Health and aging

[catherine]

We all like to talk about aging in place and it is totally fine. But also think about sudden permanent incapacity, need for advanced nursing care, or brain diseases. It is fine to say one is living independently until it takes a village of caretakers who are giving up their one or their multiple lives to keep you in place. It is most usually a spouse or partner or a child.

Had one of our top elder lawyers give a talk and even they said it is not death that is the biggest crisis for most families but any form or incapacitation whether physical or mental. It can even come on suddenly like a stroke or slowly like dementia or ALS. We need to at least have a converstation and discuss various options for each spouse. And do not forget children that may be called on to drop everything.

I agree, but that's life. We can always expect the unexpected, which I know is your point. In the "old days" people had heart attacks and died. Today, life can be extended ad nauseam, despite incapacitation. Is that a blessing or a curse? I prefer to plan prudently, but not to be prescriptive about decisions that might be our kids' rights to make at that point. I hope that when they tell me it's time to go to a nursing home, I will go graciously, as my mother did. Frankly, I hope I have a life-ending heart attack.

I wonder if we obsess too much about elder care. This is an industry that has been created fairly recently. Again, "in the old days" at-home elder care was taken for granted as a part of life. I'm not saying it's easy, or even possible these days, but sometimes the best things in life are hard.

[flowerseverywhere]

So how much is the buy in fee for these assisted living places?

I’m just not attracted to the assisted living places in the St. Louis region because they are all out in the boondocks and the architecture quality is lacking severely.

https://johnknox.com/independent-living-florida/

As you can see, the minimum fees and monthly fee are high for the smallest residence. Someone who went there for a tour got a quote for several hundred thousand then a fee higher than that for a house they would never own.

The one my friend is going to has about $90,000 buy in and several thousand a month for a small apartment. Food is an additional.buy in, depending on the meal plan. I'm sure price varies widely depending on amenities and services, area of the country and size of apartments or houses

[flowerseverywhere]

We all like to talk about aging in place and it is totally fine. But also think about sudden permanent incapacity, need for advanced nursing care, or brain diseases. It is fine to say one is living independently until it takes a village of caretakers who are giving up their one or their multiple lives to keep you in place. It is most usually a spouse or partner or a child.

Had one of our top elder lawyers give a talk and even they said it is not death that is the biggest crisis for most families but any form or incapacitation whether physical or mental. It can even come on suddenly like a stroke or slowly like dementia or ALS. We need to at least have a converstation and discuss various options for each spouse. And do not forget children that may be called on to drop everything.

This is my biggest fear..

[flowerseverywhere]

One more thing speaking of loved ones. Make sure your house is decluttered and hazard free to prevent falls. Plus we have had numerous threads about cleaning out parents houses. I try to put at least one item a day in the donation box, constantly evaluating needs and wants.

[iris lilies]

https://johnknox.com/independent-living-florida/

As you can see, the minimum fees and monthly fee are high for the smallest residence. Someone who went there for a tour got a quote for several hundred thousand then a fee higher than that for a house they would never own.

The one my friend is going to has about $90,000 buy in and several thousand a month for a small apartment. Food is an additional.buy in, depending on the meal plan. I'm sure price varies widely depending on amenities and services, area of the country and size of apartments or houses

$73,000 minimum buy in. Monthly fee of $2400 which includes meals. That seems do-able to me. I did not look at the size of the small units.

As an elderly person I want one nice room and a bedroom so that unit might be 350 ft.². I would like to be able to walk out of my living unit onto a patio or a grassy area with at least one flower bed for plants. This seems to be a realistic expectation based on the places I see.

The sticking point for me is that I can’t stand these motel- like cheap one story sprawling buildings that are typical for assisted living. I want to have SOME architectural interest, and that is hard to find because old buildings are super expensive to maintain.

[frugal-one]

I've thought about this. DH is not interested in discussing it. However, we plan to age in place, as long as possible. Although we have a 2 story home, we can easily live on the ground floor if needed, and we could put in a stair-lift if it comes to that. As we are/have always been working class, we don't have a huge amount of retirement savings but enough to live carefully on. If we went into care, it's so costly that we'd soon hit the Medicaid threshold. We did put our house in a trust so as to protect that, our only real asset, for our two adult children (who deal with some metal health challenges and seem unlikely to be high-wage earners...). I know there are some pros to renting, but when we talk to DH's older brother, who has always rented, it's frightening to hear how their rent just keeps going up. They pay more for a really crappy apartment than we ever did for a house payment, including taxes and insurance and basic up-keep, and since we paid off the mortgage, we've paid out WAY less. I know it's different in other locales, and everyone's circumstances are not ours. I am am introvert, and DH is fairly introverted. I swear, I could go for days happily not interacting with anyone in real life. The idea of living in a community with a bunch of other old people just does not seem appealing.

You choose or not to choose to interact as with any other community. It is not mandatory. The benefit IMO is that people here are all in the same situation and family is not present so they watch out for one another.

[sweetana3]

Frugal-one you are right on point. Mom's friends in the independent apartment complex saved her life twice. Others have been helped in many ways. They watch out for each other. Leave an uncollected newspaper and someone will knock on your door.

[early morning]

The sticking point for me is that I can’t stand these motel- like cheap one story sprawling buildings that are typical for assisted living. I want to have SOME architectural interest, and that is hard to find because old buildings are super expensive to maintain.

IL, around here old high schools have been successfully converted to senior apartments/ assisted living facilities. There's also a convent with almost no sisters that is now housing seniors, no need to convert. The ones I've seen are architecturally interesting, YMMV. But all are from the 1930s or earlier. Sadly, there is no private patio/garden area with any I know of. In fact the high school conversions (and many of the old existing schools that are still schools) have no actual ground floor, one goes up or down, but never just "in".

I get that incapacitation is difficult to deal with, in any form. But I refuse to stop living my life as I want it, "just in case". Look ahead, sure. And declutter, I need to work on that -but DD and I have a side hustle in resale so... there's gonna be stuff. But DD lives with us, and half the "stuff" here is hers, so I don't feel badly thinking that it's going to be mostly hers to deal with at some point. Again, I realize that everyone has different circumstances.

Anecdotal note about a FLA independent/assisted facility - DSIS had a best friend who bought into one of those independent living places that promise to move you up to assisted and then nursing home care as needed. Every step, she had to resell them her current place that she had "bought into", at a reduced rate, and buy into the next level at the new and improved (much higher) rate. By the time she got to nursing home care, the facility had decoupled from Medicaid, which they had assured everyone they would not do and that residents would be able to stay even if their money ran out. The higher buy in at each step and the requirement to resell back to the company at a reduced rate was in the contract, but the Medicaid assurance wasn't. She did not run out of money, as she died from an untreated infection that turned out to be cancer, but it was close and her daughter was frantic about it.

[iris lilies]

earlymorning, yes, I have had in the back of my mind a couple of possibilities run by the Catholic Church, or somehow associated with the Catholic Church. There’s an old school across the street from one of the house we used to own. It is senior apartments, but it’s not assisted-living. I think a convent has been converted to much like what you say in another area.

There’s also an old 1920s high-rise in St. Louis around the corner from my condo that has some element of assisted living. I just don’t know how much. But I believe there are meals offered there and they certainly have community programs to. I’ve always been attracted to that one because it’s in a neighborhood I like very near an old pretty park.

[jp1]

My sister and I were fortunate that our parents never needed us to step in and manage day to day care for them. When they were both alive they were able to care for each other. When mom died after a brief bout of cancer dad was still able to manage on his own although cooking was a big deal for him. He had never done any cooking beyond making cream of wheat every morning for breakfast for himself. So we taught him how to cook as best we could and encouraged him to splurge on meals in restaurants since he had plenty of money to afford to do so. After about 4 years he decided that it was just too much stress and moved himself into an assisted living place. I'm thankful that he did that because they had round the clock staff and residents all had those "I've fallen and I can't get up" devices. Three or four times during his stay there the device saved his life when he rapidly developed pneumonia and needed assistance. The facility itself was ok but incredibly depressing. Dad became agorophobic and bored. They had a big banner on the side of the building that read "The Villages at Lowry. Your story continues here." One day my sister and I, and our partners, were all in Denver at the same time visiting him and as we drove up I read it out loud "The Villages at Lowry. Your story ends here." It was macabre, but an entirely accurate revision. (My sister's wife was in the back seat away from the building and couldn't see the banner and was appalled, responding with "OMG! That's horrible! I can't believe they would do that!!!" which was exactly the reaction I expected and was hoping for. She's an incredibly trusting and kind person. My joke had landed as perfectly as I hoped it would.)

SO and I don't have kids so whatever end of life care either (or both) of us need will have to be purchased or given to us as charity if we can't afford to pay for it. Although the future is never certain I'm likely to outlive him since I'm 3 years younger and have no health issues beyond HBP and diabetes, both of which are well treated. SO, on the other hand, is a cancer survivor with multiple fairly significant health issues, at least when taken all together for a person his age. (Mom also expected to outlive dad since she was younger, women live longer, etc, but that's not how things worked out.) We still hopefully have quite a few years of active life left since we're both just in our late 50's, but when our work-o-meters hit zero we're both interested in looking into moving somewhere less suburban than where we are. Living in a city, not necessarily a major one but perhaps a college town like Davis California or Fort Collins Colorado, in a neighborhood that has lots of walkable destinations, and ubers available for destinations that aren't walkable, is an important part of what we both want from a retirement housing choice. Add to that a home without stairs, either because it's a condo in an elevator building or single family ranch style house on a small lot and we'll hopefully be able to age in place for as long as is reasonable.