Long-term Care Talking Points

Chances are, if you are approaching your 50s, you might have a parent in their 70s who may be at risk of requiring eventual long-term care. If you are like most people, you’d probably delay any thoughts about imagining them needing long-term care sometime in the future. That is, until one day, like me, you could see one of your parents gradually beginning to become more and more dependent on his equally aged spouse.

Without a long-term care plan you might have to help out yourself, or even take early retirement to take care of them on a full time basis. I had no such plan with my long-term “crisis” moment. Because of our family culture, due to we decided it was best that I quit my job and move close to my parents. I found myself unemployed.

Based on the demographics baby boomers represent, it won’t be Medicare, or Social Security, rather, long-term care will be our country’s critical challenge in the next decades to come. As it stands more than half of everyone over 85 is receiving long-term care, and as medicine and lifestyles improve, making it past 85 gets easier.

Long-term care is very expensive too. A private room in a nursing home is about ninety thousand dollars annually; the average total costs running almost $250,000 for about three years. Homecare can cost even more at $22 an hour. Assisted living can also cost about $3,000 monthly.

How To Prepare:
Once your parents hit their mid-fifties would be an ideal time to start conversations about long-term care. These could even start as a light-hearted at this time. Being from the tail of the boomer generation, I often joke around with my kids that they can adopt me in my old age. Actually I wouldn’t mind that in my case, but I can’t predict what my family “dynamics” will be like in twenty or thirty years. Even though my parents took care of my grandparents in our home, times have changed, and people are continuing their careers later in life, well past their fifties, and giving up careers and income to take care of an adult can be a sacrifice.

Just to provide a rough idea what choices you may encounter, I assembled a table below. As you can see, it can be quite overwhelming. You could be tempted to throw your arms up and just “cross that bridge when the time comes”. Better yet, you could answer some questions decades ahead to help narrow the choices and plan ahead. For example, are you absolutely sure you don’t want your parents living in your home, or just can’t? (Incidentally, a new trend is to build “in-law” suites to keep your parents and in-laws more independent than ever.) For that matter, could your siblings share in these responsibilities? Do your parents have the savings for assisted living? On the other hand, do you feel they could qualify for Medicaid? Are your parents already in poor health, though relatively young? Would long-term care insurance be affordable at this point? Would your parents really prefer keeping their home? Could you make some home adjustments to make it safer for them? Is remote care a possibility?

Type of Elder CareTypical Criteria (e.g. activities of daily living [ADL] deficiencies)Typical Costs (also varies by state)
Family member care:1+ ADLsTypically free for parent, but adult children (or relative) may require time off job, hidden costs of home maintenance, car ownership, etc)
Home care:1+ ADLs$22+/hour, $700-$3,800 per month, (+hidden costs of home maintenance, car ownership, etc)
Adult day care: personal and skilled care, and recreational services.1+ ADLs, Memory care$75-$100/day, $1,500-$2,000/month (+hidden costs of home maintenance, car ownership, etc)
Independent Living: no health services typically provided1-2 ADLs$1,700/mo +

Assisted living facilities: moderate personal care and health services2-3 ADLs, caregivers available, medication management$3,500/mo (keep in mind, some require entrance fees or large deposits)

Senior nursing facilities: For those requiring more intense medical care.3+ ADLs$7,000-$10,000/mo

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