1. < Caregivers: Dementia

Finances, the elephant in the room

Posted by joedeb @joedeb, Mar 22 6:00pm

Finances has to be in the back of most caregivers minds, exept for the really rich. What happens if I suddenly become ill? I'm 75 and my wife 74. We could live anothe 10 years. Do I plan for the day when I can't be her caregiver? I have checked out places to find one we would like. They are all about the same cost. Some are non profit. Some may not take medicaid initially. The game my sister and brother inlaw are playing is hide most of their assets, hope they make it past the lookback period, 5 yrs, give the care center a chunk of money then make medicaid pay for the end game. The care center goes along with it if they get a big enough chunk up front. In their case, $15,000+ per month for 2. And then the care center plays the demagraphics game on how long they last.
So do you very early on start nursing home trusts and play the medicaid game? The up front chunk looks like it has to be 4 or $500k for some places. Will medicaid in its current form even be there when the time comes? Staff per resident can greatly change the cost which is important in memory care facilities. We have used a great resource called Oasis to get questions answerred. It is an a franchise organization funded by the care facilites and free to patients looking for some initial screening and beginning questions.
The main source of economic activity in towns near us in long term care. Skilled care centers have a waiting list yet. But memory centers here usually have openings. Both spouses needing care is the most outlandish outcome. There are only a few rooms in care centers that can accomodate couples in memory care. Otherwise its double the cost.

Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.

nelms | @nelms | Mar 22 6:17pm

I think the best source for the correct, lawful, and prudent answers would be an elder law attorney.

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sillyblone | @sillyblone | Mar 22 8:52pm

This is a travesty to our dealing with caregiving and other illnesses. We would not be able to afford this amount. What has happened to our Healthcare System? It seems like no one cares.

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1 reply
pamela78 | @pamela78 | Mar 23 8:50am
In reply to @sillyblone "This is a travesty to our dealing with caregiving and other illnesses. We would not be..." + (show)
@sillyblone

This is a travesty to our dealing with caregiving and other illnesses. We would not be able to afford this amount. What has happened to our Healthcare System? It seems like no one cares.

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I believe doctors and other health care professionals do care but they are stretched very thin and under the thumbs of Big Pharma and Big Insurance. We baby boomers are filling the memory-care beds now, but what happens to all those plush facilities (the $400k-$500k ones that are proliferating everywhere) when the baby boomers are no more? Will retirement communities be the next hollowed out shopping malls? But that's for the future. What are we to do now? Impoverish ourselves after a lifetime of working and saving and leave nothing to our kids?

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bclane | @bclane | Mar 23 12:21pm

You have more choices in some areas of the country. My husband and I live in Kentucky now, but we originally lived in southwest Ohio. There are numerous CCRC choices in southwest Ohio, and only the largest homes have similar buy-in and monthly costs to those mentioned here. One we've looked at has been in business since 1912 when it was both an orphanage and home for the aged. In the '60's, it went strictly to elder care and offers everything from independent living to nursing home with all stops in between. They have the expensive freestanding homes, but they also have studios, one- and two-bedroom duplexes that are the older buildings and cheaper, and apartments. If you move out, they refund your entire buy-in and if you die there, they refund the entire amount to your heirs. We haven't checked out all the others, but many of them have also been around for quite a while, and some have lower buy-ins. It seems to be a matter of more competition in that area of the country.

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DanL | @tunared | Mar 27 11:59am

We in the tenth year of our journey with my wife's dementia and I've been looking at our options for awhile. The best (and cheapest) is to stay in our home and hire help for the house & us. All of the facilities that I've looked into are under the business model and need to make money and that includes hospitals, nursing homes and other facilities. Medicaid is a state & federal government partnership and each states Medicaid program is unique to that state. Yes there are similarities but there are also differences and how stringent they follow the 5 year rule depends on the state. States also change their Medicaid programs (sometimes annually) so what may work now, may not work in 3-5 years. Corporations are purchasing hospitals because the hospitals can be a profit center if run like a business and not a non-profit resource. I would suggest looking for a business that can provide assistance for you and your spouse in the home and help with house cleaning. It would definitely be cheaper than $15,000 a month.

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turtle4115 | @turtle4115 | 6 days ago

There are several business models for CCRCs. The one my husband and I are in has a life care contract. We paid a buy in amount much less than $400K and when he moved to nursing care our monthly fee remained the same even though I continue in an independent apartment. The difficult part was moving in when he still passed the test as independent. We are not rich. The other sacrifice was moving to Mississippi to be near our daughter. She and her family were the only people we knew in the state. The facility is great and we have made friends and their should be money left for our children. A life care contract means that we will be cared for the rest of our lives even if we do run out of funds.

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1 reply
nelms | @nelms | 6 days ago
In reply to @turtle4115 "There are several business models for CCRCs. The one my husband and I are in has..." + (show)
@turtle4115

There are several business models for CCRCs. The one my husband and I are in has a life care contract. We paid a buy in amount much less than $400K and when he moved to nursing care our monthly fee remained the same even though I continue in an independent apartment. The difficult part was moving in when he still passed the test as independent. We are not rich. The other sacrifice was moving to Mississippi to be near our daughter. She and her family were the only people we knew in the state. The facility is great and we have made friends and their should be money left for our children. A life care contract means that we will be cared for the rest of our lives even if we do run out of funds.

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Can you say where in Mississippi this CCRC is?

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1 reply
Teri | @tsc | 6 days ago
In reply to @tunared "We in the tenth year of our journey with my wife's dementia and I've been looking..." + (show)
@tunared

We in the tenth year of our journey with my wife's dementia and I've been looking at our options for awhile. The best (and cheapest) is to stay in our home and hire help for the house & us. All of the facilities that I've looked into are under the business model and need to make money and that includes hospitals, nursing homes and other facilities. Medicaid is a state & federal government partnership and each states Medicaid program is unique to that state. Yes there are similarities but there are also differences and how stringent they follow the 5 year rule depends on the state. States also change their Medicaid programs (sometimes annually) so what may work now, may not work in 3-5 years. Corporations are purchasing hospitals because the hospitals can be a profit center if run like a business and not a non-profit resource. I would suggest looking for a business that can provide assistance for you and your spouse in the home and help with house cleaning. It would definitely be cheaper than $15,000 a month.

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In Hawaii, our geriatrician told me the cost of a memory care unit is $16,000 per month, but getting care in the home 24/7 is $24,000 per month. She said to be sure to use an agency whose staff are bonded and insured and to put a credit freeze in place.

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2 replies
DanL | @tunared | 5 days ago
In reply to @tsc "In Hawaii, our geriatrician told me the cost of a memory care unit is $16,000 per..." + (show)
@tsc

In Hawaii, our geriatrician told me the cost of a memory care unit is $16,000 per month, but getting care in the home 24/7 is $24,000 per month. She said to be sure to use an agency whose staff are bonded and insured and to put a credit freeze in place.

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I've always known Hawaii was expensive but those figures appear a "little" off. I would suggest verifying the amounts on your own. It's tough to believe home health aides make $288,000 a year. good luck

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