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

nurses make 85K a year? wow should have switched majors...

My mom and I worked and saved together for over 30 years, and we bought our CA condo together. Mom passed away at age 95 last November, leaving the entire condo to me. Today, I am an unemployed age 59 single person with a genetic disability who has no children. Since I am the youngest in our family who lives mostly out-of-state, I am alone with some wonderful friends in CA except for one sibling who lives in the Bay Area. He had no children, either. One sibling who lives in TX has two out of three surviving grown children but no grandchildren. I have very little relationships with my niece and nephew. When I become elderly, I wonder what assisted living I will end up in and who will take care of me?? My own money/investments may run out when it comes time to pay for my own hopefully decent elder care. It is probably too early to worry yet, so things will be taken one day and year at time.

I think it's so expensive because of the medical and nursing care and hopefully the quality of that care. It seems like most elders need care like a child does, yet the costs are so much higher than having a child to raise. And unlike a child who usually is going to independence a elder is going in the reverse, away from independence. And the costs is so high whether it's in $$$'s, emotion, or the body for all those around that elder. That said I have read through the other comments and just wanted to add ... my family of myself, husband, and 2 children at no point could afford the premiums of long-term care. Never. My husband was in the military for most of his career and had a modest job after leaving the military. I did not work enough to get SS points, partly because of the cost of child care, partly because of the frequent moves, also his long deployments, and a child who had many health problems. Then the added health problems of my own. We did not take vacations, did not have extra money to spend on homes, cars, or anything else. We stayed out of debt. And I consider us lucky, so many bad things could have happened. So I am disappointed when I see a comment that we are in this place of worrying about not have enough funds to pay for such care. You can't really buy if you don't have it start with. And there are so many people who have worked hard their entire lives only to find that they are overwhelmed by the costs of LTC. I could not purchase LTC even if I had the money because of a medical problem. Not having the money for LTC whether it's out of the pocket or via a policy does not mean someone has been lazy or neglectful with their finances. Just said to support all those who feel like they are overwhelmed by forces and situations beyond them. This comment won't help solve their problem or ours. And unfortunately I don't see any nearby fix. I wish you all luck and a better fortune in finding a solution that will work for you and yours.

I will say why it costs so much to care for all of us: young or old is Overpopulation in the Nation! My own mother was very lucky to have my help to stay so stubbornly independent at our CA home until she was 93 years old and required a NH after several falls and failing health at our place because she could no longer care for herself. She was put in a private room up in OR because it was too expensive for myself and our family to pay in CA.

people are living longer due to medical advancements?! We like that, but the end result many times is an unhealthy person unable to care for themselves that medicine has created. yes, they are alive, but are they really. hard question to answer. my 96 yr old mother is in assisted living paying 3,000 a month with additional care, showers, taking down to dinner, dressing, assistance brushing teeth. who knew all this would be needed. she was in a nursing home after a fall and I was happy I could get her back into her AL. I would also try to pay for private extra help if needed and would be cheaper than nursing home.(her money) someone mentioned hospice and maybe assisted living did not know. they do know, in many states, if a person cannot get up on their own, they cannot remain, but if hospice can be called in, they can stay. unfortunately with obama care, hospice qualifications have changed also. sooooo much we do not know

Last post on this topic....then I'll get off my rant.

I have several friends who 'swore' they would never put their elderly parent in a nursing home. However, once that parent declined to the point of (1) being incontinent, (2) not being able to dress themselves properly - suddenly they put their parent in a NH.

A lot of it was denial. They just could not believe that their parent would "get to that point" even though I had warned them about the predictable stages of Alzheimer's disease.

BTW....I recently went to an estate sale at a house in which an elderly woman had lived - obviously, with dementia. The house was in disarray with dirty dishes all over the place, water damage on the kitchen floor where the sink had overflowed, etc. By the state of things, she had dementia for quite some time before somebody realized the state of the place. The estate sale people just held the sale "as is" - just to unload as much of the junk as possible.

After the furnishings were sold, the place had to be partially gutted and fixed up in order to make it live-able. This is not an isolated situation, unfortunately.

Sherry1anne wrote: "I always say keep people i their own home as long as possible, even if it means round the clock care."

But who will organize and supervise this "care" when the elder has no friends or relatives in the area willing to provide the oversight? Who will see to it that the utilities are paid, property & school taxes paid, etc. when the elder no longer has the mental wherewithal to take care of it themselves?

Not all adult children have an interest in helping to care for their elderly parent - or the ability. Some adult children can barely function themselves, let alone care for an 82-year-old with Alzheimer's disease.

As GardenArtist noted, many elder's health problems are beyond what can be managed at home, especially if the adult children are still working full time and the elderly person cannot be left alone at home safely even for 5 minutes. Also, what pushes most people to put their elder in a NH is incontinence. They can deal with confusion, etc. - but once a person starts peeing & pooping themselves, that's often the "last straw" for many adult children.

I disagree with the comment of "If you do not take good care of yourself before you get older, then you will probably need services." Cancer, Alzheimer's and CHF are no respecter of lifestyle. The bottom line is that if you live LONG ENOUGH, your body will fail and you will need services - no matter how much self-care you had as a younger adult.

In fact, I have an acquaintance who is a sharp-minded 100-year-old. But she just had to move herself into a nursing home because her growing frailty required a constant army of help in her apartment just to accomplish her ADLs. When one is no longer able to "do" for themselves, then others must do it for them.

I am grateful that we live in a time when nursing homes are available. Many elders were left to die alone in early centuries because (1) they had no living relatives to assist them and (2) there were no long-term care facilities. It is a myth that everyone in centuries past had all of these family members that took care of them.

I always say keep people i their own home as long as possible, even if it means round the clock care. In Alabama, depending on the area you should be able to get a night sitter for $8 - $10 per hour and a "companion" for about the same. Say $240 per day 30 days a month. That's $7200 assume family can take one shift, it reduces it to $4800. Add in taxes on their home, food, medicine etc and it is about the same for full time care as a nursing home. Under these conditions, the person has someone who gives him/her their undivided attention and they get what could be assumed the best of care.
I agree with OT Jenn, Obama care is a farce.

Has anyone thought about the homeowners getting a reverse mortgage? My father did this. I was not happy when I realized what he had done. The money was not spent wisely. It could have been saved/used for health care expenses So when the s**t hit the fan and the doctor said he could no longer live alone anymore, we moved him into assisted living. His pension and SS was enough at the time to pay for the cost. We sold or donated everything in the house and used the cash to pay off some bills. I then called the company/bank he had the reverse mortgage with, and told them he no longer lived in the house and they took it over. In this economy, it may have taken forever to sell the house. Having a POA in place, helped tremendously. I was able to do things long-distance, as he lived in another state at the time.

Please continue this converstion! I need to watch the Green Project on PBS. Sounds like a solution.

My father has settled into a Long Term Care facility that was built by some Catholic Nuns, back in the day. But he has his own private room, dialysis is in-house and they accept medicaid, So far, so good.

Lol Sherry1Anne, it sounds so wonderful! There's a lot of good that could come from vegan life-long diets, naturopathic doctors and growing ones own foods. Probably not going to happen in enough mass to change to current situation, which is millions of seniors (or baby boomers becoming elderly ) who did eat tons of pizza beer hamburgers and had lousy sex despite billions spent on little blue pills. And hardly any of them saved $500,000 apiece to pay for a NH stint, they were too busy taking jets to France or Bermuda, buying smart phones big screen TV'S and indulging their kids (or pets or organizations ). Your idea holds much promise in that if we could legislate such a radical lifestyle change for all over age 80 they would probably die of massive panic attack and that would be the better solution (maybe not ). Everyone makes mistakes, including life-long mistakes that bring on early death or gruesome debilitating disease. It all costs somebody a lot of money. It should be each individual paying their own bills--that is the ONLY way for people to truly reap what they have sown.

If the world were a perfect place, we would all eat a raw vegan diet, live to 120 and die in our sleep after having ecstatic sex with our wife/husband. Institutions are a mirror of the lives we live... too much pizza, too many hamburgers etc. We are seeing end of live conditions feeding our seniors much the same diets they chose themselves.
I would love to see a raw and living foods facility in which Natropathic doctors treated the elderly and kept them working outside in the organic gardens and harvesting the foods that they ate. It ain't gonna happen until people choose a healthy lifestyle whole they are independent.

Oh, if they own nothing, and have nothing but their SS check...Its free

Well if you think three in a room is difficult, try a small one room apt with a kitchen or a one bedroom. Minimum of $3000 a month. Then add, the blood pressure takes and the pill dispensing and your up to 4000. The meals in these beautiful facilities are institutional foods and are salty and bad. People gain so much weight. NOT GOOD weight.

There is exactly ONE green nursing home in my area, is 40 minute drive not during Rush Hour.... It's full, and only has very limited availability for Medicaid recipient. It would be great if they could build one in every neighborhood. But at $15-$20 million each to buy the land and build the building, that is not going to happen. The country is much more worried about Putin, Iran, N.Korea, and Calif drought to be giving any notice to needs of seniors. I wish it were otherwise... I would go door to door to help, but I am pretty sure the party politics would mean I would refuse to be involved.

AmyGrace, I sympathize so much with what your mom is experiencing . I am.on verge of choosing an AL with my mom, who is frail and I would love for her to live in her own home, but she has such weakness and getting slightly confused. Over half her & dad's savings was spent on my dad's NH bills, plus his funeral (which he did not pre-plan and emotional spending by mom went overboard). Mom now has just her house,.Soc Sec and a dwindling savings. I struggle to provide all her transportation, food, shopping and entertainment needs. She has been a model citizen her whole life, and didn't squander anything, and I wish she could stay in her home --I would be happy to continue providing lots of help for her, if only we could find reasonable priced in-home helpers for about 2 × 4 hr shifts a day 7 days a week.. but our local caregivers want almost $30/hr plus mileage. It is still.affordable compared to AL which starts at $4,000 in our major metro area, plus the levels of service are all additonal.....figure starting cost $60,000 per year! When she runs out of money, they either don't accept welfare or they move them to basement dormitory style rooms. Yuck. It is so wrenching to know what to do, so mom can have helpers, but not end up in the Medicaid ward.

OTJenn, that is really a cool idea. I wish there were more people inspired and ambitious enough to lead a Green project in every community. Seniors shouldn't live in fear of losing everything they have, including the family home which has to be sold, not left to the children, just so they can get government help because the cost of AL and nursing homes is so high. Most of us children don't earn in a month what an AL or nursing home charges their parents and that is why so many of us baby boomers struggle with caregiving.

What you are describing is more the norm than exception. The staffing is low, paid little, respected little and this makes for a bad situation when caring for others. The staffing in most all of these corporate facilities have been cut to the bone and at times to dangerous levels (people fall and no one finds them for 2 days, etc) but the money goes right up to the top. I mentioned earlier The Green project which was featured recently on PBS, where a community got together and build a facility and ran it. The caregivers were trained, respected, and gave good care to the residents. The residents particiapted in all aspects of life they wanted, like helping w meals, etc. The costs were about 25% of what traditional care was. Yes, we do need to start grassroots initiates to do these things in our own communities. At this price point, they could accomodate Medicaid as well as private pay Very inspiring!

CarolAnn, that sure is the truth. It is a racket and you don't get what you pay for. I can understand paying a lot for a NH where the patient gets round the clock care, turning them over, feeding and washing them, etc. But AL - I'm disillusioned. We were paying $2250 for Mom in IL and she had a small apt - kitchen, washer & dryer, living room and separate bedroom, very nice, very comfy. She got 20 meals a month also and monthly housekeeping and free activities and transportation. Now in AL, we pay $3600 a month plus $650 for level 2 care. She gets 3 meals a day (but she never goes down to breakfast so we buy things to eat in her room) She has a room half the size of the apt in IL and a bathroom, a sink, some cabinets and a microwave. For that amount of money the level 2 care, from what we can tell because they haven't been specific, consists of putting in and taking out her hearing aids, giving her a pill a day, and incontinence materials, and I assume keep track of her, and makes sure she goes to dinner and lunch. She won't let them help her with anything like showering, etc. She is mobile, dresses herself, makes her own bed, gets herself to the bathroom. Yeah, I feel there is some peace of mind that they monitor her a little bit more than they did in IL but I think its a ripoff for $2000 more. Laundry is included in the basic room rate so they wash her towels and change her sheets. But she throws her dirty clothes on the closet floor and they don't wash them so I'm still doing it. She puts her dirty dishes under the sink and doesn't wash them, they don't check, so we're still doing that. Because she is stubborn they mostly leave her alone. She's one of those people who puts on an act in front of them, acting normal and independent, and they accept it. She told me she fell and had rib and back pain. (They will take her to the doctor - for an extra fee) But she refuses to tell them and I know she will lie to them and the doctor if I do. My question is, is she walking different, or limping, are they observing her? I simply don't know if she is exaggerating to us and is ok or not because I can't get up there with my broken ankle. Yeah, paying $2400 a month more, to me, is a ripoff for what she is getting - the presence of people around but not actually doing much hands on. I could be wrong, but I simply don't know.

AL and NH have become such a racket. My dad is 90 with mid-stage alzheimers. I'm 60, retired and have diabetes & hyperactive thyroid. My wonderful husband is soon 63 with his own health problems.

We are exhausted. We looked into moving dad and quickly realized that most want $1900-3500 per month with a roommate. Insurance usually won't cover cost. Dad has money, but not for long if he moves into one of these homes.

Denmark has extremely high taxes of 50 to 70% plus 25% sales tax.

They are corporations for profit!They know there is BIG money in it or they wouldn't be in it. There will be a 70% increase in elder care in the next 10 years.There are other ways our goverment can help and subsidize care and costs but don't! Just like big Pharma why do Rx 's cost $2700 a month here but in Mexico or Europe $200 a month from the same company???It is what the market will bear. Until enough people complain and write your Congressman, President, Senators who all have great plans already set up ..it won't change and with technology/research we will keep living longer and longer and pad someone's pockets in the process...not ours....we need private small settings not big corporations. Think Habitat for Humanity.....they are able to fund housing at very reasonable prices for low income families, we could do the same with our senior population but it is all profit driven unless you are lucky enough to get into a church non profit NH center which most have several year wait lists because the families put their names on years ago. Agreed, something must change and become more efficent in the process! Our goverment has not had a good history of being a "thrifty shopper" or catching fraud that constitutes incredible losses.....why ?Not enough people...hire more.. plenty of people need jobs it's a vicious cycle. Best bet I hate to say is to live in another country where they care for their elders....we should model Denmark or Sweden but the US is too money driven."Denmark has taken the top spot on the United Nation's first ever World Happiness Report, followed by Finland, Norway and the Netherlands.
Published by Columbia University explains personal and national variations in happiness.The rankings in the report were based on a number called the "life evaluation score," a measurement which takes into account a variety of factors including people's health care, aging, family and job security,education, housing as well as social factors like political freedom and government corruption." It can be done, just not here apparently!

Anoel, yes some states Medicaid will pay for AL, does anyone know if there was a list of which? That would be helpful. What we have is called Elderly Waiver in my state (it's welfare ) but for about 24 AL's I have visited, only 3 or 4 accepted it, and they required a complete (invasive) Financial Statement showing 3 yrs self-pay, before you would be accepted. That's about $180,000 or about the average cost of a home in US so that is not too much. Unless there is CS, who might want to stay in that home, but feel (like Daffodilgal ) immense pressure to sell that home just to pay spouse's bills. Yes this is a tough situation. But the general bad economy is a huge part of the problem--my parents bought a home in 1960's for maybe $20,000? And sold it 30 yrs later for over $200,000, and it covered dad's NH stay 6 yrs. OTOH, my home bought in 1995 for $140,000 is not going to be worth 1.4 million in 2025 (ROFL!). But even if it were, the cost of NH in 2025, five yr stay, is going to be beyond 1.4 million, at the current rate of increase. I'm no mathematician and have no crystal ball, but predict that whatever pain people feel in 2015, is going to be much worse in another 10 or 20 yrs. I totally expect the gov't will just start euthanizing the elderly, which will be the majority morality of the younger voters at that time. I hope I am wrong! But again, no crystal ball.

A Noel is totally right on-- there are always going to be poor/disabled/ hard luck cases who will merit the care of society's bounty, meaning each of us (ALL of us including the 60% who pay only 2% of taxes) ALL of us are morally obligated to provide for these unfortunate cases. The problem is there are too MANY who claim they're in these unfortunate circumstances. 35 yrs of RN salary is very good pay-- But If widely recommended financial planning (saving & LTC ins) was not done, the problem is not the cost of care, or society (which is too stretched thin providing for those who really could not have saved), or who could not qualify for LTC because of genetic anomaly. It's unfortunate to get Parkinson but everyone knows about that possibility, that's a terrible disease but that's why we all save and buy LTC. It is not "punishment" it is only what all of Life is like--we all have to pay our own way. If you do truly burn thru all your savings, there is Medicaid (and as CS you do get to keep your house car, and about $114,000 so you're not destitute). $500,000 or more of care (5-7 yrs of NH) can be affordable, with 35 years of saving on average $10,000 year and a modest LTC policy. But society having to pay that for a million Parkinson patients in NH for 5-7 years, is completely unaffordable.

I am still reading through all of your responses. Here's a thought. When the Presidential election rolls around, we should all go to the town halls or campaign meetings in our local communities and ask the question: What are you going to do about the high cost of Long-Term Care? If someone could phrase this better, please do. Who knows, with so many people asking this, in so many places all over the country, we might have an impact. My husband and I do not have any children, so we will be in the system, eventually. But, not every child takes care of the needs of their elderly parents. I have seen that in the eyes of the seniors who hardly ever get a visit from a family member, and look forward to seeing me, when I come to see about my father. I did not say "visit," I see my father everyday and everyone knows me and my husband. I applaud you all for being caring children for parents who can sometimes be difficult. God Bless You!

malloryg8r: I know of one AL that accepts medicaid, only after you have lived there a year or more and paid the cash and are now out of cash. Seems like the right thing to do in that case.

AmyGrace: Nothing is free, really. Those people who have taken advantage of the system, have given up their freedom. They also have given a bad name to the system that is theew to help the less fortunate. The scriptures say that "the poor will always be with us." But, their are scammers on every level of our society. For me, the scammers are the drug companies and for-profit businesses that make it unaffordable for the rest of us, who would pay, but at $8,000 a month,,,,who can?

Disagree, some people have to work in stressful situations that take a toll on their health. That's not something they can change even if they do "take good care of themselves before they get older."

My husband was a BSRN for 35 years. He now has Parkinsons. Should he be punished because he "didn't take good care of himself before he got sick and old?"

We are receiving nothing and looks like we never will. Savings are gone and I'm still working for the time being. Will quit if he needs me full-time.

No easy answers.