. Are you in touch with area agency on aging, your senior center and social services to check if there are further resources

Here's my hard take on the risks of aging in place for non-multi-millionaires:

Remember that we have lived with uncertainty for our entire lives and have made it through to now with our personal mixes of joy and sorrow, pleasures and pains, successes and failures, seeking enough meaning to feel it's worth the effort.
And that's what it will be like until our last breath.
So far it has been more than good enough for me, and I deeply hope it is like that for everyone.

For me, aging in place means building a home and life that offer hope to continue with the most positive balance possible.

Money is part of this. It would be nice if we had a little more, but we do have enough to manage.
We looked into continuing care communities and found that the ones we can afford would require loss of our greatest joys (pets, woods, garden, fruit trees, river nearby, wild animals in our yard, family visits, favorite foods, musical instrument workshop) in return for a guaranteed bed in memory care.
The aging care professional we consulted felt we that with preparation we could have a far better life aging in our home, even with serious illness.

We have Social Security, some annuities and retirement investments. We can live without withdrawing funds for our usual expenses, and we have long-term care insurance.
Fancy vacations aren't likely.
We've always lived within our means, and sometimes those means were very slim, so we know how to find the joys of parks and the public library! In case of early death of one of us, a housemate is possible, as has been done in several nearby homes of similar design.

It's not a guarantee that our last days (or months or years) won't be difficult, but by staying where we are, I have had, since turning 70, five of the richest years of my life, so I feel the "wager" is worth it.

Looking at my balance sheet, if I had to choose between money and friends, the friends are what I need to nurture most because friends give my life more meaning, purpose, knowledge and sharing of world views, and without that, money is worthless.

I couldn't agree more @edsutton, especially what we need to nurture the most. I need to get out and make more friends as I've lost a lot of good ones the past few years. Thanks for sharing.

@SusanEllen66 : I had to deal with that $2000 limit with my mother before she passed, so I know what you are talking about. But that was for qualifying for medicaid and in-home care (called MediCal in California). But there are other situations. My son/in-law has early onset Alzheimers in Texas and we just found out that traditional Medicare pays for 100 in-home care days ( not sure of the number of hours/day yet) b/c he cannot be safely left alone and my daughter is their only income source. We couldn’t believe it but his doctor assured us it was true. That’s my point, there are so many exceptions not commonly known. And when you don’t apply, you never will know.

Thank you for your kind words. I have heard back from my therapist. Will be starting again in mid-July.

@lauren1128 This is a good example of why we need pubic information about Medicaid eligibility. Although I know that 13 states don’t take a spouses retirement into account (maybe it is limited by amount…I’m not positive) I just spent way too long on a Google search and could not find this information although we were just told this in a lawyer’s office. Medicaid eligibility is so convoluted for a reason I expect. It’s immoral that middle income spouses have to be able to come up with thousands to pay an attorney to find out how to not go bankrupt when a surviving spouse is involved.

When it comes to sorting out insurance and eligibility for assistance, there is no one place to point a finger of blame (nor would it do any good.) If someone had a crystal ball 75 or 100 years ago, and could foresee what a complex situation this would become, perhaps a different approach would have been taken.

Remember, Medicare for seniors and Medicaid for the poor only became the law in 1965. And although the Federal Government undertook the job of setting up and providing Medicare alongside Social Security and charging a premium to do so. However Medicaid is jointly funded by the Federal government and and each state, and there are vast differences in the programs available and eligibility for coverage.

I wish there was a way to provide public information like you and many others could use. But the problem is that Medicaid eligibility is that it is hugely complex, varies from state to state, and is different depending upon the age, disability status, household membership, VA, Medicare and other insurance coverage...

This is just one of the many complexities of a medical insurance system that has grown out of a variety of regulatory systems - all 50 states, the Federal government and the insurance industry (both non-profit & for profit) have all contributed.

Here is an example of the information available in Minnesota:
https://mn.gov/dhs/people-we-serve/adults/health-care/health-care-programs/programs-and-services/medical-assistance.jsp
Iowa:
https://hhs.iowa.gov/programs/welcome-iowa-medicaid/iowa-medicaid-state-plan
Texas:
https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-programs-services/programs-seniors-aging
There is no doubt that this is a daunting task, and many of us who care for friends and family members regularly spend hours doing the paperwork. But the alternative back in the 1950's and 1960's when my oldest relatives needed financial help was to live with and rely on family or receive charity-based care. The story was very much different in the 1990's and 2010 when I needed to find help for our mothers after they outlived their assets!

I often suggest that people who are overwhelmed with the paperwork ask their kids or grandkids to help - it can be done even by a family member living 1000 miles away.
Sue

Everyone costs a lot of money for the help they give. Medicaid is a tough egg to crack. Like you, I would like to know more about the five year look back so I can act accordingly.