The signs of this looming crisis are everywhere. Expensive home care, long term care and end of life care are going to be the biggest challenges facing baby boomers.
There are over 69 million baby boomers, 21% of the US population, holding 50% of wealth. Unfortunately, most are unprepared to face this crisis. I find that in my retirement community, most have not investigated options to provide for such care and have shown little interest. They say they will handle it if and when they need it.
Private equity and public companies are buying up nursing homes, hospices and assisted living facilities in record numbers as they see accelerating demand and pricing power that will sustain high profits. No wonder, most hospices now are for-profit. Along with rising costs, staffing shortages add to the crisis. I saw this
informative video on why nursing homes and hospices are so expensive in the US. It is an eye opener.
There have been a number of very good articles/Forum questions on this subject, including CCRC’s and long term care. We have heard about some strategies. Ultimately, the choices depend on individual circumstances. Money does greatly help, but you need support and companionship to navigate this tough end of life journey.
It is important to set up a plan that covers multiple scenarios as it is not possible to predict which one will play out. I am investigating various options to make a plan so it is easier on us and our children when the time comes.
I know some of you have gone through this, having supported parents and relatives. Some of you have made your choices already. Any advice you want to provide that will help us? What works and what doesn’t?
My daughter asked me about this today. “What do you.plan to do about paying for medical care when you get old?” She knows about Medicare, she’s an MPH, but maybe she doesn’t believe there will be Medicare. She clarified, What if you need full-time medical care? I didn’t have a good answer.
Part of this is that now managing my mom’s finances, I see that her long term care policy would not pay out much. I don’t see how she would ever get as much back as she put in, even if she needed full time care for years. It looks like either you get lucky and need minimal care at the end or you are sick for a long time and either don’t get care or leave your heirs nothing. Sorry to sound so bleak, but LTC insurance doesn’t look like a good investment. And with the federal gov’t and many states abandoning regulations, so called insurance looks even less worthwhile.
Risk level, duration and potential costs are unknown. This is why planning is difficult and frustrating as you say.
A lot of people are planning on home health care, but I don’t think that will be an option for most of us. That will require far more home health workers than there are now. Where will they come from?
Home health care isn’t a viable option for me regardless. I’m 75 and my only close relatives are my 78-year-old brother (who’s already in assisted living) and my 65-year-old sister, who I wouldn’t want to burden with my care. There are only a couple of CCRCs in my area, I don’t want to move elsewhere. I can see the time in the not-too-distant future that I won’t be able to drive anymore, I’m considering moving to an independent living facility before that occurs. My most likely choice is on the campus of a non-profit hospital, but independently managed. It also has associated assisted living and memory units. It doesn’t have a skilled nursing care facility, but the hospital does.
I have more savings than I am likely to need, even if I require a couple of years in a nursing home, which is considerably more than the mean nursing home stay.
Thank you for bringing this up, Sundar. After seeing how mother and wife’s aunt were mistreated in assisted living and a nursing home, respectively, my wife and I do not want to go into any LTC facility. Our funeral director told us “They’re basically all the same, even the “luxury” facility my mother was in had people die from neglect. For those like us who have children who can’t or won’t take care of us, it looks like either expensive home care or a personal robot. 😉
Home health care is very expensive. This arrangement can work for a few months. I have seen a few cases where people had to move to assisted living.
Ive commented on these pages before that my wife and I are on waiting lists for a CCRC. The decision could be 10 years off at which time we will be in our late 70s. My wife is all in on the CCRC and I’m a little more ambivalent about it even with the my family experience. I suspect part of this is our personalities and family history-She grew up with siblings and a large extended family and is an extrovert. I’m more on the introverted side and was raised in a small family. So suggestion 1: If you are in a relationship, have lots and lots of frank discussions. Suggestion 2: If you can, aim to keep your options option and have back-up plans. If goes without saying to have a plan. Suggestion 3: This comes from my family experience. When my mom had a major stroke and nursing care in New York State and I was living in PA at the time, I tried valiently to complete all the documentation required to qualify for Medicaid. I failed twice after personal interviews. I finally hired an (expensive) Elder Care lawyer who helped with a couple of bits of documentation and accompanied me to the interview. While I was previously treated like a criminal trying to fraudulently quality, the lawyer was treated like the son of God. I couldnt get over the feeling that this was a racket. But we qualified that time and after that the lawyer helped us many ways. So consider an elder care lawyer if appropriate for the situation. Good luck to all-we will need it!
Just noticed this WSJ article on the subject: The Senior-Housing Market Is About to Be Rekindled by Aging Boomers – WSJ
Can’t read it myself as there’s a paywall, but subscribers may find it of interest.
Good article. After 2019, there was a collapse of senior housing demand due to fears of Covid. Developers stopped building, but the demand is coming back strongly. By 2030, there will be a huge shortage of senior housing (independent, assisted living). 50% of seniors cannot afford such housing. Of those who can afford, 35% elect to age-in-place. Developers are building more profitable luxury senior housing to cater to wealthy retirees.
Thanks Sundar for a good post about a topic all seniors should be concerned about. DW is 82 and I am 80. We are living in our home of 51 years and our desire is to live out our lives year. It is getting harder as we have over 2 acres of mostly woods which I have to keep up with.
Our son lives nearby and is a remodeler. He can do just about any home maintenance that we need, although we try to minimize asking him for help. Our daughter lives 4 hours away, and has a disabled child, so we are reluctant to ask her for help.
I would like to move to one of these Over 55 communities, but that is a tough sell with my wife. I am not excited about these CCRC communities and my wife is even less so. A lot of seniors at our church have joined them and seem satisfied. My older sister joined one in DC and is not happy with it, although I think part of that is on her.
We have the resources to do whatever we wish, but living our your life in your own home is hard to beat.
yes, hard to beat…. until you can’t. Which may happen suddenly. My wife and I are making the hard plans to move near our daughter (7 hours away) and sell the home we built and have lived in/raised our kids in. It’s tough. Our same-aged friends are “aging in place”, but they don’t have an answer when I point out the obvious potential eventualities and ask how they will deal with them.
Will, we moved to be near our kids also before it was needed. Agree with your thoughts. Chris
Hi Sundar, this is a thoughtful post, not only for oneself, but also for siblings and close friends.I have several siblings who never married; other friends/relatives are divorced or widowed like myself.Financial pressures in retirement plus lack of immediate family will loom large for many. So much uncertainty – really tough choices are ahead for those who aren’t willing to start planning well ahead… or who simply can’t plan ahead emotionally. The decisions will cast ripple effects among extended families and friends.
Thanks Sundar. This issue is becoming more important with each passing birthday. We are fine for now (I think!), but we’ve learned that things can change quickly. I think it is important to start to plan for contingencies when we are still pretty sharp. Moving closer to our children was a big step. We hope to never burden them with primary care, but even making it easier to visit would be a help.
Researching and selecting good senior care facilities near children is a good first step. You may not need it now, but you know to where to go if you are forced to use such services.
Sundar, I told Spouse we need to start looking here for MIL in case it comes to that. The best places have waiting lists, I know. Chris
Sundar, thank you for this. We are in the middle of navigating some of these issues with our parents at this time. My mother had a stroke in ‘21 and was no longer able to live safely in her home. She has been paying for an assisted living facility. She had some assets and her home was sold. The money is getting lower now and there is a chance of her being kicked out of her AL place if they don’t end up taking Medicaid (not all AL do). So, I am guessing she would have to go to a Medicaid nursing home? My sister in town is the POA.
Spouse’s parents have more assets and should have enough for LTC. They are in their homes still, but MIL is in early stage of dementia. We are 4 hours away and have had to visit her more in the last year. It has been difficult b/c she thinks there is nothing wrong and she can still take care of herself. Spouse is POA. A couple of things that are helping: 1. MIL’s dr assigned her a nurse navigator that Spouse communicates with regularly. 2. Spouse set up to receive text notices with some of her accounts when they are used. She was not happy about this, but hopefully has forgotten by now. She has been turned into the BMV in her state, so we are expecting her drivers license to be taken away soon, so this should force her into AL. We hope….
FIL and stepmom seem to be plugging along but we have concerns about his driving also since he has had a few accidents. But never his fault, of course…
Folks here also know Spouse’s brother has ALS and I wanted to mention that SS and Medicare were just wonderful when it was time for him to transition from work and got his benefits started right away. His life insurance at work also had a clause that he was able to receive it while still living, which was a blessing for them. Chris
You have handled a variety of family needs for senior care and your post is very educational. Thanks, Chris.
Chris, you and your wife are really good people to be shouldering this burden. It’s a labor of love, but still quite challenging. My wife and I have a lot of experience with both parents and her widowed aunt. You mentioned you have POAs for your Mom and MIL. My only suggestion is to do everything you can to have financial POAs filed with their various financial institutions. That can take a while, and not every institution accepts a standard POA. We were lucky that our parents and wife’s aunt trusted us and were willing to give up control off their finances. Once we got everything simplified and under control it was much less worry. Best of luck.
Rick
Making sure beneficiaries are properly documented for each financial account will help when the need arises.
Thank you, Rick, Spouse got the last financial POA over to MIL’s bank when we were there last week. They had done the brokerage acct earlier
Thank you, Sundar, for the comment about account beneficiaries for MIL. I will have Spouse check that, but think they are ok. My mom, I think there will be nothing left. Dad and stepmom have a trust.
It is a lot to learn. Chris
I look forward to reading the responses.