Long Term Care

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nobbie48

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It's no secret that LTC is often a disaster but has socialism made it worse, the expectation that someone else will take care of the problem or pick up the tab. Try and get a direction on that from the government.

There are numerous people on this site that may have to make related decisions for themselves or parents in the not too distant future.

How many people think about it before it's too late to adjust?

What is a realistic cost for a LTC room?
- A cheap motel room is $50 a night
- Catering from McDonalds is $30 a day.

That's $2400 a month without allowances for special needs and care.

Throw in some cultural ideologies like having a built in mindset that you leave the estate to the children. You don't sell the family home to provide for long term care. Sell a million dollar home and at $50,000 a year it keeps a roof over a 75 YO for 20 years. Capitalists don't like that. One must have more today that yesterday.

I knew a guy that was really put off that his father's very modest estate had to be signed over to his LTC facility to offset his keep. The father got a small allowance. However pops would never be thrown out when the assets were exhausted. Junior was annoyed because he saw his inheritance being eroded.

On the other hand, I know a family that paid for nurses aid 24/7 for the father when he was deteriorating because of a cancer related condition. Over six months the cost was IIRC around a quarter million. The father wasn't rich but had sold the family home, had a good pension, CPP, OAS, RRIF, and likely savings. The kids weren't rich but were financially solid.

A friend of a friend moved into a special LTC home because his wife has Alzheimer's at $7,000 a month each. He had to move out to a cheaper place because he couldn't afford the $14,000 a month.

Let's face it, when we're 21 years old the toys are #1. At what age do we, if ever, say I have to look at the inevitable?

The ugly part is that changing diapers on a cute infant is something we accept. To change diapers on an incoherent 80+ isn't as easy.

How much is a LTC worker paid?

Would you do it?

FWIW An organic face mask as used for spraying oil paints also filters out the smells of fecal matter and vomit. I don't know what our infant daughter ate that day but the diaper routine was causing the wallpaper to curl. I threw on a paint mask and got the job done.
 
My late fil was in an inexpensive place in Kitchener at $3500/month.
This post. There is a lot food for thought.
 
Honestly, a very reasonable solution economically is to call it once quality of life drops below a certain standard (obviously up for discussion where that line is). Nursing homes are full of people with no quality of life (many begging to die). Why do we keep them alive for decades but pull the plug on brain-dead patients in days? There is a limited pool of money, keeping everyone alive for as long as medically possible ensures there is not enough money for each individual patient.
 
GreyGhost said:
Honestly, a very reasonable solution economically is to call it once quality of life drops below a certain standard (obviously up for discussion where that line is). Nursing homes are full of people with no quality of life (many begging to die). Why do we keep them alive for decades but pull the plug on brain-dead patients in days? There is a limited pool of money, keeping everyone alive for as long as medically possible ensures there is not enough money for each individual patient.
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iu
 
I know what you are saying. And you are not completely wrong. But in the last 10 years i have spent a bunch of time in ltc for my Mom and my fil. There are a lot of different levels of care. Some people are very independent and only need minimum help. At the other extreme are those with severe memory loss and at high risk of injury. My fil had dementia quite bad, but it was the happy kind of dementia. Never left the ltc, but told stories of going on dates with the nurses to Stratford to watch Justin Bieber.
I saw a lot of lonely folks that just needed a little visit from family. That is a big problem!
 
I started managing my parents finances when they hit 70. They made a good life for themselves, in their 80s still live at home. I have space for them when the day comes, if care dictates a home then it will be a top quality facility.

I have managed to build their retirement nest egg to a point where it kicks off enough monthly to pay for top notch care, so they will never be financially burdened or stuck in a government subsidized dumpster.

Working on the same plan for me and the misses, my kids won’t need to be burdened.

Advice: plan and stick to the plan, it’s not hard, but it takes discipline. If you want the government to look after you, just remember you’ll get what you pay for.
 
Here is something I am thankful for ... my parents didn't need much in the way of long-term care.

Mom fell and broke her hip in May 2006. The cause of the fall turned out to be a brain tumour. No way to treat it. In September she was gone. She spent a couple of months in a nursing home.

My dad had cancer, but was more-or-less mobile and functional until very close to the end. I took him out to lunch in late October 2014, which turned out to be the last time he left the retirement apartment building where he lived at the time. He went downhill fast, and was gone a month later. There was beer in the fridge for visitors right to the end.

You never forget when, where, and how. It would have been nice to share some accomplishments since then with mom and dad, but in some ways I'm glad they did not have to go through some of the things that have happened since then. The last year would have been awful.
 
Wingboy said:
I know what you are saying. And you are not completely wrong. But in the last 10 years i have spent a bunch of time in ltc for my Mom and my fil. There are a lot of different levels of care. Some people are very independent and only need minimum help. At the other extreme are those with severe memory loss and at high risk of injury. My fil had dementia quite bad, but it was the happy kind of dementia. Never left the ltc, but told stories of going on dates with the nurses to Stratford to watch Justin Bieber.
I saw a lot of lonely folks that just needed a little visit from family. That is a big problem!
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My wife worked in ltc for a long time. Some patients hadnt had a family/friend visitor in years. In almost every case, if a medical decision was required, those same family members would say to do everything medically possible to keep them alive. You should either be active in their life or not. Expecting the public purse to finance perpetual care because you dont want a sense of loss is beyond stupid (not to mention selfish/entitled/...).
 
Some of the people living in the old-folks homes don't exactly help matters themselves. My dad went through a few retirement apartments before he found one that he liked. All of them have activities for the residents ... my dad's approach to these was simple. "Sign me up for all of them." Couldn't always do them all, but he tried. Meanwhile he said a lot of people seemed content to stay in their apartments doing nothing, and they were hardly ever seen except at meal time ... at which time, they usually did nothing but complain about stuff. If you're not nice to be around, no one is going to want to be around.
 
Riceburner said:
I built on my retirement since my first job/early 20s. The kids better not be hoping for an inheritance....I'm spending it. Got their education paid for though.
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I don’t think you ought to work and suffer just to create an inheritance, but I do look at it differently.

My kids enriched my life. They helped with work around the house, in our family business, they help with my parents - because of their contributions I am a richer man, both in life and money. I call that family equity.

I could blow it all, time it so my last beer uses my last dollar... but I won’t. The kids will get a share of the ‘family equity’ when it’s time, probably before I go so they can start looking after it for the following generations.
 
nobbie48 said:
What is a realistic cost for a LTC room?
- A cheap motel room is $50 a night
- Catering from McDonalds is $30 a day.

That's $2400 a month without allowances for special needs and care.
Click to expand...

Not quite, Rooms for Rent are $600-750 in the city. Groceries for a week per person averages about $75. That's about $1,000 a month. Now shove 3 or more people in each room, cheap out on meals, like Long Term care homes do, and your closer to $500 a person.

There is no current minimum hours per resident, but the current post-COVID outbreak recommendations lists 4 hours a day. That's about $100 a day (based on majority PSW work, and the current MOH payments to LTC's). Since PSW's also take care of the sanitary needs of residents, janitorial staff isn't needed. One receptionist, someone to run the kitchen, and perhaps a security guard split among the the average 125 residents per home.

Add some incidentals, and you might be hitting $4,000 a month. The Ministry of Health Pays $170.14 per day. That's about $5,000 a month. So these private LTC's are trying to squeeze in about $1,000 per resident at Government rates. Got your family in there privately? And they'll rake in more for perhaps a semi-private room.
 
GreyGhost said:
Honestly, a very reasonable solution economically is to call it once quality of life drops below a certain standard (obviously up for discussion where that line is). Nursing homes are full of people with no quality of life (many begging to die). Why do we keep them alive for decades but pull the plug on brain-dead patients in days? There is a limited pool of money, keeping everyone alive for as long as medically possible ensures there is not enough money for each individual patient.
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The Mrs and I were discussing this today, drifting off to the other side when there was no quality of life. There are so many considerations. If a person had a end of life kit with a push to activate button would they push it just because they were having a bad day?

Everyone wants to live forever but no one wants to get old. What is the criteria?
 
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Chris-CJ said:

MYDIGNITY (Your Care, Your Way) |Home Care Assistance

mydignity.ca
- insurance for senior needs

Province Listings

www.homeinstead.com www.homeinstead.com
- caring for seniors

Make a living will that includes a trusted person to pilot a senior's needs when the time comes.
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Haven't looked at your links. They may be just fine. But there are a lot of people that will take advantage of seniors and thier money.
I called Home Instead a couple months ago asking for a quote (never got one) and they have been relentless calling every week till i blocked them.
 
Mad Mike said:
I started managing my parents finances when they hit 70. They made a good life for themselves, in their 80s still live at home. I have space for them when the day comes, if care dictates a home then it will be a top quality facility.

I have managed to build their retirement nest egg to a point where it kicks off enough monthly to pay for top notch care, so they will never be financially burdened or stuck in a government subsidized dumpster.

Working on the same plan for me and the misses, my kids won’t need to be burdened.

Advice: plan and stick to the plan, it’s not hard, but it takes discipline. If you want the government to look after you, just remember you’ll get what you pay for.
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That is one of the good stories. I wish it was the norm.

Why isn't everyone in the same boat?

I'm sure we all know of cases where the person died in poverty after squandering every cent they made. If they enjoyed the blast were they better off than the prudent ones that never kicked up their heels?
 
MM, applause for your planning.
Thing is that a nest egg is subject to the vagaries of the market and what is sufficient for today (or the next 10 years) may not be enough for tomorrow.
But I guess that the best way out is the plan you have laid out.

Wingboy, for the links I have posted, I have no connection or gain benefit from those entities, I was just doing research.

Am not sure if the senior's insurance (MyDignity) is actually viable. Insurance companies are betting that the insured stay healthy and do not impose on the plan. Besides there may be limits on disbursements.
As for "HomeInstead", there is a market sprung up for delivering senior care at home, they all promise compassionate care but who knows if that promise holds when push comes to shove.
 
Wingboy said:
I know what you are saying. And you are not completely wrong. But in the last 10 years i have spent a bunch of time in ltc for my Mom and my fil. There are a lot of different levels of care. Some people are very independent and only need minimum help. At the other extreme are those with severe memory loss and at high risk of injury. My fil had dementia quite bad, but it was the happy kind of dementia. Never left the ltc, but told stories of going on dates with the nurses to Stratford to watch Justin Bieber.
I saw a lot of lonely folks that just needed a little visit from family. That is a big problem!
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Your post and that of @GreyGhost contain relevant points of view. To these we add the personalities of the individuals in question. One extreme is a healthy 90 something that still enjoys company and tells interesting tales but recognizes reality. The other is a lifetime merchant of misery that wants to live forever to be able to spew more venom. Who gets the short straw?

It splinters off from the cost of LTC realities and those not looking forward to living with diminished capacity, either physical or mental.

What percent of the population will end up dying of Alzheimer's?

We have medical insurance in case of a crash. What would Alzheimer's insurance cost if it isn't already available. Disability insurance is more predictable for the younger crowd.

People live longer due to intervention. The spin off is more age related diseases. Do we stop curing cancer and heart disease?
 
Another thing to consider - long term care for the most part is 'for profit'. The players answer to the shareholders, care of residents is secondary. Who's to blame ? Mike Harris - he deregulated the business when he was premier, and no subsequent government has had the nuggets to do anything about it. He's now the big kahuna for a lot of the privately run homes. A real, enforced provincial strategy would go a long way to protecting residents and front line care givers. We have a provincial health care system that we all pay into, and reap the benefits. The same thing could work in LTC (or motor vehicle insurance, but that's a topic for another day).
 
Wingboy said:
Haven't looked at your links. They may be just fine. But there are a lot of people that will take advantage of seniors and thier money.
I called Home Instead a couple months ago asking for a quote (never got one) and they have been relentless calling every week till i blocked them.
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The ones taking advantage could be relatives as well.

I'm cynical when it comes to money. I have a feeling that potential heirs and lawyers think of inheritances as found money that hasn't been worked for and therefore subject to looting.

One of my original thoughts in this post is "What are reasonable costs and profits in LTC and what are reasonable markups?

For profit LTC could work but profit increases would have to come from the residents understanding you get what you pay for.

Publicly traded companies have to show more profit every year or no one wants to buy the shares. How does this merge with socialism?

The alternate is government run and right now I wouldn't trust them to walk a dog. Increasing costs mean increased rates for people that may not be prepared. Alternately it becomes a growing tax burden.

LTC wages have to be high enough to attract workers and keep them happy.

That has another spin off problem. If a person isn't happy in their job and needs to be, in essence, bribed to come in they get used to the bribe and six months or a year later they need another bribe. How much is a dedicated LTC worker worth?
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