I’m pretty much in this situation. I’ve seen my elders decline and day before me. Here is my data collected over the years from my family. 90% of them require some assistance for months or years to take care of health and finances. 10% die relatively suddenly without need to rely on others. Of those people who require assistance, all of them had adult children to assist in their final years.
I’m different. I don’t have children who can step in for assistance. What do people in my situation typically do as they decline in health and mental capacity?
When you say assistance are you talking about financial assistance (money to pay for long term health care), physical assistance (i.e. help around the house), or health care assistance (i.e. help getting into an assisted living facility when it’s appropriate)?
We could also dangle unrealistic dreams of an inheritance before our nephews/nieces in exchange for letting us use their spare bedroom or basement crawl space.
If I had children, the last thing I would do would be to impose myself on their lives in my declining months or years. My grandmother had to take care of her mother-in-law for 7 years after the father-in-law died, and it nearly killed her (great-grandma was in her 90’s, grandma was in her late 60’s and early 70’s). Then a couple of years later, her own husband died.
No, taking care of myself is my responsibility, and I think I probably have enough assets to do so.
As much as you’re able, save money for that final phase of your life. As your ability to care for yourself and manage your estate declines, you’ll need to hire folks to help you:
If you’re living in your own home, you’re going to have to hire people to take care of it for you (lawn maintenance, snow removal, home repairs, etc.).
You may need help with daily chores like laundry, cooking, and grocery shopping. Services like Home Instead can help with those kinds of chores.
If you are no longer safe behind the wheel, you’ll need something like Uber or Lyft to get you to/from places.
If you’re having trouble managing your finances, you may need to hire an accountant, or even hire someone with power-of-attorney who can actually take care of your investments and/or pay your bills without having to explain every last detail to you.
If you don’t have a family member who can serve as a medical advocate or be appointed as your medical power of attorney to make health care decisions when you’re unable - and perhaps even if you do have someone who can do this - you should draft a living will and put it on file at hospitals where you could conceivably end up.
When living at home on your own just gets to be too much, you can move to an independent living retirement community. These places let their residents come and go freely, but they provide some/all of the meals for their residents in an on-site dining facility, and take care of some/all of the day-to-day chores like laundry, housekeeping, and maintenance tasks in your residence.
As your mind and body decline further, you may need to move into an assisted living facility. These places take some legal responsibility for your care: they will take care of obtaining your prescribed medications and bring them to you when you’re supposed to take them, provide daily health checks, arrange doctor/hospital visits as needed, and so on. If you need help showering, toileting, or getting (un)dressed, they’re there for you. All your meals are provided in a dining facility (or in your apartment if you’re not able to get to the dining room for some reason), unless you’re off-site with friends/family. They may let you have a microwave oven, but probably not any open-element stove. Since they’re managing your meds for you, you can request OTC meds like ibuprofen, but they might not let you keep a bottle of it yourself.
“Memory care” facilities are for residents with severe dementia, i.e. Alzheimers and the like. You need a passcode to enter a place like this, and also to leave.
“Skilled nursing” facilities are for people with severe physical decline and provide assistance for whatever your needs are, up to and including feeding you. Residents here often have some degree of dementia, but with their physical limitations they tend not to pose a flight risk, so exit doors aren’t typically locked.
As is the case with anything else, you get what you pay for. The care facility horror stories you sometimes hear about on the evening news don’t tend to happen at upscale places where the staff are well paid. Even moderately priced places sometimes drop the ball; my parents needed a lot of help from us kids to care care of countless odds and ends when they were in assisted living; their lives would have been a fair bit less pleasant without our help. Bottom line, if you want good care when you can’t care for yourself, start saving now, and save a lot.
If you need assisted living or skilled nursing but have no meaningful financial resources, Medicaid will kick in, but don’t expect five-star accommodations.
Having kids does not mean that they would be helping, though they might. It seems like that is sort of an obligation of the past which is waining. I blame the boomers who didn’t have many children and that places the burden of elder care on fewer kids which broke the system. So I think the lucky few has children who are able to care for them. In my case I have my dad who can use company, however I have a kid who needs me. Guess who wins here and I have about 10 more years to go with him till he can fly on his own, which is asking a lot of my dad in terms of hanging on.
This will be me, if I oultlive Mrs. H. I plan to live out of a camper van and travel around the country until I can’t care for myself any more. I’m genuinely not sure what will happen then. I have a cousin with kids, it’s possible I could talk one of them into looking after me. Failing that, I suppose I could try to find a decent nursing home with the little income I’ll have. There’s also medically-assisted end-of-life whatever-it’s-called (assisted suicide, if you’re not getting it).
There was an article in our local paper recently maintaining that this is a growing situation. I didn’t read it as I’m pretty comfortable with my expectations and resources.
If you wish to exist beyond the point at which you are able to live independently, you should research what sorts of assisted living will be available to you given your means. And if you wish to exist beyond your ability to manage your affairs, then you ought to find someone to point as your power of attorney. I would expect such a person/organization to expect some compensation.
For me, I can imagine downsizing to a small, 1-level apartment in an elevator building, with all goods and services delivered, and Uber to take me anywhere. Once I am able to manage that, I’m pretty sure I’d just as soon check out. My best insurance is to do what I can at this point (early 60s) to keep my mid and body sufficiently sharp to push those eventualities off as far in the future as reasonably possible.
No one should “impose themselves” on anyone. But the thing about having children is they may voluntarily help. When my mother was in her 90s and was hospitalized for congestive heart failure, there was a discussion about moving her to a nursing home after she was discharged. I was strongly opposed to the idea, and believed that she should live with us in our suburban home.
It was a very tense time for everyone. My brother was firmly of the belief that she’d be better off in a nursing home, I was equally adamant about the opposite. Long story short, she made her own decision, and that was to live in our home. My brother was apoplectic and it was the worst argument we’ve ever had. But it turned out to be a blessed decision. I still have fond memories of her puttering around the flower gardens, listening to the vast multitude of birds we had around the place. It always gave me a smile to hear her claim, as she puttered around her flowers, that the birds “were singing for her”. I would regularly drive her to shop at a particularly wonderful upscale boutique grocery store that she loved – she was far from wealthy, but she didn’t need to buy much. She shopped carefully and appreciated the quality. She had personal care, nursing, and dietary services at home thanks to our public health care system.
Point is, children can, in fact, be a great help to elderly parents if circumstances permit.
I work for my county’s aging and long-term care division. One of the things we do is use Medicare funds to pay for personal care in clients’ homes. This can be family members or unrelated, hired caregivers, often through an agency. Even clients with adult children sometimes use non-family caregivers.
The trick is to find somebody. It’s a tough position to hire for. Good wages used to compensate for the unappealing job description, but haven’t been able to rise in pay elsewhere.
There are various levels of assisted living for the elderly. All the way from apartments designed for the elderly up to nursing homes. The cost goes up with each level of care needed, but I think people don’t need intensive care for very long.
The median time spent in an assisted living home is 3-4 years. The median time spent in a nursing home is 5 months.
I assume they do a step by step increase in the level of care they get. Maybe the first step is moving to a smaller, senior friendly house or a senior community. After they can’t keep up with that they hire outside help. After that doesn’t work then they do assisted living. After that, a nursing home (if necessary).
My grandma had a lot of kids and grandkids. While they did help here and there she was mobile and independent until she was about 80. After that she moved to an assisted living facility, lived there for about 4 years and died. Had she not had kids and grandkids to help out she probably would’ve moved into an assisted living facility a year or two earlier.
Thanks for all of the comments especially those that say “we shouldn’t be a burden” on our kids. The fact is…Every old person has told me this, and they always intend on taking care of themselves…but…the evidence I’ve seen over the last 60 years is that all of the elderly people I’ve watched deteriorate required and used family members to assist them.
Its one thing to say you won’t be a burden, but actual evidence and data demonstrate that most elderly people who have family get that help from them
The thing is, in my experience, it doesn’t matter how much money you have (within reason). If you don’t have somebody on your side fighting for your well-being, you are easily ignored. That person is in most cases your child.
It isn’t solely a matter of assets. Many people wind up needing somebody who can manage their financial affairs, intervene for them in the health care system, even make sure the cats get fed.
@suranyi’s entirely right. In the current USA health care system, you need an advocate.
And the current system assumes you’ve got somebody to help; it’s not remotely well set up for people who live alone. I’m far from the only person who’s been sent home from hospital under the assumption that there’d be somebody there to take care of me for the first couple a weeks. A friend stepped in. She’s no younger than I am, and has been stepping in for more than one friend and family member; she can’t help everybody, or anybody every time.
If you’re already old and already broke, this advice is very much not useful.
Also, such expenses can be extremely high. Even people who appeared to have quite a lot of money set aside can run through all of it in a few months or years.
Also, in many areas, it’s close to impossible to hire enough help. Even twenty years ago, we couldn’t get more than sporadic at-home help for my mother (who could at the time afford to pay for it); and the help we could get, whether through an agency or as individuals, was often incompetent and/or sometimes just didn’t show up.
Some such accommodations are straight-out terrible. Especially if there’s nobody in good enough shape who will come check on you and do the work of advocating if/as necessary.
If I had children, I wouldn’t want them to destroy their careers, marriages, health, and relationships with their own children because of me.
In my case, if need assistance, I’m going to take some of that money I was able to invest because I didn’t have kids, and hire people to take care of me.
Look into long-term care insurance if your health is reasonably good and you’re not close to retirement age. You would want to consider different policies carefully, but a policy with the appropriate amount of coverage might ease your mind.
So you think every couple should have a lot of children, and to hell with overpopulation? I don’t think you really think that, and I’m pissed that you blame it on a generation instead of on economic realities. More children = poorer parents by the time the last child is grown, parents who are then condemned to rely on their children for their old age care because they spent all their lives and money caring for a big family. Please re-think this sentiment.