Tuesday, January 31, 2006

The High Cost of Aging

Which will give out first, Mom's health or her assets?
Financial matters are hard to talk about when caring for an elderly parent. Living arrangements, care, and medications are more commonly discussed.
Leave it to the Wall Street Journal to tackle the financial issues head on. On January 23, 2006, the WSJ printed a fascinating portrait of Milo Tedstrom, who lived 104 years, and of the various housing and financial arrangements that made his later years happy and comfortable. Order the article by Kelly Greene for $4.95 at http://online.wsj.com/public/page/3_0466.html?KEYWORDS=Learning+from+a+Long+Life&x=3&y=6.
Greene reports, "In the end, Dr. Tedstrom's body gave out before his assets did."
That's the goal my siblings and I hope for--to keep Mom in a cheerful, comfortable residence all the way to the end, even if it drains her resources to nearly zero.
The big question is: what if her assets reach zero a year or two before she dies?
Would we pay her expenses ourselves, or would we move her to a residence whose cost matches her monthly income?
In any case, we would have to eliminate the personal caregivers who chat with her, give her daily baths, and tend to her needs, so she doesn't have to wait her turn as a staff of 4-5 care for the 28 residents on her floor.
Currently we keep caregivers with her 6 am to 2 pm and 2 pm to 10 pm for $14 per hour at a weekly cost of $1,456 or about $6,000 per month, plus the Ocean View Assisted Living fee of about $6800 per month.
Her monthly income is $4862, so we are draining her resources at a rapid rate.
When my siblings and I sold her house in 2002 and moved her into an independent living residence, I thought she had a good nest egg that would enable her to live comfortably and give each of her children a six-figure inheritance.
But my brother Bill, a doctor, predicted that she would run right through the whole amount in medical and living expenses before she died. He had seen it happen before to countless patients, many of them paying huge medical expenses in the final weeks of life.
I didn't believe him then, but now I am convinced he was right.
The ideal would be for her to live off her monthly income and not touch her CDs, but there are only two ways to do that:
1) Place her in a nursing home, without personal caregivers.
2) Move her to live with one of her children, with 10-12 hours of assistance per day from caregivers.
The first option would probably be miserable for her at this point. Skilled nursing facililities are fairly grim and hospital-like compared to the nicer assisted living residences.
The second option would require me or one of my siblings to be her caregiver for the remaining 10-12 hours, and it would change the family life of whichever one of us took on the job.
We'd rather see her use up her financial resources than go to either of these options.
One thing we could do, however, is try to wean her off the caregivers she has in addition to her Ocean View Assisted Living expense.
If we succeed in doing that, we would save $6,000 per month. She wouldn't like it, but we could try. She would have a bath only four times per week, and she would have to wait her turn to get dressed in the morning, be taken to meals, and get her bath in the evening.
The worst part would be that she would either have to sit in the living room/recreation area all day with the other residents, or she would have to sit alone in her room in front of her television.
She doesn't like either option, but as she sleeps more and becomes less likely to try to get out of her chair when alone, it could be done.
Unless she has another health crisis that lands her in a nursing home with no debate.
Stay tuned for the next chapter of the story.

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