getting old is too expensive: senior care for boomers and dinosaurs

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Nocturtle: Mar 17, 2007

The Washington Post has a good recent long article about the economics and lack of affordability of senior care. It's US-centric, but the same basic issues likely arise in many places. The entire article's copied below, but the main points are:
-assisted living is comically not affordable for normal working people, check out the graph below for the US situation
-the infirm elderly are uniquely vulnerable yet there's usually no real social safety net and family members struggle to pick up the burden
-costs are increasing, both individually and society-wide, not helped by profit-seeking in the care industry

One thing the article doesn't really mention is the abysmal level of care most non-rich elderly receive in assisted living or nursing homes. You really do not want to end up in the lower-priced range of nursing homes, but that's where even people that "do everything right" likely end up because good-quality care is completely unaffordable for non-rich people.

A lot of people on this site are around the age where their own parents might be dealing with these issues, so insights or experiences are relevant. There's a lot to be said about how society got to the point that treating the elderly well is a largely unobtainable luxury, or what that says about our society. People may also like to discuss the solution proposed in the "Hurling Day" episode of the ahead-of-its-time television series "Dinosaurs". Generational conflict/warfare discussion is probably better here than the economics doomsday thread, but isn't super welcome.

Look at these numbers, these are monthly

The article

quote:

A CRISIS OF CARE
Senior care is crushingly expensive. Boomers aren�t ready.
Long-term care options are too expensive for middle-income Americans, narrowing options for millions of seniors

By Christopher Rowland
March 18, 2023 at 6:00 a.m. EDT

Beth Roper had already sold her husband Doug�s boat and his pickup truck. Her daughter sends $500 a month or more. But it was nowhere near enough to pay the $5,950-a-month bill at Doug�s assisted-living facility. So last year, Roper, 65, abandoned her own plans to retire.

To the public school librarian from Poquoson, Va., it feels like a betrayal of a social contract. Doug Roper, a longtime high school history teacher and wrestling coach, has a pension and Social Security. The Ropers own a home; they have savings. Yet the expense of Doug�s residential Alzheimer�s care poses a grave threat to their middle-class nest egg. At nearly $72,000, a year in assisted living for Doug, 67, costs more than her $64,000 annual salary.

�It�s devastating,� she said. �You can�t wrap your head around it.�

A wave of Americans has been reaching retirement age largely unprepared for the extraordinary costs of specialized care. These aging baby boomers � 73 million strong, the oldest of whom turn 77 this year � pose an unprecedented challenge to the U.S. economy, as individual families shoulder an increasingly ruinous financial burden with little help from stalemated policymakers in Washington.

The dilemma is particularly vexing for those in the economic middle. They can�t afford the high costs of care on their own, yet their resources are too high for them to qualify for federal safety-net insurance. An estimated 18 million middle-income boomers will require care for moderate to severe needs but be unable to pay for it, according to an analysis of the gap by the Center for Retirement Research at Boston College.

�It�s this really enormous financial bomb sitting out there that most people are just hoping won�t hit them,� said Marc A. Cohen, co-director of the LeadingAge LTSS Center at the University of Massachusetts at Boston. �There�s an incredible amount of confusion and denial.�

It�s no surprise that people put off decisions about how to get by during the final years and decades of life; it�s unpleasant to consider, and in the United States, there are few good options. Home care aides are in short supply. Nursing homes are seen as overly institutional and cater to the most disabled.

Assisted-living facilities, the fastest-growing category of elderly care, provide an independent, homelike environment for seniors who need some help with day-to-day functions. Chandeliers, comfy sofas, wood paneling and plush carpets are standard in common areas. You can get your own apartment with your own bathroom. But it starts at $60,000 a year on average, according to the National Investment Center for Seniors Housing & Care (NIC) � and costs go up as residents age and need more care. Locked units for dementia patients, which increasingly are being established within assisted-living facilities or as stand-alone facilities, run more than $80,000 a year on average.

Decades of neglect in nursing homes spur Biden plan for staff mandates

Long-term care costs represent �the single largest financial risk� facing seniors and their families, the National Council on Aging and UMass Boston researchers said in a 2020 report.

�It has to be addressed because ultimately it will be a societal crisis. These are the schoolteachers and the firefighters, the working people who take care of all of us, who cannot afford the [senior housing] that is being built out there right now,� said Beth Mace, chief economist for NIC.

Polls show the vast majority of people would prefer aging in place, in their own home. But median costs for 40 hours a week of assistance from a care aide in the home, for things like bathing, dressing, eating and toileting, run over $56,000 a year. A shortage of home care aides, moreover, was exacerbated by the pandemic.

Nursing homes provide the most intensive care for the most dependent seniors and function like medical facilities, averaging $120,000 a year unless you qualify for Medicaid, the federal insurance program for the poor and elderly. Medicaid will kick in only once an elderly person�s resources are drained away.

Nursing homes are viewed as a destination of last resort. More than 70 percent of older Americans say they are unwilling to live in one, according to a 2021 poll by the John A. Hartford Foundation, which advocates and funds research about age-related issues.

Families often rush to shop among these care options when a health or safety crisis strikes. They take out loans, liquidate real estate and ask family members to chip in for costs. They turn to public internet fundraising sites like GoFundMe for help.

But because of the daunting expenses, many simply allow elderly people with dementia and other infirmities to remain in precarious conditions at home, possibly alone or cared for by an aging spouse, extended family, and neighbors or volunteers. Adult children sometimes upend their own lives to care for an aging relative.

�There are people who are in cruise ships and yachts, and there are people who can barely afford to have a life preserver,� said Lin Chojnicki, who toured several assisted-living facilities for her mother near their homes in Enfield, Conn.

The buildings she saw were inviting and seemed safe, she said, but they were unaffordable at over $4,000 a week for base rent and much more for people with dementia. So her mother continues to live alone in her own home, getting by with daily drop-in visits from family.

Advocates are calling on assisted-living developers to build more-affordable options.

�It seems like a failure of industry because you�ve got money on the table and you have people who could afford monthly rents and the industry is not meeting that need,� said Caroline Pearson, the lead author of a landmark 2019 demographic study called �The Forgotten Middle,� warning that millions won�t be able to afford long-term care in old age.

�It is disturbing that the only option is to completely spend down and impoverish yourself,� said Pearson, who is now executive director of the Peterson Center on Healthcare.

Assisted living too often fails older, sicker residents, report says

Growth in assisted-living facilities has been fueled by real estate investment trusts, which are focused on generating stable, recession-resistant returns from their properties, say experts. That means attracting wealthy clients with greater luxury and amenities.

In 2020, according to federal estimates, there were 818,000 people living in assisted-living and residential units for dementia patients, compared to around 1.2 million in nursing homes. The number of assisted-living facilities grew 24 percent from 2015 through 2022 in 99 U.S. metro areas analyzed by NIC, while the number of nursing homes declined 2.8 percent.

The assisted-living industry�s major Washington trade group, the National Center for Assisted Living, said in an emailed statement that it recognizes affordability is a problem. It said government must have a role in creating better options.

About 17 percent of people living in assisted-living facilities in 2020 were supported by Medicaid insurance, compared with around 75 percent in nursing homes, according to federal data. A persistent concern of the industry is that Medicaid reimbursement does not fully cover the costs of care.

�Even before the pandemic, the long-term care system in this country was broken. It�s too expensive for most people, yet it needs further investment to ensure front-line caregivers receive a competitive wage and facilities continue to modernize,� said LaShuan Bethea, NCAL�s executive director.

�You�re combining housing and health care, and most Americans haven�t thought about or can�t afford to plan for this expense,� she said.

Advocates for the elderly say a solution would be to build insurance programs that will pay for all long-term care and spread the financial burdens over everyone. Germany, Japan and South Korea have government-sponsored long-term care insurance. Congress authorized a long-term care insurance program as part of the Affordable Care Act in 2010, but after 19 months of study, the Obama administration dropped it, calling it unworkable.

Washington state this year is launching a long-term care insurance program, financed by a mandatory employee payroll tax of 0.58 percent, that will provide families $100 a day toward long-term care with a lifetime cap of $36,500. Proponents are working on building support for similar programs in California and Michigan.

Absent any comprehensive insurance, interviews show, family members are left with the burdens of high costs.

One danger is the escalating care fees � as medical need grows � that create a trap for people who think they can afford assisted living over the long haul, said Sherri Lewis, an HIV activist and former pop singer in Los Angeles who placed her mother in a high-end assisted-living facility in Beverly Hills. Lewis�s mother, 93, had a long-term care insurance policy that paid $4,000 a month for life, plus another $3,000 a month in Social Security and other spousal benefits. That covered her mother�s care until her needs grew and the monthly bill rose to $10,000. The facility asked her mother to leave last year and she�s now in a nursing home, Lewis said.

Lewis turned to internet fundraising in a bid for financial help from her network of friends. She said she was considering giving up her mother�s long-term care insurance policy in a desperate bid to qualify for Medicaid.

�Now we�re really in this horrible money pit,� she said. �I�m burned out. I�m at the end of my rope.�

Another Los Angeles resident, Marsha Stevenson, a graphic designer who works from home, lives with and cares for her mother in an apartment. Stevenson got married in June 2020 and still has been unable to move in with her husband. She has taken a pass on career promotions because of the demands of caregiving.

�In the time I�ve been more consistently caregiving in the last 3 years, I�ve gained 20 pounds and have more cardiovascular issues,� said Stevenson, 53, in an email. �Even aside from the pandemic, I no longer can easily get out to see friends or attend events and am often too tired even if I could.�

In Topeka, Kan., Hugh Fitzpatrick, a 70-year-old retired musician with Alzheimer�s, spent the last two years living in his son Bryan Fitzpatrick�s basement, burning through the remnants of $88,000 he received in proceeds from the sale of his house in Houston. Much of the money was spent on a $175-a-day adult day care program. Once the house money was gone, that enabled Fitzpatrick to qualify for Kansas Medicaid, said his brother, Chuck Fitzpatrick.

He moved into a �memory care� unit, as the dementia-care facilities are called, that costs $5,440 a month, Chuck Fitzpatrick said. Medicaid will contribute $4,415 monthly toward the cost and Hugh�s Social Security payment of $1,025 will be applied.

How much Beth Roper�s financial woes will grow depends on unknowns, including how long her husband, Doug, survives and what happens to her own health over the next two decades. In addition to postponing retirement, she abandoned plans to pay for her daughter Kathryn�s wedding.

Doug Roper, who was a history teacher and wrestling coach at Tabb High School in York County, Va., began showing signs of forgetfulness that seemed to accelerate in 2018, the same year he retired, Beth Roper said. By 2022, he could no longer drive and it became clear he needed professional help.

�He got to the point where he was confusing the key fob with the garage door opener trying to unlock the car with the garage door opener,� Beth said. He began ripping up his own clothes. She realized she could no longer trust him on his daily walks, after he started trying to open the doors of random cars around the neighborhood.

Beth scrambled over the summer to find ways to care for Doug. She started to apply for adult day care openings, but the application process was taking too long. Home-care agencies seemed too costly and would still leave her with the heavy burden of caring for Doug overnight. She never seriously considered nursing homes, she said, because Doug was fairly healthy except for his cognitive decline.

She found a suitable room in assisted living for $3,500 a month, but after just four days there the facility management told her he was a wandering risk and needed to be placed in a costlier, locked memory care unit, Beth said. Even there, he recently fell and suffered cuts and bruises on his head and face. Now Beth worries about when she can retire and what, if anything, will be left for her own long-term care.

�You can�t plan for the future. Not to be morbid, but we don�t know how long Doug will live,� she said.

She�s baffled there is no safety net for families in her situation. The Ropers saved for college, they paid off their house, they tithed at church, and they paid thousands of dollars in taxes for more than 70 years of combined work.

�We did everything our country asked us to do,� she said.

# ? Mar 18, 2023 20:02

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# ? Apr 28, 2024 21:43

War and Pieces: Apr 24, 2022; DID NOT VOTE FOR FETTERMAN

This thread pairs well with "Rejected Parents"
https://forums.somethingawful.com/showthread.php?threadid=3893726

# ? Mar 18, 2023 22:24

Al!: Apr 2, 2010

we should recycle them

# ? Mar 18, 2023 22:33

Jose: Jul 24, 2007; Adrian Chiles is a broadcaster and writer

https://www.youtube.com/watch?v=hXVjhSNcqww

# ? Mar 19, 2023 00:39

Weka: May 5, 2019; That child totally had it coming. Nobody should be able to be out at dusk except cars.

I didn't read that whole article but do you really need a qualification to wipe an old nutters arse? Just get a nice illegal immigrant to come and stay with you or something.

Anyway I live in a country where the government does things so it's illegal to charge more than $800 a month for rest home care.

# ? Mar 19, 2023 01:52

Al!: Apr 2, 2010

Weka posted:

I didn't read that whole article but do you really need a qualification to wipe an old nutters arse? Just get a nice illegal immigrant to come and stay with you or something.

Anyway I live in a country where the government does things so it's illegal to charge more than $800 a month for rest home care.

yeah and depending on their duties they may need several certs

# ? Mar 19, 2023 01:55

Buck Wildman: Mar 30, 2010; I am Metango, Galactic Governor

I rode backup on a family member's charity visit to a publicly funded hospice facility once and it was one of the most acutely morbid experiences of my entire life. the hardest "tu fui ego eris" experience I've ever had

# ? Mar 19, 2023 02:40

Weka: May 5, 2019; That child totally had it coming. Nobody should be able to be out at dusk except cars.

Al! posted:

yeah and depending on their duties they may need several certs

I don't mean legally, just practically.

# ? Mar 19, 2023 03:33

Al!: Apr 2, 2010

Weka posted:

I don't mean legally, just practically.

well i mean theoretically if someone is wiping her rear end and mee maw starts having a seizure theoretically i'd want someone who has put some effort into proving they would know what to do

# ? Mar 19, 2023 03:40

Pepe Silvia Browne: Jan 1, 2007

my grandma just got out of the hospital with COVID and Pneumonia. She's coming up on 90 soon and seems to have lost a lot of joy from her life, she basically constantly talks about how she was ready to die in the hospital and kind of expected to. kinda sucks that she can't just choose to OD on heroin in a safe way imo.

# ? Mar 19, 2023 03:47

Nocturtle: Mar 17, 2007

Weka posted:

I didn't read that whole article but do you really need a qualification to wipe an old nutters arse? Just get a nice illegal immigrant to come and stay with you or something.

Anyway I live in a country where the government does things so it's illegal to charge more than $800 a month for rest home care.

The article is definitely long, and doesn't even really get into what's driving costs. Any non-trivial amount of care will be expensive, as it can easily require a full time worker which already makes it effectively unaffordable for the large majority of retired people. This isn't even getting into cases with medical issues requiring specialized care. Also as a practical point underpaying the people doing thankless and difficult care work may not work out well for the person receiving the care.

Which country is that out of interest? It would be interesting to hear how this issue is handled in different places. In Canada and the US it's very much on individuals to pay for senior care and there's only limited social support available at low incomes. It's sort of like everyone just ignores that they can't actually afford to pay for a good nursing home for themselves or their parents unless they're wealthy. In this respect it's like the US healthcare experience, where people just have to hope they don't develop a significant medical issue because it can easily become unaffordable even with private insurance.

# ? Mar 19, 2023 03:57

lobster shirt: Jun 14, 2021

seems bad to discuss problems with elder care and not mention medicaid clawback - even after spending down all your assets (no cash to give to your kids) to get on medicaid, after you die, they are coming for your house.

# ? Mar 19, 2023 04:02

bedpan: Apr 23, 2008

amazing that even spending $120,000 a year, the standard of care is just dreadful.

# ? Mar 19, 2023 04:04

Weka: May 5, 2019; That child totally had it coming. Nobody should be able to be out at dusk except cars.

lobster shirt posted:

seems bad to discuss problems with elder care and not mention medicaid clawback - even after spending down all your assets (no cash to give to your kids) to get on medicaid, after you die, they are coming for your house.

That stuff needs to go in to a trust I'm guessing.

Nocturtle posted:

Which country is that out of interest?

New Zealand, which is supposed to be expensive.

# ? Mar 19, 2023 11:45

Xaris: Jul 25, 2006; Lucky there's a family guy
Lucky there's a man who positively can do
All the things that make us
Laugh and cry

Pepe Silvia Browne posted:

my grandma just got out of the hospital with COVID and Pneumonia. She's coming up on 90 soon and seems to have lost a lot of joy from her life, she basically constantly talks about how she was ready to die in the hospital and kind of expected to. kinda sucks that she can't just choose to OD on heroin in a safe way imo.

yeah at some point someone has the right to say "alright, it's been fun yall, thanks for all the fish" and be an accepted thing. america has a very unhealthy attitude in general.

for me, when i'm permanently unable to wipe my own rear end, it's time to go into the abyss. i can't think of many living scenarios less enjoyable, humiliating and embarrassing than having some underpaid nurse wipe my rear end multiple times a day for the remaining years of my life and just sit there stoically lusting for death.

# ? Mar 19, 2023 11:54

lil poopendorfer: Nov 13, 2014; by the sex ghost

Al! posted:

well i mean theoretically if someone is wiping her rear end and mee maw starts having a seizure theoretically i'd want someone who has put some effort into proving they would know what to do

They call 911and maybe put them in a rescue position to stave off asphyxia. U think a home health aide can do much else?

# ? Mar 19, 2023 12:08

lil poopendorfer: Nov 13, 2014; by the sex ghost

Pepe Silvia Browne posted:

my grandma just got out of the hospital with COVID and Pneumonia. She's coming up on 90 soon and seems to have lost a lot of joy from her life, she basically constantly talks about how she was ready to die in the hospital and kind of expected to. kinda sucks that she can't just choose to OD on heroin in a safe way imo.

You can, it�s called �withdrawal of care� or �comfort measures only�. Next time she goes to the hospital bring it up and they�ll put her on a morphine drip and let her die of thirst. Duke the nurse an extra $500 to have them �help� her along or else it�ll take days

# ? Mar 19, 2023 12:11

Nocturtle: Mar 17, 2007

There's a tension between wealth-sheltering shenanigans for people trying to leave their kids something and the reality that the level of senior care that can be afforded with just social support programs is hugely inadequate and not compatible with a good quality of life. Especially this:

bedpan posted:

amazing that even spending $120,000 a year, the standard of care is just dreadful.

This is correct. Nursing homes can be crushingly expensive, especially when caring for people dementia or medical conditions, and even after spending that much the care isn't even good. No working person can budget or save up for even mediocre care by themselves, let alone afford actually good care.

This situation is not totally unique and part of the solution would be universal long-term care insurance program, ideally run by the govt. Doesn't seem likely in the US though.

Cross-posting from the econ megathread:

anime was right posted:

yeah multigen households are good. theyre denser with all the benefits that come of that, and make things like childcare and eldercare much cheaper and more manageable as a society. its just our housing environment is built entirely for like two specific generations to live independently and to kick their kids out and not for three-four generations to live together

Multigenerational households are probably going to be another common solution, with people try to avoid paying astronomical assisted living costs for as long as possible. Housing becoming increasingly unaffordable will likely make this more common anyway. However this can be challenging for working-age people trying to balance staying employed with caring for parents.

# ? Mar 19, 2023 15:24

lobster shirt: Jun 14, 2021

Weka posted:

That stuff needs to go in to a trust I'm guessing.

yes but there is a five year lookback period so you have to create the trust well in advance of when you actually want to go on medicaid, and it can cost more than 10k in fees. the grim reality is that people whose real asset is their house dont think about estate planning and therefore dont think about needing to put their house into a trust, if they can even afford to do so. just another way this country punishes anyone who isn't extremely wealthy.

# ? Mar 19, 2023 18:53

War and Pieces: Apr 24, 2022; DID NOT VOTE FOR FETTERMAN

I wonder how much assisted suicide is going to cost once it's legalized?.

# ? Mar 20, 2023 20:10

Stevie Lee: Oct 8, 2007

my elderly, disabled mother currently lives in a crack den after being evicted from her apartment last year. america is the greatest country on earth

# ? Mar 20, 2023 20:13

War and Pieces: Apr 24, 2022; DID NOT VOTE FOR FETTERMAN

Is there a Catholic Worker house near her?

# ? Mar 20, 2023 20:59

Stevie Lee: Oct 8, 2007

War and Pieces posted:

Is there a Catholic Worker house near her?

yeah she's got a case worker there. there's just nothing better available around here right now, she's on waiting lists for everything even with an active housing voucher.

something will come through soon, maybe. I do what i can to help (a bit more than she did as a parent tbh)

# ? Mar 20, 2023 21:21

Terminal autist: May 17, 2018; by vyelkin

My parents are rich and own a bunch of rentals. Sucks for you though OP

# ? Mar 20, 2023 21:24

wash bucket: Feb 21, 2006

Pepe Silvia Browne posted:

kinda sucks that she can't just choose to OD on heroin in a safe way imo.

Xaris posted:

yeah at some point someone has the right to say "alright, it's been fun yall, thanks for all the fish" and be an accepted thing. america has a very unhealthy attitude in general.

Didn't Canada try medically assisted suicide recently only to have it go wrong in exactly the way everyone feared it would? As in, people using it to escape poverty and debt instead of illness and poor quality of life.

Edit:

�Disturbing�: Experts troubled by Canada�s euthanasia laws

quote:

Some disabled Canadians have decided to be killed in the face of mounting bills.

Guess we can file that under things we should do but we're too morally bankrupt to do it right.

wash bucket has issued a correction as of 21:51 on Mar 20, 2023

# ? Mar 20, 2023 21:42

War and Pieces: Apr 24, 2022; DID NOT VOTE FOR FETTERMAN

Honestly it seems tane if they're merely executing debters rather than saddling their relatives with their debt AND the cost of excecution

# ? Mar 20, 2023 21:54

Dreylad: Jun 19, 2001

McCracAttack posted:

Didn't Canada try medically assisted suicide recently only to have it go wrong in exactly the way everyone feared it would? As in, people using it to escape poverty and debt instead of illness and poor quality of life.

Edit:

�Disturbing�: Experts troubled by Canada�s euthanasia laws

Guess we can file that under things we should do but we're too morally bankrupt to do it right.

I don't even think it's about morality, it's just the logic of the economic system taking hold over something that should be used to help people who want a way out of extreme chronic pain or untreatable conditions. Unfortunately "being poor" got added to the latter.

To tie it in with this thread, it's going to get worse because much like in childcare, there's a serious labour shortage of personal support workers and nurses who could provide support for people who need it, but surprise they're paid like poo poo for extremely demanding work and people move on to other careers.

I need to dig up some articles to do a small effort post, but things are only going to get worse when it comes to senior poverty. France isn't the only country that's kicked the can down the road on old age pensions and how they're funded -- most of Europe and China are facing the same problem because of demographics and how they've chosen to fund their systems. Macron obviously did it in the dumbest way possible and there are other ways to address the issue instead of raising the retirement age, but this has been a problem that's been known about for decades. Demographics don't sneak up on you, just no one wants to do anything about it.

It's going to lead to a pretty interesting situation where you have a politically active and dominant elderly population that needs the younger working population to work as much as possible in order to support them, while the younger cohort will be mostly politically disenfranchised with their only form of leverage at all is to withhold their labour. should be a blast

Dreylad has issued a correction as of 22:22 on Mar 20, 2023

# ? Mar 20, 2023 22:14

wash bucket: Feb 21, 2006

Dreylad posted:

I don't even think it's about morality, it's just the logic of the economic system taking hold over something that should be used to help people who want a way out of extreme chronic pain or untreatable conditions. Unfortunately "being poor" got added to the latter.

Well that's the root cause of most of our problems. We leave everything to be handled by for-profit corporations which are just systems built to make money in the near term. How do we make money off providing care? By providing as little care as we can get away with.

But yeah, this is going to be a huge problem and it's going to get worse every year. Like you said even the good care facilities can barely staff themselves and most folks can't afford them anyway.

Edit: Well now that I say all of that maybe Canada's medical suicide system is actually working as designed.

wash bucket has issued a correction as of 22:45 on Mar 20, 2023

# ? Mar 20, 2023 22:41

Nocturtle: Mar 17, 2007

Medical suicide laws in Canada and other places are a complex topic. They probably weren't crafted with the intent of killing off the old and disabled. As others mentioned the underlying problem is people requiring assisted living or 24/7 care for themselves or their loved ones could look at average care prices and easily conclude that it is too expensive for them to live. In Canada's case this kind of situation was given the spotlight when people started applying for medical assistance in dying (MAID) because they couldn't afford the care they needed. However it's not like this kind of situation is unique to Canada, the article in the OP is filled with examples of people in the US confronted with this same dilemma.

On the other hand people who have spent time in the dementia ward of a nursing home can understandably not want to end up in the same situation. It's for this reason I originally thought the assisted suicide process was a good idea, but I'm ignorant and didn't understand that in practice it would be disproportionately applied to the disabled poor.

Dreylad posted:

To tie it in with this thread, it's going to get worse because much like in childcare, there's a serious labour shortage of personal support workers and nurses who could provide support for people who need it, but surprise they're paid like poo poo for extremely demanding work and people move on to other careers.

Some of the employment-seeking sites (Indeed, Glassdoor) have employee reviews of the nursing homes they've worked for and they are dire.

# ? Mar 20, 2023 23:18

lil poopendorfer: Nov 13, 2014; by the sex ghost

lobster shirt posted:

yes but there is a five year lookback period so you have to create the trust well in advance of when you actually want to go on medicaid, and it can cost more than 10k in fees. the grim reality is that people whose real asset is their house dont think about estate planning and therefore dont think about needing to put their house into a trust, if they can even afford to do so. just another way this country punishes anyone who isn't extremely wealthy.

It�s like $1-2k on average to set up a trust, and I think there are cheaper options available. The alternative is spending a year and about 20% of the estates value to go through probate court

I agree with your 2nd & 3rd sentence

# ? Mar 20, 2023 23:31

Xaris: Jul 25, 2006; Lucky there's a family guy
Lucky there's a man who positively can do
All the things that make us
Laugh and cry

Nocturtle posted:

On the other hand people who have spent time in the dementia ward of a nursing home can understandably not want to end up in the same situation. It's for this reason I originally thought the assisted suicide process was a good idea, but I'm ignorant and didn't understand that in practice it would be disproportionately applied to the disabled poor.

absolutely. even if the State paid 100% nursing home poo poo for me, if i'm losing my faculties and ability to wipe my rear end, i'm sorry but it's time to check-out. americana protestantism seems to have a cruel attitude toward keeping people alive long past any will, desire, and ability to live

of course balancing the "i'm poor, *roy batty voice* time to die" versus "i'm poor, being an undue horrible burden on my relatives, rapidly losing my memory and ability to function by myself, kill me pls" is very very easily resolved by making people not poor, but very tricky otherwise.

# ? Mar 20, 2023 23:37

wash bucket: Feb 21, 2006

Not that it will do any good for folks in the US, but what are some countries that are handling this correctly? Or at least better?

I mean, I know it's silly to ask because the answers will involve healthcare systems and social safety nets we can only dream of.

# ? Mar 20, 2023 23:37

Smythe: Oct 12, 2003

cool part about dementia is you're too far gone to know when you're too far gone. pretty epic for me and half my living and dead relatives. ive read all kinds of stories about "assisted suicide pacts" between parents and children dealing with dementia and they make me very sad. soon this burden will inevitably fall upon me, and then to my kin. pretty based. great disease.

# ? Mar 20, 2023 23:44

Baudolino: Apr 1, 2010; THUNDERDOME LOSER

Simply removing the suicide laws wont do any good. Those people are still in a desperate situation. Either there is a complete top to bottom reform of society which i would not bet on or we help them die with as much dignity as can be managed or we let each induvidual organize their own exit (or abandon them to suffer alone). It`s better to have publicly funded euthanisia programs than to have nothing at all.

# ? Mar 20, 2023 23:46

PoundSand: Jul 30, 2021; Also proficient with kites

Good thing there's no generational animosity in the US from a lifetime of economic vampirism. I'm sure all the zoomers and millenials paying off their student loans into their 50's are going to be well equipped to support their parent's poor retirement planning.

Even people who want to probably can't really afford to bail out their parents, I guess maybe people who nailed a computer related career or such maybe. My wife and I are doing better than average for our generation and don't have kids but it's still gonna be a bit of a coinflip on whether we'll be able to save enough to handle notable medical expenses.

PoundSand has issued a correction as of 23:56 on Mar 20, 2023

# ? Mar 20, 2023 23:53

Harold Fjord: Jan 3, 2004

Age caps

# ? Mar 20, 2023 23:55

my bony fealty: Oct 1, 2008

have the olds tried voting?

# ? Mar 21, 2023 00:37

Dreylad: Jun 19, 2001

Nocturtle posted:

Some of the employment-seeking sites (Indeed, Glassdoor) have employee reviews of the nursing homes they've worked for and they are dire.

Yeah I have no doubt. COVID devastated these places. In Ontario they had to call in the army to help in a few residences. Privatization meant that old people were left in bed for over 24 hours without any check-in. I heard a few stories from a couple of relatives who work in the industry and it's terrible. My mother-in-law currently works in a nursing home and I'm convinced she's immune to COVID because she's been exposed like a dozen times because residents are transferred on to her floor and no one tells her or the other staff that the new person tested positive for COVID.

# ? Mar 21, 2023 00:51

War and Pieces: Apr 24, 2022; DID NOT VOTE FOR FETTERMAN

Multiple visits per week are your grannies only hope she's in a mid nursing home. And they took those visits away during Covid lmao

# ? Mar 21, 2023 01:35

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# ? Apr 28, 2024 21:43

wash bucket: Feb 21, 2006

War and Pieces posted:

Multiple visits per week are your grannies only hope she's in a mid nursing home. And they took those visits away during Covid lmao

I can assure you they brought back the visits in 2021. And the covid.

# ? Mar 21, 2023 01:55

The Something Awful Forums > Discussion > C-SPAM > getting old is too expensive: senior care for boomers and dinosaurs

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