Why are the costs for nursing care and long-term care beyond what is affordable?

Oregon Girl, I am wondering what this means, you wrote "We paid in both sides as we were self employed. We only GET ONE SIDE in SS." I am not sure what this is? I am self-employed too, I pay in the full 15.3 % SocSec/Medicare taxes, and when I retire I can collect on my contribution, and my spouse can collect on theirs. After one of us dies, the remaing spouse can collect on the higher of ours (my spouse's probably). That is the way it is for everyone. What situation are you describing? I'm just wary, since you mention you're self-employed.

It would be wonderful if we could all live at home or in assisted living with support until the end, but the reality is that many people need a higher level of care than can be provided for in that setting, and that level of care comes at a cost. Even here in Canada where we have universal healthcare and the cost of long term care is subsidized there is no free ride. Those with more material wealth can afford private rooms and extras or can avoid nursing homes altogether and pay for round the clock care. Those who can't get room-mates and basic care at the home the gov't chooses. Still, no one is put out on the street, there are safety nets in place for those who are truly needy. Those of you in America have medicaid that serves to help those who can't help themselves.

The thing that I find most frustrating is the whole structure of long term care. Too often we seem to be paying for sub standard care, god help those who have no one to advocate for them. I have read of some wonderful concepts out there for a more compassionate way to spend our final days. Unfortunately most of us are just looking for somewhere decent close to home to place our loved ones, we don't have the resources of time or money to be jetting off across the country or around the world looking for the better alternatives.

Not sure why you would ask a question that there is no valid answer for. Ask your town's council on aging if you still are in a quandary.

I think too, that the "costs" are not just MONEY but someone's TIME. Usually, the in - town daughter is The One who has the privilege / duty / honor / burden. If the more selfish kids have the cunning ability to forsee the excruciating amount of Time it will cost them, they will move away from their home state, far far away and when parents need help, throw up their hands and say, well I am just too far away (and then they go on about their lives & careers and leave the mess to the local kid).
I don't know of very many that will make the choice to spend their own Time or pay their own expenses to go across the country ( or even 1 or 2 states) to assist, on a regular, meaningful schedule. So while the dollar costs to an elderly person are extremely high, the personal costs (and dollars) to their kids, is also extremely high. Care takes more than dollars, it takes family attention, and these days, increasingly, nobody "wants" to do that, even for their own parents. All the more reason, IMHO, parents should plan on spending their budgets planning for their own future needs -- nobody is going to do these things on their own Time, or at little Cost.

You're onto today's reality!! With our current Social Security system, EVERYone is seeking "employment" so they can create a Social Security record of eligibility! Anyone who stays home to care for family members faces poverty in their old age! Women, in particular, misunderstand the Social Security benefits they will be entitled to. At best, if married for 10 years (and not remarried) the maximum you would receive is 1/2 as much as your former spouse!!

How about this: When you file a joint tax return, WHATEVER the total joint income, credit 1/2 the Social Security payment to EACH spouse! So, no matter how long you are married, or how many marriages, each spouse OWNS their own Social Security record. The Caregiving spouse may not have been "employed", but has certainly upheld 1/2 the value of the partnership.

If this seems like a responsible idea to help "Fix" Social Security, PLEASE contact your U.S. Senators and Representatives. We CAN make a difference!

Vaccinations are evil. I am so sorry that this was perpetrated on your poor mother. My mother is much the same, very alert, interested, active until an undiagnosed hyperthyroid put her into arial fribulation. She has lost lots of her oomph and not has to be accompanied at all times. We refuse all vaccinations and most antibiotics save sulfa. She is allergic to most antibiotics and has an extreme anaphylactic reaction. I'm sorry for the loss of your mother and for the burden that the irresponisble health care system put on you.

Mother is also legally blind due to macular degeneration.

malloryg8r, I agree in regard to TIME. I know for me, time is money. If too much time is taken then I need to hire someone to do the things I normally would be doing myself at my own home. That is money that is not going into my retirement.

My parents have saved for those big "rainy days".... I just wish they would blow the dust off the stocks/bond/money markets and use some of it. They are retired, have been for almost 30 years.... they have all the time in the world... I don't.

Thus, I understand why Assisted Living/Nursing Homes have a high expenditure, to which they charge a high price to the patient to help pay for those costs.

Mailory....What I mean is I was self employed and NO EMPLOYER paid the Employer side and as an employee of my own corporation I paid the employee side also. I paid the employer and the employee side.
Yet, when I collect I only collect on the EMPLOYEE side. Simple but unfair. I threw money away every month. I was the Employer and the employee. We had a corporation so I drew a salary from the corporation. I took little in the way of a salary, so when I retired, my ss was less than my husbands who made less money than I did BEFORE putting it through the Corporation.

Social security check is calculated on reported earnings so better make sure the earnings are reported correctly and if self-employed, better make sure you report all earnings. After that, there are financial planners who specialize in so-called maximizing the amount of SS you will receive, so maybe that is an option for Oregon girl or anyone who is needing maximization. I know my fin planner plotted out all the possible scenarios, and for our situation the "benefit" of waiting til age 70 to collect, didn't appear until after age 90, so we are going to start collecting at the regular ages. Hope you can find a good, commonsense financial planner oregongirl!

I think nursing care costs are so high because of all the expenses they incur such as employee salaries, insurance etc. But I also think one of the reasons for the high costs is the fact that they take people into their nursing homes because no one can deal with them and no one wants them - so they get away with the astronomical fees. Sick but true.

I believe one thing that pushes up healthcare costs, and by extension some parts of nursing home cost, is health insurance itself. The health insurance industry is full of millions of people who have to be paid and companies that are trying to make a profit, and the money for all this is coming straight out of our own money spent for healthcare. It seems that once some form of insurance gets involved in anything, the costs of the service itself goes up. I've had doctors tell me that taking care of patients is easy, but dealing with the paperwork associated with insurance for that care is difficult, time-consuming and expensive. There was a wonderful discussion (a real "eye opener"!) of this subject in The Atlantic a few years ago titled "How American Health Care Killed My Father" by David Goldhill that addresses this subject very well and challenges the entire system in this country.

The answer is, because people are desperate, and they *can charge that much. No way is it worth it. That being said, my mom is on Medicaid and we pay her SS check minus 50 as a copay. I still feel it's too much! The private pay cost in all 22 NY nursing homes I prices is $450 a day.

I once itemized the cost of the non-medical care my mom gets (3 cafeteria-style meals per day $120 a month, a SRO with a shared toilet $640 a month, etc.) I did not include the medical attention because Medical is covered by her MEDICAL INSURANCE!!! YEs, nhs are a total rip-off, but if your loved one is so ill that you are not equipped to care for them at home, you're at their mercy. So am I.

That being said, things vary by location. Pamstegma, I don't know what a "private pay nursing home" is. In my mind, all nursing homes need to accept Medicaid in order to stay in business. There aren't many people who have $144,000 a year to keep paying a nursing home. Since my mom is on Medicaid, I guess she's not in a "private pay nursing home." However, she has had a private room since she got there in November of 2014, simply because the dementia units are all private rooms. So, original poster, shop around, you may get lucky.

Wow, Christine73, that IS expensive. In the Cincinnati area we're paying $210 per day, so it's above $6000 each month. I suspect that regulations, etc. imposed by various government agencies helps to contribute to the high costs. As I recall, charges in parts of such states as Arkansas and Louisiana can be as low as the $40K-$50K range per year.

It seems that just about every week my mother, with her poor memory, asks me what it costs to keep her in the nursing home. I usually tell her the daily rate, and she asks "how can we afford that" and I explain that with stock, dividends, SS and father's pension, the expenses are covered. Then she asks what other people do, and I explain that some are probably also private pay, some may have long-term care insurance, and others are probably using Medicaid. That usually satisfies her until the next week!

NH and AL are business and need to charge enough not only to cover the costs of doing business, but making a profit as well.

Hello everyone! Here is my update. After looking all over for a nursing home, I had my father placed in a older, formerly catholic, long term care/rehab/nursing facility. He had to go on medicaid because the cost was far beyond what what was affordable. It has a lovely chapel and had one wing just for nuns. a few priests live their also. I think those items made things a little more tolerable, although their were challenges. Everyone has a private room and bathroom. I saw my father, DAILY. This was vitally important. The staff realized I was going to be totally involved in my fathers care and they made sure he and I were happy. If I had a concern, I let not only the floor nurse know, but the social worker and the Head Nurse when necessary. This facility also had an on-sight dialysis unit, which was great. No more having to take him out on a cold day to go to dialysis. My father was only a resident there for 8 months before he passed away. I was able to request Hospice to come in when he was on his final days. They did a wonderful job helping him and comforting me. Now that time has passed, I have been attending mass their during the week. I pray for the residents when I go. I pray that those of you who are still dealing with these issues, find the resources you need to address your situations. I hope that our new President and his administration do not cut the funds for Medicare or Medicaid. His veterans benefits (aid and attendance) were cut when he entered the nursing facility. These are much needed resources that many, many families need to care for their loved ones. I could not have done it without that assistance, and my faith.

I'm disturbed by some of the comments that if a person ends up on Medicaid it is somehow their fault because they didn't save or spent their money "frivolously." Or that if you just "take care of yourself" when you're young, you won't need assistance when you're older. In my experience, neither of these points have been true. My 78-year-old aunt was on Medicaid and in a NH at the end of her life. She worked hard her entire life, didn't take extravagant vacations, etc. She was solid middle America, from Iowa. For part of her adult life she worked, but made minimal salaries. She was married and was a homemaker for much of her adult life. She had no pension, no 401k, etc. When her husband died, he had no assets to leave her. They had no children. She had only Social Security to live on. Fortunately, my dad (her brother) took her in. But she developed dementia and other severe medical problems and the family could no longer take care of her at home. We tried to find a place for her, but even pooling our own assets we couldn't afford the exorbitant prices charged by private facilities. I still feel guilty that we had to move her to a NH. But we, too, are solidly middle class and had no way out. So we had to resort to Medicaid and thank God it was there for her. I loved her very much. She died in 2008 and I still think of her all the time. What has happened to this country that we have become so unwilling to help those less fortunate than ourselves, especially the sick and the elderly? What has happened to compassion? It is the greed and selfishness of companies such as the insurance and pharmaceutical industries and their race to "maximize profits" and line the pockets of their executives that have created this situation. The profit motive has overtaken every other motivation we have had. It makes me sad and angry to see the attitude of "I've got mine and to h*ll with you" that seems to be gaining among so many today.

Stargazer: Spot on!!!

I know what you mean by small. got the MIL and FIL in a dubble room fixed up a TV, little table, and a chair for each. if one goes, the table will have to go, the TV will have to be replaced with a small one the size of a postage stamp,the one bathroom can't be closed if you're in a wheelchair.wont be able to put the pictures on the wall, already have to put the walkers out in the hall way.and the cost is $ 272 per day each. and this home was just rerentavated and had a waiting list and is one of the better ones. so I feel for the patchents and is the reason i fought so hard to keep them out.

Actually,we were looking for Independent living and the better facilities start at 222.00 for studio. Where is this going. What about those who cannot afford it. Some now offer no meals or drivers to grocery stores. I wonder what is going to happen to
That is about 26000 a yr. Wow.
I

I meant 2,200 a month and 26,000 a yr