I’d be interested in the thought/event process that led to your parent or relative moving to an Assisted Living (or other) facility.
What happened to their home/apartment and all the stuff in it?
I’m looking at this for my mother. There are many things to consider, not the least of which is how to pay for this care. The entry level monthly fee for a decent place seems to be around $3,800/month and it goes up (waaaaaay up) from there. If she needs any extra services, like help managing meds, dressing, or bathing, most (but not all) facilities add on an extra $300-$500/month for each of those services.
Both my parents ended up in a nursing home. They both had dementia and could no longer safely live in their own home.
They had the money to pay for it, so that’s how it got paid for. I hired a care manager, who was very familiar with the local facilities, to suggest a few that would be suitable for their needs and then make the application for admission.
I had power of attorney so I paid the bills, sold the car and the house. I hired a clean-out service to deal with all their stuff - I took the important papers and other items we wanted to keep; the rest was either tossed or donated to a resale shop.
One important thing to make sure of is that the facility will accept Medicaid if your relative runs out of money to pay; it’s also much easier to choose and get into a facility while they still have their own money to pay. People who must rely on Medicaid from the start can be much harder to place.
I’m going through this now with my 94 year old dad. He has been in declining physical health for years, and until early this year had a full time live-in caregiver who we hired from an agency. This worked well for 5+ years and was mostly paid for (three years) by his long term care policy. Once that was exhausted, he paid out of pocket for the live-in caregiver at about $7k/month.
In February, he went into the hospital with a pleural effusion which didn’t resolve after being drained twice. He wants no heroic measures, so it was expected that it was the end…then he rallied. He’s lucid for the most part, but is very weak and can no longer walk, so he’s bedbound.
He just got a long-term room in the nursing home he went to for (theoretically) rehab to home after the hospital, but it’s clear he can no longer live at home and there’s no way he could afford the increased help and support he’d need to be at home, so it’s the nursing home. This is a nice place and it’s not cheap at about $418/day or close to $13k monthly. YIKES. Even if you have a bunch of $$, you’ll go through it quick at these places.
His funds are pretty depleted as you might guess, he had one annuity which could be liquidated, so my brothers and I are curently working on clearing out his house to sell it. Things, things, things…holy crap. We are starting with the town wide tag sale this weekend, then we have an auctioneer who will take everything that’s left over and sell it off and keep 15% off the top for himself. Then we sell the house (quickly, we hope). Once everything is liquidated, we have to run those funds out while we’re applying for Title 19. Fortunately, our lawyer has someone in his firm who specializes in these applications. It ain’t easy.
It’s also sad and maddening to think that a retired university professor with a pension, long term care plan and reasonable savings winds up having to go on Medicaid. Seems like you have to be a billionaire to manage growing old without some sort of financial assistance.
The lesson I’m learning from my folks is: don’t be so damn healthy and outlive all your money. My mom was the wild one who smoked and drank and ate candy and tacos, she got out easy and died in her sleep (at a very respectable 83) with a big pile of $$$ in the bank.
We just moved my Mom to Assisted Living, and then, within a week into Memory Care at the same facility. Mom has long-term care insurance, which should pay for three years of care, but so far, the claim has not been processed. We expect it to start soon, but in the meantime we are paying from her trust.
I had to liquidate most of my mother’s estate so she could get on Medicaid. I did this during the years she lived at home (I had DPOA plus her health proxy). The saving grace was her house, which she’d put in my name before she’d been diagnosed with dementia. Because I’d lived there for X years taking care of her before she put the house in my name, I was covered under my state’s “caregiver clause”, meaning that the state couldn’t count the house as part of her assets.
Had my state not have this clause, I would’ve had to have sold the house to pay for the NH. I also would’ve been homeless.
My father-in-law is over 100, and he moved into assisted living about 6 months ago. He was in an independent living room in the same senior center for about 10 years before that. He moved because he fell sometimes, though he is still pretty sharp mentally.
He had only a little bit of furniture that didn’t fit, we got a mover to put it into a pod and sent it to our house, and my younger daughter took a lot of it. Moving from his house to the senior center was a lot more painful.
Biggest negative about assisted living is not internet service in that part of the building. But he was having trouble typing by then anyway. He was doing on-line stock trading at 99, and making money at it.
My parents moved from their house to independent living recently because my mom has developed major mobility/dexterity/balance issues. She could no longer easily manage household chores, and felt socially isolated because she didn’t want to leave my Parkinsons-afflicted dad alone for long. In the place they moved to, there is a nice restaurant on site, with all meals as part of their residence plan, so no cooking required by my mom. Housekeeping comes by every couple of weeks (and they have an independent housekeeper stop by during the off week); they vacuum, tidy up, and change the bedsheets.
My parents saved/invested aggressively over their lifetime, so they have a substantial nest egg. Add in Social Security for each of them (they both worked), and a federal employee pension for my Dad. We are estimating that if they transitioned from independent to assisted living tomorrow, they could cover their costs for the next ten years or so. If my mom continues to decline, this transition may actually happen relatively soon.
There was a massive downsizing that happened when they moved. Some of their things were early-inherited by us kids and grandkids, but a great deal of it is going to craigslist, a consignment shop, or the mother of all garage sales. Their apartment in the independent living place is spacious enough that they kept a fair bit of their furniture, but (for example) virtually all of my dad’s tools, a ton of their clothes, and various exercise machines all needed to be given new homes.
Not the one paying. My aunt was in that situation for years. Her house basically sat vacant until after she passed; SS and pension combined covered her expenses so there was no need to liquidate. She always had hopes of getting strong enough to go home even after she had gone from the “light assisted” to “guarded” to “fully assisted”. She didn’t like it very much but on many levels she realized it was the best thing for her.
If your loved one is of the World War II generation, be sure to look into the Federal government’s “Aid and Attendance” benefit. This free benefit is for veterans of WW II and their spouses. Any V.A. office can give you the details.
My Mother’s situation was that she received around $2000/month S.S. benefits, around $600/month from an annuity that she had set up years earlier, around $1200/month in the Aid and Attendance benefit. Her monthly bill was closing in on $5000/month when she passed, so I was glad she got the A.A. benefit…
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My parents sold their house when they moved. They knew it would be a one-way trip, which is part of why my dad resisted the move for so long. Like your aunt, he’s not thrilled with having made the move, but he recognizes that it needed to happen.
My mother in law passed away around 2010, but she was in assisted living for about three years before that.
It was mostly paid for through Medicaid. At the end, the cost was about $10,000 a month. We actually saw it all coming and begged her to transfer her savings (about 200,000 invested in CDs) so that it wouldn’t come up on Medicaid’s look-back period (three years at that time, five now). She refused and so she paid the first year or so out of pocket and when she had nothing left, Medicaid kicked in and claimed all of her monthly pension and SS benefits except for $59 a month for personal expenses (even a phone was a personal expense). If she’d moved the money out of her name, the family could have used it for her benefit.
So my first bit of advice, if you even think this might be an issue in five years: get any assets out of her name, now! Some people gift it, others use a trust… find an advisor who can help with the details. Even with a home, you can put it in someone else’s name while she continues to live there.
Her home wasn’t an issue because she’d been living in a “mother in law unit” at her adult grandson’s home. It’s like a separate attached apartment but not really (because of zoning, it’s a wink-wink-nod-nod kind of thing). It’s his house, and he just started renting out that space for profit after she left.
As for her furniture: some of it moved into assisted living with her. The rest my wife and I put into storage. Some we are using and some we gave to family, but a lot just went to charity eventually.
MIL is in assisted living. She has enough assets to pay it - total assets probably around 1 mill, so between interest and assets, she shouldn’t be able to outlive her funds. Dementia, lung cancer, etc. - but will not die.
When she lived in a condo, we hired 24 hr live-in, so she wouldn’t burn the place down smoking while on O2. Had her license revoked, etc.
Moving her was just downsizing from a 2 bdrm condo to a smaller 1 bedroom unit. Other belongings were distributed among whomever wanted them, sold, donated, or discarded. Beware of siblings being incredibly difficult when it comes to dividing up possessions… :rolleyes:
Sold the condo and rolled the proceeds into the estate. She had already named a power of atty, and we worked with her to complete all necessary DNR, etc. The live-in was supposed to be as short solution, as her doc didn’t expect her to last 6 mos. It lasted 3 years. She’s now well into her 2d year at assisted living. Ain’t modern medicine grand! :rolleyes:
I’m always a little surprised when folk appear to believe an individual ought not deplete the majority of their assets before qualifying for various assistance. You wanna leave your assets to your kids? Fine. Kill yourself.
Sorry, the warehousing of the elderly pisses me off.
It’s always been my understanding that Medicaid won’t pay for assisted living, only NH. Assisted living is totally out of pocket. Or am I missing something?
I don’t know the finer points of the distinction between the two or Medicaid’s policy on it. My MIL moved between a lot of places and it’s true that some of them would not accept her on Medicaid, but some gave her an option. She had Parkinson’s and needed constant care for everything.
I remember that there was a group home that called itself assisted living and said they also took Medicaid patients. If memory serves, they had a dozen residents and six could be on Medicaid. The plan was a smooth transition when she ran out of money. (Unfortunately, she was there during the period in which she believed that she could move back home if she just got herself kicked out of every place we found for her.)
Some facilities (nursing homes, assisted living) will transition you to Medicaid when you run through all of your money. Some will not. They will move you someplace else. So talk to each facility and find out what their particular policy is.
I’m in favor of nonprofit facilities, because a lot of them are mission-driven, rather than bottom-line driven (Brookdale, I’m lookin’ at you), and many of them have a fund to help people who have spent all of their money on care. I used to work for one of these facilities and wrote grant proposals for such a fund.