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A few weeks ago, I saw an embroidered dishtowel that said, “This too will pass. It may pass like a kidney stone, but it will pass.” I thought to myself, this is how I feel about this month. Normally a festive time, much of our attention was focused on getting my father transitioned from independent to assisted living on short notice and making some other associated changes.
Dad went into the hospital in November. We were already planning to come for a visit in February but decided to get ourselves to the U.S earlier. It was good that we did. Following the hospital stay and toward the end of his rehab, his continuing care retirement community delivered the news that he was welcome to come back, but not in independent living. His last Medicare covered day in rehab would be December 24.
His community had an assisted living studio that was about to become available, but there would still be a gap of some days. Besides, it was much smaller than his independent living apartment, and quite expensive. Fortunately, a sister facility nearby had a studio available that was not only cheaper but more spacious, which would allow him to bring his most treasured things. My wife was amazing in organizing the space so he could have as many of these as possible, not to mention keeping me sane.
The biggest catch was that we had only a few days to make the move happen. Sparing the details, suffice it to say it was tight enough that we delayed his move from rehab by a day to allow his bed and recliner to arrive, and were still working the morning of his arrival on December 23. Also, as you might expect, a CCRC is understaffed during the Christmas week, so everything didn’t go swimmingly, but it turned out okay (sparing the details again).
In addition to getting him settled in over the next few weeks, we also turned to helping him revise the complicated will he had said last year he wished to update, convincing him to give up his car and getting it sold, and filing a claim with his long-term care insurance. We’re usually outside the U.S., and I was keen to have these done before we left. As many readers will understand though, it can be counterproductive to push too hard on such things, especially when it’s my dad. I’m happy to report the will is updated and the car is gone. The insurance claim is well underway and my fingers are crossed.
It’s not what he wanted, but his new place has upsides. For one thing, it has a better wellness center. He rarely used the one at his previous place, but he’s going to three different classes now in addition to his therapy. The person who runs it happens to be a kettlebell instructor, so that was an instant connection. There’s also a tai chi class which is a draw for him as a kung fu black belt even if it’s chair tai chi. He’s finding his way back to intentional movement, which is awesome.
He’s also eating two meals a day in the dining room. We suspect it was closer to one meal a day when he was independent, if that. The ability to sit in his room and enjoy a cocktail sometimes took precedence over going down to a meal. The twofold benefit of less alcohol and better nutrition can only be good. His medications are managed for him too, which was a source of concern for us.
Someone is checking on him every two hours. Dad has become less responsive to calls and texts, so when he doesn’t pick up the phone, it’s no longer cause for worry. Admittedly this part is mostly better for us; he was never worried about himself when he didn’t answer our texts.
We’re grateful this has turned out as well as it has, and to have accomplished so much over the past few weeks. I’d be prouder if my own self-care had been good too, but we can’t have everything.
I’m sure that are a bunch of lessons from this experience that I should offer. It’s too much to do right now. I mostly just wanted to relate the experience and prompt some thoughts. I hope everyone else who must do this eventually, perhaps us included, is able to do so in less of a rush and with at least as good an outcome.
It will be wise to scout out several Assisted Living facilities in the area before you actually need it. At least you will know which is a good facility. One manager of such a facility told me ” We get 48 hours notice that a patient is moving in. This often happens on Fridays. In many cases, patients have no choice.”
MIchael, I read so many smart decisions in your story. You’re a good son, with a good wife. The unwritten side of the tale comes through loudly, as well. I’m sure that time was a whirlwind of work and emotions. I hope the whole family can now have an extended time of peace and rest.
Thanks Ed, I appreciate that. “Whirlwind of work and emotions” about captures it. There are still things to do but with less urgency and from anywhere, so yes, taking a breather right now. I hope things are going well on your end.
Trying to catch my breath! But no real problems, just busyness and unanticipated changes to my plans.
Ed,
Good to see you commenting more frequently. I assume you had been too busy with settling your mother in law to have the time to post/comment. Your comments are always thoughtful and spot on.
Thank you so much, David. Actually, I’ve been so busy that my semi-retirement has been severely crimped. I’ll tell you about it sometime.
Congratulations on getting through this so well, especially given the lousy timing. Good that he likes the new place, although one reason I like the CCRC concept is that I expect stay on the same campus for both Assisted Living and Skilled Nursing. All the AL units at my CCRC are now one bedroom, I think partly so that couples can chose to move together if one has to transition to AL.
Thanks Kathy. That was my dad’s expectation as well, and he might have done so had the timing been different. But then he wouldn’t have found the activities he has now. Silver linings…
Having been through this with my mother-in-law, I’m glad you are on the other side of the move. I ask my wife after these adventures, why are we always reacting to these events rather than implementing well thought out plans? The issues can be anticipated. People don’t get younger. They usually do not get healthier. A fall or health crisis is part of life after a certain age. How can you plan for the next big event in your father-in-law’s journey? I have not solved this for my mother-in-law, but I think of it often.
In my dad’s case, the rush was due largely to circumstance rather than failure to plan. He had already chosen and moved into a CCRC, and part of his thinking in the choice was that it had multiple levels of care. I already had POA so I could do a lot on his behalf. My sister already had health care POA. We had also already broached the topic of assisted living with him, though he wasn’t ready to make that move.
An emergency trip to the hospital and the rehab that follows just happens. Given his condition at that point, we were aware that his community might not let him back into independent living. Knowing a couple of weeks in advance that they might say this helped but still left a lot to do. It just happened when it did.
All that said, there are plenty of people out there who don’t have estate documents and aren’t on CCRC lists.
The next big event for my dad would be a move to skilled nursing or memory care, or to pass away. Along with the will, we just updated the POA so my sister is on it as a backup; it just named me before.
Michael,
Have you had time to reflect on what plans you should make for when you are in a similar situation your selves? If so, it would be interesting to read.
One thing is that I now lean even further away from spending money on LTC insurance. Among its downfalls is that it requires proof of need. If you plan to self-insure, you can choose to go into assisted living when you feel like the need is getting close rather than wait for it to happen. Of course you can still do that if you buy insurance, but part of the money you’d use to pay for it has already gone to the insurance company.
Also, though not a direct result of this experience, we’re already on two CCRC lists even though we have no plans to settle anywhere in the near future, and we already have estate documents in place.
I never thought that a LTC policy was affordable for us. After years of saving for retirement however we are in good financial shape for a CCRC in the future. Many of the compounded dollars and earnings would not be there if we had purchased a policy with its huge inflationary increases. In retrospect I think investing the money instead of paying LTC premiums may be a smarter decision. There is also the advantage of not having to jump through the insurance companies’ hoops when you need the care. One caution is you need to move to a CCRC before you might end up with a disqualifying diagnosis.
Yep. Many people want to enter a CCRC while still independent, and the LTC insurance isn’t helping at all until more care is required – and crucially, until the need for it can be proven.
Determining how to fund Long Term Care can be a challenge. Approaches may include Medicaid, insurance or self-funding. Not all are available depending upon circumstance. Insurance is best an early decision as rates increase dramatically if one attempts to get insurance later in life. Some companies offer a discount if a couple obtains policies simultaneously. Obtaining insurance may require a medical screening.
I don’t remember if Doug and I got a discount when we bought our policies around our 50th birthdays (he was six months older than me), but when he died without using his (and, of course no refund of premiums), I was able to take advantage of a waiver-of-premium benefit on the smaller of the two policies for me. We had purchased the main policy for both of us, plus smaller ones that provided inflation increases on the benefits. So I went from paying for four policies annually to one. The premium has increased a lot, and will continue to do so, but it’s still less than what I understand other people pay, so I’ve decided to stick with it, regardless of the premium increases. The company desperately wants me to accept a cash payout, but I’m not taking it.
Michael, sounds like things went ok. We were doing the same thing with Spouse’s mom last month, only she moved from her home. I hope your dad is settling in ok. MIL is still anxious, but she has Alzheimer’s. You got a lot done while you were away from home. Chris
Thanks Chris. Yes, all in all it has gone well. Best for you and your MIL.