Follow
Share

My mom is makes too much money? She has no other assets than her retirement. She needs assisted living but can’t afford it? Am I just waiting until she is so unwell that she has to be placed in a nursing home? I just don’t understand how everyone on here is talking about assisted living like it’s no big deal?

Assisted living’s current model relies on assumptions that become more untenable with each generation. Current residents grew up in a time when mom didn’t have to work outside the home for a family of four to six to have a house, two cars and a vacation to Disneyland every year.

Most ALs offer marketing promos on the value of downsizing as they assume people will bring the house. If you don’t have that, well, they just move on to the next customer.
Helpful Answer (1)
Reply to PeggySue2020
Report

All of the answers here are valid. When my mother needed assisted living she was getting less than $2500 in benefits per month. She never owned a house and had few assets to downsize. She did however have seven children. Using her benefits six of us got together and paid the difference of that cost and home care until she could no longer function in assisted living and needed to move to a nursing home for long term care. It amounted to about $400/ month for each of us.

when she needed LT care, we applied for medicaid and they now pay the difference that her benefits don't pay. Her VA benefits have changed over time and been (believe it or not) decreased and because of that Medicaid has increased their contribution.
Attaining Medicaid was a long hard struggle but now that it's in place it is helping. We live in MA.

Im not sure how else to be helpful but feel free to add followup questions if we can be of help.
Helpful Answer (5)
Reply to Zoebyrd
Report

In setting out the well-known criticisms of age care in the USA, looking at it from the outside, I should have added that it is a very difficult issue and every system for dealing with it has its problems. In other countries, these include:
- Poor quality funded services.
- Not enough funded services, or none at all.
- Much lower incomes for medicos providing services.
- Much higher taxes to fund better services.

It’s always a problem, and always a balance exercise. Everyone wants high quality services ('just like a hotel'), but no-one wants high prices
Helpful Answer (3)
Reply to MargaretMcKen
Report

People who can afford it get the assisted living.
Those who can't, stay home now and end up in nursing home. Her income may not even be enough for NH, but state Medicaid is very likely to cover the difference.
If there's a chance of using Medicaid, keep records of expenses she pays that, don't give her home to any family member or sell below value. Don't do gifting to others. Those things create penalty periods for Medicaid to start. Medicaid looks back 5 yrs in most states.
Helpful Answer (8)
Reply to my2cents
Report

Give us old people a pill to take when we have had enough!
Helpful Answer (19)
Reply to Puma1953
Report
Barbaradoll Jun 2, 2024
I want one when it’s my time
(4)
Report
See 2 more replies
Your question has only a political answer. USA governments (and voters) have decided that people only get free care when the reach the extreme of needing around-the-clock nursing. Otherwise they fend for themselves. To fill the gap, a large private-for-profit age care sector has entrenched itself, and would be very hard to wind back. It is propped up by the large private-for-profit medical sector that can keep people alive for far longer than in the past.

At the moment it works a lot of the time because older people often have adult children to step in, plus assets that can be sold to pay the private sector. Heaven help the others when they need it. Think about the political problems Obama had with acute care. The private age care sector has more players and would fight even harder.
Helpful Answer (6)
Reply to MargaretMcKen
Report
my2cents May 30, 2024
Sorry to say, but needing round the clock care won't qualify for anything itself.
It all comes down to pay as you go or qualify for Medicaid programs....meaning based on income and you've spent your savings down to a minimum ($2000 in Texas)
(2)
Report
See 1 more reply
Lostinthedetail: Your mother's monthly income is almost four times of that of my late mother's = $1,234.00 per month. It is difficult. Good luck.
Helpful Answer (1)
Reply to Llamalover47
Report

$8500 a month quoted for memory care in central Texas yesterday. This was reported to me by a friend who is looking for a place for her family member. It is a private pay facility only. Private room with bathroom and all-inclusive - monthly haircuts, all food, transportation, 24/7 nurse there during the week and on call weekends. They recommend to use their doctor, who visits twice a month and works closely with the nurses. Doctor is included in the fee. Weekly emails from the nurses outlining the resident's care and activities. About 40 residents.
Helpful Answer (1)
Reply to Fawnby
Report
AlvaDeer May 30, 2024
In bay area and without all those amenities, about 20,000 would be more the norm.
(2)
Report
Can your mom be home with home care or is it beyond that? Sometimes you can hire an aid to help her with her daily needs part time and increase hours as needed.So sorry these decisions can be so difficult.
Helpful Answer (4)
Reply to Bubba12345
Report

The place my Dad is at also starts at $4800 per month per room, plus caregiver costs depending on need. THere are some unrelated people who cant afford it so they are letting them share a room, so then the cost is much less for each.

A friend of mine - his dad went to Thailand to an assisted living there, as he loved the country, and he was still reasonably healthy upon moving, and costs there were much lower than in the US
Helpful Answer (5)
Reply to strugglinson
Report

North Carolina, South Carolina, and Puerto Rico might be cheaper. It’s unfortunate that middle class people will have the most difficulty finding a memory care facility.
Helpful Answer (9)
Reply to DianaGearhart
Report
geddyupgo May 30, 2024
I believe the OP is in NC
(1)
Report
See 1 more reply
My mother also makes too much money. All you can really do is shop around and hope that you can find something. It may be that you have to place her in a facility that is further away. Also, it may mean placing her in a facility that aesthetically isn't as pleasing. And, it may mean you have to pay for things. A lot of folks on this forum advocate for folks not to pay for things, and for good reason, but with the prices, you may not have a choice. Or, at least, that's how it was for me. Although assisted living is one option, there are group homes which house a smaller amount of residents. I recommend contacting an Ombudsman. They would know of smaller group homes in your area.
Helpful Answer (7)
Reply to Rhetorica
Report

Assisted living is expensive $$$$$. Unless you have at least $2 to $5 million in assets, you are out of luck to get in assisted living. Medicaid will not cover AL. Walking in independently to a facility is the best way to get into a continuing care retirement facility.

The next level is the NH for care that Long-Term insurance will help, but unfortunately, Long-Term care insurance is not available for everyone. They will ask you too many questions, especially memory tests to determine eligibility. Coverage is expensive, too. Medicaid will cover the difference between your limited income and NH costs when all your assets run out.

If you get sick or injured, you are forced into a nursing home. The government doesn't care about people. Hope no one gets tossed into the street.
Helpful Answer (1)
Reply to Patathome01
Report
Fawnby May 30, 2024
I know people whose assets are way less than $2M who are in assisted living.
(6)
Report
I am so sorry you are experiencing this. There are many answers in this forum that definitely don't think assisted living is no big deal. My sister and I are very lucky that my parents bought a long term care policy back in the 80s that never runs out. They don't sell those types of policies today. Most only cover around three years of assisted living. Mom is 98, in the last stages of Alzheimers disease, and has been in assisted living/memory care for six years. One of the responders below is correct that most AL facilities are run by corporations out to make a buck. I have a friend who is in a group home due to developing Parkinson's disease related dementia. His care is far better than my mother is receiving, even with all her resources. You might find a group home a much better choice, but doing research and visiting is your most informative course. Our country neither supports the aged, nor the young, and our social safety net is a joke compared to other industrialized nations. I'm sure this doesn't help you much to know, but I hope you understand that many folks here have faced your challenges. Research the forum and find answers that fit your economic situation.
Helpful Answer (10)
Reply to horticulturist
Report
Fawnby May 30, 2024
People don't seem to realize that LT insurance can be very limiting, depending on the policy. I didn't ever find one that gave me confidence. My choice was to save and invest for my long-term care on my own. Yes, we can do that! Just earmark a certain investment, such as a mutual fund that consistently does well, for Mission Long-term Care and invest in it monthly and automatically for many years. Don't touch it. No one has to know about it. When I choose to draw upon that money for my care, no one can tell me what kind of care I'm allowed to have or who has to provide it.
(4)
Report
See 3 more replies
Then why do they force us to live so long with no quality of life? I will tell you why THE MONEY GRAB until you eventually die. Most average Americans can't afford the cost of assisted living so give us the pill!
Helpful Answer (10)
Reply to Puma1953
Report
Fawnby May 30, 2024
Often it's the adult children who don't want to let go and will hang on until momsey or dadsey is begging to die. And still they cart them around to doctors and chemo and refuse to give up because they love them so much. I'm in favor of setting my own expiration date and peacing out on my own terms. Unfortunately, that's not possible in my state. It should be in every state.
(13)
Report
My parents have long-term care insurance and I had a very difficult time getting them to pay when the time came for both home care and assisted living. I had to hire a company to help me get the money out of Continental General and they did help. But wow… CGI wouldn’t even return calls or emails regarding claims after my parents paid into their company for over 25 years!
Helpful Answer (3)
Reply to Jupiter5
Report
AlvaDeer May 30, 2024
Reports here on LTC vary WIDELY.
Some say it bumped up their income so that it wasn't enough to pay for anything BUT was too much to qualify for any aid.
Some say they cannot get coverage unless their MC has a full time 24/7 RN, and that just doesn't exist.
All mention the cost which can be onerous.

And then there are those that LOVE it.
So I would say this is one contract you MUST read every word of and in fact I would have an elder law attorney look it over.

There same varying feelings exist on reverse mortgages.
Worked GREAT for my partner's mom and kept her in her home until her death.
For others it is a nightmare.

Tough to make all these decisions to be certain.
(5)
Report
See 1 more reply
I feel you and totally agree. My (95 yo) Mom's net income is only $2000/mo! She lives with me, and I pay over $1500/mo for 3 gals to come in and help her out for a few hours each day in order to keep my sanity. I still have to work even though I should be retired (UGH). These Assisted Living places are making a killing at the expense of the elderly - no way we could afford to put her in one.
Helpful Answer (10)
Reply to LadyDi6653
Report

We need to think about Long Term Care insurance. This is my situation also. The assisted living/personal care life is outrageously expensive. Don't forget the $3000.00 community fee they ask for too.
Helpful Answer (1)
Reply to Onlychild2024
Report
igloo572 May 30, 2024
From whom??? Most of the insurance companies have totally exited writing any individual LTCI policies. MetLife left in 2010 or 11, John Hancock in 2015, Humana in 2018. Like even Genworth exited any new individual in 2019. They all still technically service existing policies with hefty increases in premiums and do it via TPIs / 3rd part administrators. But zero new individual underwriting. The business model of LTCI does not work unless huge HUGE premiums with regular allowed by your States Dept of Insurance for the increases and lots of cancellation on existing policies. Increases is flat not what retirees on fixed income can do.

Really imo the only “insurance” option out there would be if you did a hybrid - so it's a whole life with LTCI benefit bank as part of the policy. These are the sexy new trend. But these need a lump sum buy in. Like 100K -300K. But unless ya have the six figures liquid to start this, it’s not even worth thinking about. If u have the purse for this, there are choices. But pay attention to the initial exclusion period as it will be bigger window than the old LTCI did. Like a hybrid will do 90 - 180 days as opposed to old school LTCI which did maybe 60 day exclusion.

the only way imho for get into traditional LTCI are if you are still working, below age 60, work for a large group (school district, university) that still has these with open enrollment within their regular employment benefits options. So premiums paid from your check. And once you retire, then you pay premiums and all increases. Most do $260 max day rate paid if deemed medically eligible for a set time period. Maybe 18 months.

My mom’s 2nd and eons better NH did not take LTCI at all. Private pay or LTC Medicaid only. Signs up on this. I asked why and billing said it was just too much paperwork of filing and refilling to get paid. Often insurance wanted details on staff and staffing patterns, like if work done by a RN vs LPN. Immense foot dragging. That it was way better to have a bed be LTC Medicaid resident as most residents had the NH be their representative payee for SSA ($ ach usually on 3rd of each mo) and the State Medicaid $ was paid in real time to the facility. Bill & pay, no fuss no muss once a resident was eligible.
(7)
Report
You look into placement in:
- board and care home. Will be way less than a NH and probably at the lower end of day rate for what AL do in your region.

- congregate living type of facility run by a nonprofit. These are usually a division of a religious organization. Like Catholic Charities or JFS or Methodist Ministries

-section 202 housing, this is low income senior only housing. Kinda like Section 8 housing but the property is seniors only. Most have supportive services (meals, transpo, wellness cks) that tie into other “at need” programs. They will have to go through the documentation process to show “need”.

- if your area does PACE, get them on their list to have an assessment (of health care need) done and then onto the PACE system. I personally am not a fan of PACE, but for those who have parents of limited means who live with them or vice versa, their folks both going onto PACE could be the bandaid till they enter a NH.

all of these have an application and a process to show eligibility. And a waiting list. There is no placement manana anywhere unless you have significant assets to hand over 3 months worth of private pay to a facility. Or they are currently in a hospital and being discharged from the hospital to a skilled nursing facility for rehabilitation as all this is a Medicare health insurance benefit. That flat is what it is. So get your folks applications done and get them on lists. If you are rural, go beyond your county.
Helpful Answer (10)
Reply to igloo572
Report

My mom’s AL is $5000 a month. She stayed in her home longer than she should, at 91 she had to go. She had about $50k in the bank and we had to sell her house to afford the rent. I had about $90k set aside from my dad’s estate that I will use if she runs out of money. If that runs out, her SSI and my husband and I with my brother will make up the rest.
Helpful Answer (3)
Reply to LoriF1
Report

Twelve years ago when mom first went to assisted living, it was $1400 per month. We had to pay an extra $400 per month for them to give her meds and reminders when to come eat. That quickly jumped up every year and of course moms income stayed flat. I think that same AL apartment goes for $3,000 per month today.

Mom had a little equity in her home so when I sold it, that money was put into her bank account and I pulled from that to combine with her pension to pay her rent. When she worsened and moved into the locked down memory care section of the building, the cost was $4600. She ran through all of the funds in two years and we were told she would need to apply for Medicaid and find a facility that accepted Medicaid. Her pension was more than the Medicaid cut off so we hired an elder lawyer who suggested we create a Miller Trust. So I basically have to put all of her money into the trust except $52. Then I write a check to the facility from the trust and Medicaid covers the rest of the bill. The $52 she gets to keep monthly are for haircuts and clothing. I have supplemented my moms income for the past 15 yrs. Doing her laundry, buying all of her toilet paper, deodorant, and haircuts and clothing. I was trying to make her money last as long as it could.

I don't know what state you are in, but how much is an assisted living apartment? Can she find one for $3,000?
Helpful Answer (3)
Reply to Jamesj
Report
Michfish May 30, 2024
You are right. Here in the Los Angeles area minimum assisted living is $5000. If you have to move to memory care with extra services it can be double that. It’s just awful!!!
(1)
Report
I'm sorry you're going through this. I had the same question. My mother is in assisted living and the bill is close to 6,000 a month. Her social security (2,000) and retirement check (2,000), plus money from selling her house, will pay for another 4 years. After the house-sale money runs out, my salary will have to pay over 2,000 a month to keep her there. Thank God my husband's paycheck can support me and him. The financial side of elder care is a STRAIN. But I've told my husband I'll work two jobs if I have to, just to keep from moving her into our house. I'm 55.
I tell people all the time now, "SAVE MONEY FOR YOUR OWN ASSISTED LIVING. Stop buying things. Get rid of those TV packages. You don't need a nice car or the newest phone or more clothes...you need $500,000 in a savings plan."
Helpful Answer (16)
Reply to BlueHeron
Report
Monomoyick May 31, 2024
Absolute best advice, BlueHeron. I see far too many of my peers caught up in sheer YOLO exuberance as they approach their 60s and 70s, somehow telling themselves the years of scrimping are over and they now can enjoy lavish vacations, luxury cars, and other pricey indulgences. Have they forecasted out exactly how far this will go? We all hope to die before we become a burden on family or society, but the reality is it’s not our choice to make. We need to be prepared. My mom lived on only social security and alimony for years, and I was always frustrated that she lived so frugally and was so focused on saving. But now she is funding her own AL with savings she hoped to leave for me. I never wanted her money, I have earned my own, and this truly is a huge gift to me that she might live out her years there if I simply continue to manage her money wisely. The best legacy we can leave for our loved ones is to fund our own end of life care.
(3)
Report
$4900 a month is quite a lot compared to.what many non-Medicaid - eligible people have coming in.
Helpful Answer (10)
Reply to RedVanAnnie
Report

The middle class is screwed in these situations. The poor can get Medicaid and the rich can afford what they want. That is the reality. Depending on where you live you may can find AL for that amount. In Texas we have some good facilities that are around $4000.
Helpful Answer (8)
Reply to Tresha
Report

As my brother said many times - when it comes to assisted living, it is best to either be very rich or very poor. The people in the middle are pretty much screwed.
Helpful Answer (13)
Reply to olddude
Report
lfm5252 May 30, 2024
This doesn’t only apply to assisted living but across the board. If you don’t qualify for Medicaid transportation costs for handicapped is outrageous.
My husband is only 72 and we are caught in the hole.
(4)
Report
See 1 more reply
$4800 a month income is 3 times more than my mom gets. All AL and memory care costs are insanely high. Most are 8k- and as high as 22k a month. Outrageous. Your mom’s income is very high. 24 Home care is even higher. Unless you rich or are an illegal it is almost impossible to get help.
Helpful Answer (6)
Reply to Hopiegirl
Report
Katybr May 30, 2024
You have to be very fortunate to get $4800/month from SS and/or pension. Most facilities where I live in PA are waaaaay over what everyone here is quoting except you, Hopiegirl. Assisted Living at a decent place here is $10,000/month and my husband is in a Skilled Nursing facility to the tune of $16,000/month. I have an Elder Law attorney and a financial advisor and the answer to not having these funds is to apply for Medicaid. We must “spend down” to the bare minimum and I get the house, car and $150,000 that’s left. Anything over that goes to the nursing home. If you don’t have any money you apply for Medicaid.
‘Also, I’m shocked at how many people pay for their parents’ care! I can see taking them in and trying to make that work, but, paying your own savings for their care in a facility?? No way! My parents both told me that’s horrendous to put that on your adult children with their own families. I feel the same way! I would never take that from my grown children and their young families! That’s on me - my fault if I didn’t plan correctly or squandered money on bs stuff like jewelry or just having to take that cruise once a year, etc. etc. As you age you need to “somewhat” prepare for the fact you may need a backup plan in case you become incapacitated and don’t expect your adult child to be compromised! I know my sons’ spouses would go ballistic if I expected them to help their dad live in his facility. The spouses have parents, too. You can’t support everyone!
(8)
Report
My mother is in AL, Florida, nice facility $4.800 a month. She has little needs beyond that point, her other expenses are around $200 a month.

She gets $2,000 a month in SS & dividends, the balance comes out of her investments.

If your mother has a home, it should be sold and the money used towards her AL expenses. Liquidate everything that you can and go from there, that is what we did.

If one doesn't plan they plan to fail, too late for any catch up. We are all living too long, just the reality of this thing we call life.
Helpful Answer (8)
Reply to MeDolly
Report
Jacquelinezr May 30, 2024
You've hit on a very big issue.. living very long lives. People easily live into their 80s and many are living into their 90s. That means a good 20 years in retirement and you need to have saved up a good amount to afford that. Personally, I do not want a very long life. I see first hand how hard it is on old folks.
(12)
Report
See 1 more reply
Many people have worked hard all their lives and invested in a home 50 or so years ago. The home appreciates in value and they sell it, using the money for their elder care.

Example: (Not me, but a friend.) She bought her very ordinary "2 BR with den and no garage home" in Florida in 1975 for $40,000. It was in a pleasant but not fancy neighborhood. The house sold a couple of years ago for $700,000. Subtract the real estate commission, and that's a healthy chunk of change. Her really nice continuum of care apartment costs $84,000 a year and includes transportation, field trips, a clinic onsite, housekeeping, three great meals per day and snacks. She won't run out of money for years, and she is now living a carefree lifestyle with no costs of running a home.

Assisted living is not a big deal if it's been planned for over a lifetime.
Helpful Answer (8)
Reply to Fawnby
Report
Tynagh May 30, 2024
Unfortunately, there are many people who don't have the opportunity for it to be "planned for over a lifetime". Many lower-middle class and middle income folks make enough to pay rent, make sure other necessaries are paid for, and pay for a car. Although they live in the "comfort zone" (they aren't starving, they may be able to indulge in a dinner out or even a sometimes vacation), they certainly don't have the means to save a great deal for retirement. While it's great that your friend's parents recouped more than $600K from their modest home, most people aren't that fortunate. And if they happen to live in a more expensive place, they are out of luck.
(20)
Report
See 2 more replies
My mother was trying to spend money for years on purpose in order to force me to take her in to live with us rather than go to assisted living . Dad did block some of her spending fortunately . But after he died and I had to place her with dementia , I was worried she would run out . Fortunately she did not , but it was pretty close .
Helpful Answer (2)
Reply to waytomisery
Report

I could find no income limit for Medicaid in NC nor could I find that they allow for Miller trusts. I just found contridictions. In my State of NJ, our income limit is a little more than 2300. Your Mom would not qualify for Medicaid. But we allow for income trusts which the overage would go into.

You need to speak with a Medicaid caseworker to see what the assets and income limits are. Your Mom does not have a home?
Helpful Answer (3)
Reply to JoAnn29
Report
mstrbill May 30, 2024
North Carolina has a different way of doing it. The key is you have to medically require SNF care. If you do, you pay what you have and what you can each month, and LTC Medicaid will pay the difference in costs.
(1)
Report
Ask a Question
Subscribe to
Our Newsletter