Comment by horsawlarway
3 years ago
Yes - that's not unreasonable for a full time care facility for something like dementia or Alzheimer's in the US (it's below what we paid for my grandmothers).
If you're lucky - they have long term care insurance, and that covers most of the expenses for approx 2 to 10 years (depending on how old the insurance is - it's getting harder to find long plans, and they're all getting significantly more expensive as it turns out more folks needed them).
Otherwise... you spend everything, and then your kids pay.
We split my grandmothers down the middle - my mom's had insurance, we covered my dad's.
I'd rather just die. Throw a party. Tell my kids they're getting a ton of cash. Say good bye on happy terms.
Vs. a miserable decay for everyone involved at huge expense. It's not worth it. Forget the money. The emotional toll is large and for whose benefit?
Normally, I would not comment on this.
You say that now.
I am close to someone looking at this now after holding that exact view for a lifetime, what I see them actually doing is delaying and delaying and confronting that, even on their darker days when they are thinking hard about doing it, the logistics of zero-risk-of-survival suicide are pretty terrible.
It's sobering to watch because I, too, hold the view you lay out above, and now watching this, I think I'd better work out my logistics while I'm relatively young and healthy.
I wonder if that is due to the lack of good options for the ending life? I currently feel like I would like to go on my own terms when the time comes, but none of the options available look very appealing! (and many of them can come with legal trouble for anyone who helps).
1 reply →
Even ignoring the fact that human euthanasia is illegal in most of the US, it's rarely that easy. Both of my paternal grandparents lived into their 90s but suffered from mental decline (different forms of dementia) and died as shells of their former selves. If you could have spoke to either of them at the end of their lives but with their full mental capacity, I suspect they would have said that they'd have preferred to die earlier rather than live through that decline... but in reality by the time anyone understood how severe their mental decline would become they were already well past the point that they could have consented to euthanasia.
In theory you could presumably have some kind of system where a person of sound mind could that said, in effect, "if my condition declines beyond _____ then I want to end it," but doing so would be an incredibly touchy subject even if euthanasia was legalized. Unfortunately there is a very real potential for such a directive to by abused by people motivated by greed (gimmie that inheritance) or who simply don't want to deal with an aging relative who needs more help but hasn't reached the point where their euthanasia directive should be triggered.
Assuming forethought one can set up a living trust. I have one. If I can no longer consent then a family member I designated can consent for me. It isn't without risk and requires a lot of trust.
> but doing so would be an incredibly touchy subject even if euthanasia was legalized.
It would, but the alternative is to make people live though this mental decline as we currently do. IMO it would be well worth the risks to be able to ameliorate the end of peoples lives.
My plan is to end my life well before I hit severe mental decline (not “if it gets worse”, with all the ambiguities that entails). If that cuts a few years off then a be it!
It really, really doesnt have to be that complex. If people are religious nuts to believe suicide would bring them to some religion's hell (it won't, since it doesn't exist even if their variant of god(s) would exist), there are tons of ways to pass out rather quickly and not fulfill that criteria, and not bother anybody with the process (various car/train jumpers or suicide-by-cop doers whom I consider utter selfish a-holes).
Walk out to a storm or blizzard not equipped for it. Go fight a bear or lion or crocodile. Go for a swim that you can't come back from. Do some high risk type of adventure that in high age is not even discussed. If you make it, great experience, move to next one.
The list is literally endless and can be done in some form even by quadriplegics. It allows you to plan goodbye and closures, wills etc. The fear and pain and suffering is concentrated into such a tiny sliver of time compared to dying discussed its uncomparable.
It just takes balls to accept that this is it, what mattered for you in life is over, and now its time to think about your closest ones and not yourself. Like a breakup, many will continue living in bad relationship since its a small amount of pain and evil every hour, every day. Instead of standing up and walking off to uncertainty and freedom.
Medicaid will pay for nursing homes (if medically justified) once you run out of money; but the per diem isn't that much. Apparently a lot of nursing homes will commit to accepting medicaid reimbursement for continuing care if you can commit to paying N years first. I've heard usually 2, sometimes 3. If you can swing that, your kids won't have to pay, or they'll pay for incidentals, but not the whole thing. There are homes that just straight up take medicaid, but they review poorly; it's not enough to pay decent staff at reasonable levels, so there you go.
What I've heard about long term care insurance is you can't really buy a plan with useful coverage anymore. The old plans were good as long as the insurer remained solvent, but many didn't.
"Otherwise... you spend everything, and then your kids pay."
That's incorrect. With Medicaid, the recipient is require to spend down their assets to a small amount, then Medicaid will pick up the remainder. The recipient's children aren't on the hook for anything. Of course, they won't receive any inheritance since the estate of the recipient has been drained prior to Medicaid.
This is wrong. Or rather, correct, but only in certain states, and for certain facilities.
IMD over 65 is only offered in some states, and have strict requirements for facilities that accept medicaid (not all that many do near us).
In our case, the waiting time was about 3 years for a room in the facility closest to us. Alternatively, there was an option about 4 hours away.
Worse, both medicaid facilities we looked at were... bad. Frequent complaints about abuse, very high rates of staff turnover, very little stimulation for residents (one was basically a single old tv on the wall in a cinderblock room - it looked basically like prison).
So yes - Medicaid will cover some costs in some cases, but really - the kids end up paying.
My father had long term care insurance. He got Alzheimers, and went into a nursing home, and passed after 3 years. The insurance covered most of nursing home fees.
I did some math on the premiums he'd paid for the insurance, and the payout. It was a break even.
In other words, putting the premiums into an HSA would have financially worked out a lot better.