Author Topic: expenses in old age  (Read 6244 times)

Runrooster

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expenses in old age
« on: May 15, 2017, 05:05:07 PM »
Hi.  I apologize if this has been asked and answered a thousand times, but I'm trying to find some good articles on how to allocate for increasing expenses as we age.  I think I've read there are studies that say average people spend less as they age, but I suspect the spending shifts.  In other words, I don't know how easy it is for MMM types to avoid the costs of aging, not the least of which is health insurance and getting sick more frequently.  I suspect even MMM himself will cut down on  his bike riding as he enters his 70's.  Or  not? What do you think?

Mtngrl

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Re: expenses in old age
« Reply #1 on: May 15, 2017, 05:14:15 PM »
It's an interesting question. I can't point you to any articles, but I can relate my experience with two different older relatives/acquaintances. My husband's parents are 85. They spend less now than they ever did, but as you say, the kinds of things they spend money on has shifted. They seldom drive, they don't go out or spend money on entertainment. They go to doctors more and take more medication, but that is all covered by Medicare and their Medicare supplement. They eat less, so grocery expenses have gone down. They don't buy clothing. We recently reviewed expenses with them and are trying to persuade them to hire a housekeeper and someone to do yard work. Even if they 'splurged' on these expenses and shifted to Uber instead of driving at all, their expenses would be below their spending in peak years.
My other experience is with a 90 year old friend. She recently gave up her car and either walks or gets rides from relatives and friends (oh, to be as spry as she is at 90). So -- car expenses gone. Medical covered my Medicare. She has a housekeeper every other week -- one person in a small place doesn't make much mess. Minimal food and clothing costs. Minimal entertainment and travel costs.
So -- I don't really see that old age is more 'expensive' if you are able to stay in your own home.

GizmoTX

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Re: expenses in old age
« Reply #2 on: May 15, 2017, 05:36:36 PM »
IMO, it only gets expensive if a person can no longer function alone. More so if active nursing care must be added.
Otherwise, one gets to an age where travel and/or sporting activities are no longer appealing or physically possible, there's little need or interest in more possessions, & housing is usually downsized.

Cassie

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Re: expenses in old age
« Reply #3 on: May 15, 2017, 05:40:14 PM »
At 62 we are spending more $ on insurance premiums, traveling and eating out.  Due to having a few friends die in 50's and 60's we are determined to do what we want now because you never know.  We don't spend much $ on clothes and don't drive nearly as much so those expenses are down.   What I saw with my Mom is that by 80 her desire to travel was done and she was a big traveler. She spent less and less as the years went by.  She cleaned her own apartment at 90 until she died of cancer.  She said it was important to keep moving.  Her sister is 91 and lives alone and cleans, etc.

Runrooster

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Re: expenses in old age
« Reply #4 on: May 15, 2017, 05:44:40 PM »
Active nursing care is a tough one, and there's no doubt that will increase a mustachian budget.
The need can also run into a decade.  ER helps people stay in better health overall, but I don't think it can avoid disability itself. That's just luck.
Common sense says that by the time most people need active nursing care, it will be okay to draw down on principal.
Insuring against that need is costly for most of us, who didn't start on it young.

MayDay

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Re: expenses in old age
« Reply #5 on: May 15, 2017, 06:18:53 PM »
I've seen eating out go up as cooking became harder.

GizmoTX

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Re: expenses in old age
« Reply #6 on: May 15, 2017, 08:25:35 PM »
My MIL at age 90 was losing weight because cooking had become too much work. She didn't go out to eat because driving had become scary & she didn't want to go by herself. Her children finally convinced her it was time to move to a senior community. Hers was a CCRC independent living facility, meaning she bought into the community rather than rent, paid a monthly fee for the dining room, utilities, & housekeeping services, & 90% of the principal is returned at death or when leaving for a nursing home. Since the CCRC required everyone to eat 2 meals/day in their really nice dining room, the cooking problem was solved. Most residents ate leftovers from the dining room for their 3rd meal. I don't think my MIL ever cooked anything on her stove after she moved there.

Lisapants

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Re: expenses in old age
« Reply #7 on: May 15, 2017, 11:42:48 PM »
Check out this BLS Consumer Expenditures write-up about older Americans (55 and up):

A closer look at spending patterns of older Americans
https://www.bls.gov/opub/btn/volume-5/spending-patterns-of-older-americans.htm

There's data for all individuals over 55, those aged 55-64, 65-74, and 75 and older. The older the age group, the lower the overall expenditures. However, the amount spent on healthcare increases with older groups.


Cranky

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Re: expenses in old age
« Reply #8 on: May 16, 2017, 04:56:11 AM »
Health is the big variable. Both my in-laws and my mom were healthy and independent until their late 80's, and I know that my mom's expenses went lower and lower over time. She didn't buy clothes or need any more stuff or drive very far. She had a sizeable surplus in her bank account every month.

Which is a good thing, because once those people hit their 90's, there was nursing care and assisted living to pay for.

Mr. Paws

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Re: expenses in old age
« Reply #9 on: May 16, 2017, 07:29:26 AM »
Healthcare is what worries me the most for old age.  I really don't want to end up in a nursing home after seeing two grandparents in one.  I had one set of grandparents that had enough money to have 24 hour nursing at their house when they became too old to take care of themselves.  However, if i remember correctly, I was told that nursing care alone cost about 12K/month.  What is everyone's plan for late life?  nursing home? private care?

spokey doke

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Re: expenses in old age
« Reply #10 on: May 16, 2017, 07:54:06 AM »
Let's connect some dots...fear about expenses late in life, and not having enough money to cover them, seems to be keeping people from spending (and I suggest, working longer than necessary)...see:

https://forum.mrmoneymustache.com/welcome-to-the-forum/rich-retirees-are-hoarding-cash-out-of-fear-bloomberg/

Finding some good resources on how best to account for late-life expenses is a part of assuaging those fears (and getting them dealt with so people can move on)...help on that front???

Runrooster

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Re: expenses in old age
« Reply #11 on: May 16, 2017, 10:29:47 AM »
Healthcare is what worries me the most for old age.  I really don't want to end up in a nursing home after seeing two grandparents in one.  I had one set of grandparents that had enough money to have 24 hour nursing at their house when they became too old to take care of themselves.  However, if i remember correctly, I was told that nursing care alone cost about 12K/month.  What is everyone's plan for late life?  nursing home? private care?

I doubt you can get 24 hour nursing for 12K, maybe closer to 20k.  I guess that's close to hospice care level help, something you'd need for maybe six months?  I do know someone who needs daytime help, for about 10k, could be less if insurance wasn't paying.  But that will probably last ten years.

Mr. Paws

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Re: expenses in old age
« Reply #12 on: May 16, 2017, 12:28:52 PM »
Healthcare is what worries me the most for old age.  I really don't want to end up in a nursing home after seeing two grandparents in one.  I had one set of grandparents that had enough money to have 24 hour nursing at their house when they became too old to take care of themselves.  However, if i remember correctly, I was told that nursing care alone cost about 12K/month.  What is everyone's plan for late life?  nursing home? private care?

I doubt you can get 24 hour nursing for 12K, maybe closer to 20k.  I guess that's close to hospice care level help, something you'd need for maybe six months?  I do know someone who needs daytime help, for about 10k, could be less if insurance wasn't paying.  But that will probably last ten years.

It definitely could have been more this was a few years ago.  12K just sticks in my mind.  They had these nurses for a few years before death. 

MrsPete

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Re: expenses in old age
« Reply #13 on: May 16, 2017, 06:59:28 PM »
I think the spending people are describing here is realistic:  Once you're "really old", you won't spend on travel and clothes much anymore ... and I suspect all of us are most concerned about that biggest expense in old age:  Medical care.

Thinking of my grandmother, I can make these comments about her spending:

- She cooked breakfast for herself every morning.  She'd buy the frozen sausage patties that cook quickly, and she'd cook an egg and/or a packet of instant grits to go with it. 
- Towards the end, she could only manage simple meals:  A can of soup, frozen pot pies, a baked potato.  She didn't like cold food like sandwiches or yogurt, but she could make plenty of simple things ... and I constantly visited /brought her big containers of her favorites, which could just be warmed up.
- She had Meals on Wheels for lunch 5 days a week, and the meals were large enough that she often saved half for her dinner. 
- Between all her children and grandchildren, she frequently went out to lunch or dinner with someone.  Again, since she ate little, she often took home enough food for 1-2 more meals.  She learned to order carefully; for example, she'd order a couple slider burgers instead of one big one ... easier to take home. 
- Something no one else has mentioned:  She lived alone for years (her choice), and heating/ cooling a whole house just for herself was less efficient. 

My thoughts about our own elderly years: 

- My husband has it made.  He's older than I am and in worse health, so he has me as his built-in caretaker.  The likelihood is that I'll be able to provide the care he needs in his old age /take care of the house. 
- People don't tend to go from able-to-manage-it-all to needing nursing home care.  I want to stay in my own house ... and I'm planning to hire cleaning help, yard help, couple-hours-a-day-personal-care help for myself. 
- We're building a retirement house for ourselves, and we're building in items to make our lives easier in our later years; for example, a no-barrier entry shower, laundry room adjacent to the master closet, covered entrance, walker-friendly hallways.  We're also building two masters:  One up, one downstairs ... the downstairs is for us, and with the upstairs master available, hopefully I could have one of my children, future grandchildren, or even a paid caregiver "live in". 

ubermom4

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Re: expenses in old age
« Reply #14 on: May 17, 2017, 04:09:09 AM »
Most of the articles we read online about aging and expenses are written by young journalists. Bud Hebeler retired in his 50s (then a very early retirement) got bored and very interested in  better/ more sophisticated retirement planning. He is an engineer and was a very senior Boeing executive in charge of planning. Anyway, he has a blog called 'analyze now' that has a bunch of articles about the unexpected pitfalls of retirement. He has been asking his retired friends about their own surprise expenses. There were many -- often people do not budget ongoing savings in to their plans (sinking funds to replace cars, roofs, exterior painting, etc.), people don't plan to have to support their parents who may still need help, people don't expect to have to support multiple grandchildren who are in tough situations, etc. Budgeting for such a long period of your life is extremely complicated. His blog has a wealth of information. Hope this helps you.

iris lily

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Re: expenses in old age
« Reply #15 on: May 17, 2017, 07:21:39 AM »
This is kind of random, but I will say that we drve more in retirement than we did when we worked. More miles go on the car. We are doing a variety of things that we dis not so when we nosed the grindstone.

MrsPete

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Re: expenses in old age
« Reply #16 on: May 18, 2017, 11:14:16 AM »
Most of the articles we read online about aging and expenses are written by young journalists. Bud Hebeler retired in his 50s (then a very early retirement) got bored and very interested in  better/ more sophisticated retirement planning. He is an engineer and was a very senior Boeing executive in charge of planning. Anyway, he has a blog called 'analyze now' that has a bunch of articles about the unexpected pitfalls of retirement. He has been asking his retired friends about their own surprise expenses. There were many -- often people do not budget ongoing savings in to their plans (sinking funds to replace cars, roofs, exterior painting, etc.), people don't plan to have to support their parents who may still need help, people don't expect to have to support multiple grandchildren who are in tough situations, etc. Budgeting for such a long period of your life is extremely complicated. His blog has a wealth of information. Hope this helps you.
Thanks for this -- I wasn't aware of this blog, but I want to look it up. 

This is kind of random, but I will say that we drve more in retirement than we did when we worked. More miles go on the car. We are doing a variety of things that we dis not so when we nosed the grindstone.
I expect we'll be the same, but we plan to downsize from two cars to one ... so I'm expecting that losing the maintenance /taxes /tags on the second car will kind of "equal out" and cover the extra miles put on the first car. 

henceforth

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Re: expenses in old age
« Reply #17 on: May 18, 2017, 07:08:27 PM »
My parents (mid-60s), in-laws and many of their friends complain frequently about the dental costs that have started to come with advancing age.

Linea_Norway

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Re: expenses in old age
« Reply #18 on: May 19, 2017, 02:32:39 AM »
My mother (67), widow for many years, but still living in the big house from the 70s. She is spending most of her time at home. She does spend money on readily prepared food from the grocery store (not cooking from scratch). And she regularly visits both a hairdresser and a beauty person (skin treatment), I think once a month or so. She doesn't drive much. She manages to save a sum every month, so her bank account is growing. She is investing in the house from time to time and needs to hire people for that. If she wouldn't do it, the house would easily loose it's value. It is already not looking very well maintained in all places. I think she also hires a gardener from time to time.

FIL and MIL used to live together in their big house in a remote place, bought after they FIRED. The house still has a mortgage. It has been for sale for a long time, but not been sold. In recent years they have hired a cleaning lady once a week. Since a few months Mil is living in a care home, down the same street, as she has developed dementia. In the years prior to that my FIL took care for her, but he has also hired a lady that could take her out on trips once a week and sometimes the cleaning lady to look after her for a day. All this care has been paid from his private money. Also the care home is a private one and costs hotel prices. He is also still driving A LOT, as he lives in this remote place, far from all people and places he wants to visit. He drives probably 3 times as much on his own as my DH and I do together. He also drives his wife around every day, because she can't do so much else than that. Apart from that he is a frugal kind of person. But he is giving away a lot of his stuff, as he has a big, full house. We have suggested to use the local version of Graig's list, but he doesn't like the idea of strangers visiting. He maybe he will change his mind. He is still coping with the money, but his economy has become a lot tighter after his wife becoming expensive.
« Last Edit: May 20, 2017, 09:21:59 AM by Linda_Norway »

deborah

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Re: expenses in old age
« Reply #19 on: May 20, 2017, 03:40:47 AM »
From things I've read, the last eight years of life tend to be expensive - multiple hospital visits, care expenses and moving from home to care facilities all add significantly to people's costs. Until then, people tend to be living on less because they have fewer needs. A broken hip or alzheimers tends to put paid to independence. And if you have both, you'll never walk again, because you need to relearn how to balance yourself.

historienne

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Re: expenses in old age
« Reply #20 on: May 20, 2017, 01:02:18 PM »

 
- People don't tend to go from able-to-manage-it-all to needing nursing home care.  I want to stay in my own house ... and I'm planning to hire cleaning help, yard help, couple-hours-a-day-personal-care help for myself. 


I'm confused about this statement.  Do you mean that people don't tend to go straight from one to the other?  That's true (I suspect), but it doesn't mean that the same people don't end up needing nursing home care eventually.  For how long is the big question.  Both of my grandmothers lived into their 90s, and both had about 2 years of nursing home care at the end of their lives - expensive, but of the order of magnitude that can be covered by drawing down a 1+million$ stache.  The risk is something like Alzheimers, which can leave people needing skilled nursing care for a decade or more.

FWIW, both my grandfathers benefited from the same age/health differential as your husband, and aged in place until just before they passed.

Bicycle_B

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Re: expenses in old age
« Reply #21 on: May 20, 2017, 02:13:47 PM »

 
- People don't tend to go from able-to-manage-it-all to needing nursing home care.  I want to stay in my own house ... and I'm planning to hire cleaning help, yard help, couple-hours-a-day-personal-care help for myself. 


I'm confused about this statement.  Do you mean that people don't tend to go straight from one to the other?  That's true (I suspect), but it doesn't mean that the same people don't end up needing nursing home care eventually.  For how long is the big question.  Both of my grandmothers lived into their 90s, and both had about 2 years of nursing home care at the end of their lives - expensive, but of the order of magnitude that can be covered by drawing down a 1+million$ stacheThe risk is something like Alzheimers, which can leave people needing skilled nursing care for a decade or more.

FWIW, both my grandfathers benefited from the same age/health differential as your husband, and aged in place until just before they passed.

I too plan by separating end-of-life costs vs the ordinary costs of living a long time.  I read somewhere that in the majority of cases, costs due to declining health average less than $100,000. 

Due to a parent with Alzheimer's, agree that the Alzheimer's case can be much more.  My parent's case cost in the neighborhood of $200k from the time we got the court to recognize that he needed care, and therefore that his powers of attorney should be invoked to put the kids in charge, to the time when he passed away.  That's the total of all expenses that were paid, after getting Medicare to pay for the bulk of medical expenses.  Costs included about 2 years in an assisted living facility, plus about 5 months in a specialized Alzheimer's-only unit.  He did not have long term care insurance, so these costs were paid out of his savings when they reached beyond the amount of his employer's retirement pension payment.  Someone in better health pre-Alzheimer's could have lasted several years longer after diagnosis.  I can easily imagine costs for me being 400k if I get it too someday.

That said, it makes sense to me to assume that the stash lasts until some Terminal Illness or Age sets in, at which point depleting resources is safe.  My present stash of 450k might mean cutting it a little thin if Terminal Illness arrives at the same time as a market low.  But I don't need 450k to live on plus 400k for illness, the total needed is less, I think. 

Due to family history, am presently pondering long term care insurance (an affordable expense of maybe 50k) plus my stash, vs accumulating a bigger stash with no LTCI.  Maybe the LTCI is a minority view on this board; I welcome others' comments.

deborah

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Re: expenses in old age
« Reply #22 on: May 20, 2017, 03:55:10 PM »
My grandmother was diagnosed with alzheimers at about 82 - she definitely had it before that, because the people in the shopping centre were used to her showing them a handful of money, and taking what was needed... But at 82 she couldn't live independently any more. She died at 98. One of her SILs had it for about the same length of time. That's a very long time to be in care, and it's very expensive.

People can go downhill very quickly. Operations really knock the elderly around, and if they have an anesthetic, they can take a year or more to get back to where they were beforehand. A broken hip (generally because of frail bones and a fall) is the single most common thing that forces people into nursing homes, and that happens very quickly.

cacaoheart

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Re: expenses in old age
« Reply #23 on: May 20, 2017, 06:06:14 PM »
Due to family history, am presently pondering long term care insurance (an affordable expense of maybe 50k) plus my stash, vs accumulating a bigger stash with no LTCI.  Maybe the LTCI is a minority view on this board; I welcome others' comments.

I've considered long term care insurance but so far my impression is that at my age (early 30s) my money may be better spent as general retirement savings, versus paying premiums for decades on a plan that may or may not pay out when I want it to.

I used to work in a continuing care retirement community and could see potentially moving to one around age 70. At the one I worked at, it was a non profit controlled by the people who lived there, with the idea being that people move in when still independent and healthy, and if/when more care is needed they can move into an assisted living apartment or a floor with round the clock staff, remaining within the same community. Once someone buys into the place they needn't worry about being kicked out if they run out of money for monthly premiums, so I guess the initial 6 figure buy-in is a sort of LTC insurance. One challenge is the multi-year wait list for getting into many such places, and it's necessary to join long before help is needed. Many people live there for decades, with fine chefs preparing meals in the dining hall, buses taking people shopping and to theatre shows, and large community areas on site.

Pigeon

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Re: expenses in old age
« Reply #24 on: May 20, 2017, 06:20:32 PM »
Beyond having a large stash, I don't think there's all that much actual planning that I can do at this point.

I recently buried my 94 yo father and my 93 yo MIL.  They both had Alzheimer's toward the end.  A fall put my father in a nursing home.  He and my step-mother had an apartment in a senior housing complex, and she's 90 and still there.  The nursing home was a horror show, but he had too many physical problems at that point to be at home, even with 24/7 nursing care.  The senior housing place where she lives is nice, with a few services, transportation, a dining room and nice apartments.  It's more than a regular apartment, but not really expensive.  The huge plus is that my step-mother has made friends there and there are outings and social activities.  She is healthy and doesn't need assisted living.

My MIL insisted on staying in the family home, which was way too big for her.   After FIL died a few years ago, she was very, very isolated.  She had a few sons in the area and we'd visit when we could, but we all work full time and have kids.  She was  a very social person by nature.  She equated any kind of senior living situation with the worst type of nursing home and refused to even discuss options, much less visit anywhere.   After the Alzheimer's became apparent, she moved in with my BIL, and that was a terrible situation.  We finally got her into a memory care facility that was fabulous, and she was much happier there than she was at BILs, made friends and enjoyed the social activity.  It was very expensive, but she could afford it.

After watching them age, I would prefer not to stay in my house when I can't get out to do things on a regular basis.  I think it's too lonely, even with a spouse, and I'm a fairly introverted person.  Having money in the bank gives you options.

MrsPete

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Re: expenses in old age
« Reply #25 on: May 21, 2017, 05:39:05 PM »

 
- People don't tend to go from able-to-manage-it-all to needing nursing home care.  I want to stay in my own house ... and I'm planning to hire cleaning help, yard help, couple-hours-a-day-personal-care help for myself. 


I'm confused about this statement.  Do you mean that people don't tend to go straight from one to the other?  That's true (I suspect), but it doesn't mean that the same people don't end up needing nursing home care eventually.  For how long is the big question.  Both of my grandmothers lived into their 90s, and both had about 2 years of nursing home care at the end of their lives - expensive, but of the order of magnitude that can be covered by drawing down a 1+million$ stache.  The risk is something like Alzheimers, which can leave people needing skilled nursing care for a decade or more.

FWIW, both my grandfathers benefited from the same age/health differential as your husband, and aged in place until just before they passed.
I mean people don't tend to go from being just fine, able to manage everything for themselves ... suddenly needing a nursing home. 

Instead, most people are going to slow down gradually.  Perhaps an elderly lady will be just fine at 80, able to do everything she could do in the past -- just a little more slowly -- then she gives up driving at night, then she gives up driving altogether and counts on her children to drive her to church and the grocery store.  Then she starts needing help with the heavy cleaning, though she's still fine doing her own dishes every day.  Then comes the day when she needs more help around the house:  can't do her own laundry, needs help with cooking. 

I think this is more common than going from "just fine, independent, etc." to needing full-scale nursing home care.

cacaoheart

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Re: expenses in old age
« Reply #26 on: May 21, 2017, 06:27:57 PM »
I mean people don't tend to go from being just fine, able to manage everything for themselves ... suddenly needing a nursing home. 

The main exception that comes to mind for me is a stroke, the 5th leading cause of death in the US. At 60 my dad went from being the person that helped everyone else to not even being able to sit up without constant vertigo, so he spent his last 3 years in bed before dying of another stroke. The first one was thought to be a result of a medication he was on for pain in his knees, Vioxx, which was later pulled from the market, and had he lived near a major hospital they would have done the appropriate testing to see what kind of stroke he was having and treated him accordingly so he may still be walking around today.

My take from this is that I will always live near a major hospital that can provide modern treatment and take care of myself to minimize the risk of needing such care. I work as a cardiac nurse and have identified strokes in patients. It's been rewarding to be able to catch the symptoms in time and hear about their recoveries.

Linea_Norway

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Re: expenses in old age
« Reply #27 on: May 22, 2017, 05:48:13 AM »
I mean people don't tend to go from being just fine, able to manage everything for themselves ... suddenly needing a nursing home. 

The main exception that comes to mind for me is a stroke, the 5th leading cause of death in the US.

I wonder if it would be a good idea to buy an extra insurance for this. Currently I have such an insurance through work, but we might need to by some privately. Of course these get expensive as you grow older.
The need for a nursing home is probably not so big, as long as you have a spouse who want to be your nurse. But I have seen with my FIL how big a burden this can become for the spouse. And when the patient starts to require help 24 hours a day, the spouse can't handle it anymore.


Gin1984

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Re: expenses in old age
« Reply #28 on: May 22, 2017, 06:09:20 AM »
Beyond having a large stash, I don't think there's all that much actual planning that I can do at this point.

I recently buried my 94 yo father and my 93 yo MIL.  They both had Alzheimer's toward the end.  A fall put my father in a nursing home.  He and my step-mother had an apartment in a senior housing complex, and she's 90 and still there.  The nursing home was a horror show, but he had too many physical problems at that point to be at home, even with 24/7 nursing care.  The senior housing place where she lives is nice, with a few services, transportation, a dining room and nice apartments.  It's more than a regular apartment, but not really expensive.  The huge plus is that my step-mother has made friends there and there are outings and social activities.  She is healthy and doesn't need assisted living.

My MIL insisted on staying in the family home, which was way too big for her.   After FIL died a few years ago, she was very, very isolated.  She had a few sons in the area and we'd visit when we could, but we all work full time and have kids.  She was  a very social person by nature.  She equated any kind of senior living situation with the worst type of nursing home and refused to even discuss options, much less visit anywhere.   After the Alzheimer's became apparent, she moved in with my BIL, and that was a terrible situation.  We finally got her into a memory care facility that was fabulous, and she was much happier there than she was at BILs, made friends and enjoyed the social activity.  It was very expensive, but she could afford it.

After watching them age, I would prefer not to stay in my house when I can't get out to do things on a regular basis.  I think it's too lonely, even with a spouse, and I'm a fairly introverted person.  Having money in the bank gives you options.
That is my mom to a t.  She says she'll kill herself before going into one. 

MayDay

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Re: expenses in old age
« Reply #29 on: May 22, 2017, 06:12:54 AM »
I have no interest in being anyone's nurse. I'll ship my parents and husband off to a home, tyvm.

Villanelle

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Re: expenses in old age
« Reply #30 on: May 22, 2017, 06:35:57 AM »
Healthcare is what worries me the most for old age.  I really don't want to end up in a nursing home after seeing two grandparents in one.  I had one set of grandparents that had enough money to have 24 hour nursing at their house when they became too old to take care of themselves.  However, if i remember correctly, I was told that nursing care alone cost about 12K/month. What is everyone's plan for late life?  nursing home? private care?

This could change, but at some point, my plan is "overdose". 

I lived with my grandmother at the end of her life.  Grandpa had died a couple years prior, and fortunately, just as grandma was starting to have trouble living fully independently, I moved to her city with my now-husband to whom I had recently gotten engaged.  At first, I just bought groceries and changed a light bulb here and there, or brought the trash to the trash chute and maybe ran a load of laundry.  She was generally fine, but just not getting around super well.  By the end, she was bed-ridden and hadn't bathed for weeks.  (She refused to let either me or the hospice nurses who stopped by a couple times a week bathe her.)  She was miserable. I couldn't so much as walk my fiance down to the car to kiss him goodbye because that could be the moment she needed to urgently use the bathroom, and I might return to a huge mess, walls and carpet to clean, and a humiliated grandma. It was awful for her, and made her fairly unpleasant to be around, but understandably so.  She had no real quality of life.  Even in rare moments she felt okay-ish, she simply laid in her bed and waited.  That was really all she could do. 

No thanks.  If I get to that point, I hope I'm well enough to grab a handful of pills, or I have someone in my life kind enough and brave enough to help me. 

To be clear, I think that there is a lot of territory between "totally fine" and "laying in a bed hoping today is the day one dies", and there's a lot of quality life to be had in that territory.  But I don't fetishize living as long as possible no matter what.  (Again, I readily admit this might change when it's not just an abstract concept for me.) 

Linea_Norway

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Re: expenses in old age
« Reply #31 on: May 22, 2017, 06:55:08 AM »
No thanks.  If I get to that point, I hope I'm well enough to grab a handful of pills, or I have someone in my life kind enough and brave enough to help me. 

To be clear, I think that there is a lot of territory between "totally fine" and "laying in a bed hoping today is the day one dies", and there's a lot of quality life to be had in that territory.  But I don't fetishize living as long as possible no matter what.  (Again, I readily admit this might change when it's not just an abstract concept for me.)

You might want to consider writing your will at some point, when you approach your grandmother's situation. And include in that will that you don't want to be revived after a stroke of something similar. This is at least a way to let life end it's natural, in a legal matter, at a time you don't want it to be prolonged.

About your other point, I would probably also end it actively. For a Dutch person, there are legal ways of getting help from doctors to do this. But you need to write a specific will for this while you are still clear in your head. In my case, I need to leave Norway, where helping a patient end his/her life is considered a crime.

Laura33

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Re: expenses in old age
« Reply #32 on: May 22, 2017, 08:36:21 AM »
I will say the 75+ years are a major reason why I want "extra" in the 'stache. 

Exhibit A:  My MIL was diagnosed with a very bad version of cancer (we're talking one-year survival rate below 10%).  Within a week, my FIL had her on a plane and at Hopkins for a meeting with THE guy; she was in surgery within 10 days from original diagnosis.  The money wasn't even an issue -- they have a couple million saved, I think.  So instead of worrying about what is covered, who is in the plan, etc., they were able to ask "who is the best guy for this" and go straight to him.  That was almost 4 years ago.  What is the appropriate "price" for 3+ additional years of life?

More recently, the chemo hasn't been as effective, and the only option is an experimental drug.  It started out at $12K/mo, Medicare denied the claim, the company refused to provide it for free.  FIL appealed, and now it is down to $2-3K/mo.  All of which falls into the "donut hole" and so is out of pocket.  Whatever:  again, it was "get her on the drug first, figure out the reimbursement later."  This is also not a "cure" drug but a "maintenance" drug, so these costs will continue for as long as she can hang on. 

Now, admittedly, most folks may never be in this position.  But for me, if worse comes to worst, I want to be in a position where I can focus on getting the best possible treatment first, vs. having to choose based on cost -- or, even worse, forcing my kids to choose between trying to keep me alive and saving for their own future. 

boarder42

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Re: expenses in old age
« Reply #33 on: May 22, 2017, 08:52:46 AM »
my grandparents are going into active care he has alzheimers.  this is where it gets expensive.  there was a thread focused specifically on how to plan for this.

My plan

1. the 4% rule usually grows money infinitely.
2. i'm retiring in my mid to late 30s i'll probably earn more money
3. as care like this becomes more prominent and more expensive robots will replace it and make it cheaper.

i'm not really that worried about it

if you're retiring later maybe you have more cause for worry.  and if you are retiring that much later 1 extra year of work could be worth thousands.
in my own situation if i go OMY i increase what we can spend by 12k ... OMY again and we can spend 26k more per year.... OMY again and we can spend almost 40k more per yaer.   if i work just 5 years longer than my expected FIRE date the amount of money we could spend would be double what we expect to spend.

the largest risk to FIRE IMO is not pulling the plug.  you can always come up with reasons not to do this.  see above for my golden handcuffs that could keep me from pulling the plug.

Villanelle

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Re: expenses in old age
« Reply #34 on: May 23, 2017, 01:56:23 AM »
No thanks.  If I get to that point, I hope I'm well enough to grab a handful of pills, or I have someone in my life kind enough and brave enough to help me. 

To be clear, I think that there is a lot of territory between "totally fine" and "laying in a bed hoping today is the day one dies", and there's a lot of quality life to be had in that territory.  But I don't fetishize living as long as possible no matter what.  (Again, I readily admit this might change when it's not just an abstract concept for me.)

You might want to consider writing your will at some point, when you approach your grandmother's situation. And include in that will that you don't want to be revived after a stroke of something similar. This is at least a way to let life end it's natural, in a legal matter, at a time you don't want it to be prolonged.

About your other point, I would probably also end it actively. For a Dutch person, there are legal ways of getting help from doctors to do this. But you need to write a specific will for this while you are still clear in your head. In my case, I need to leave Norway, where helping a patient end his/her life is considered a crime.

As I understand it, there's not a great way to stipulate this sort of thing.  I don't necessarily want a DNR (though at some point, I might) because it depends on the circumstances.  I just don't want to linger if there's really nothing left for me.  If I'd put a dog down in a similar situation, I'd want to be put down.  My dad had a stroke (he was in his early 60s, I believe).  He recovered 100%.  So a "don't bother in case of a stroke" would have been a catastrophic mistake, as he's still alive, active, happy and kicking ass in his 70s.  But had be been left just chilling in his bed, unable to really interact or participate in life, maybe the next step would have been a different one. 

It's kind of an "I'll know it when I see it" situation, and I guess I have to hope that either I'm cognizant enough to see it and express my wishes, or those around me--to whom I've pretty clearly expressed my wishes--make the most humane decisions, even if they are also really difficult decisions.