End of life planning

[Pizzabrewer]

What are you doing to plan for the last years of your life?

I realize most of you here are much younger than me.  You're excited about the prospect of retiring early (as well you should be), and are planning your living expenses based on the 4% rule (or something similar) and your current living expenses.

Yet someday you won't have the independence and health you have now.  You will need some kind of long-term care solution in the last 5-20 years of your life.  Assisted living, nursing home, hospice, etc.

How are you planning and budgeting for that?

I ask because my sisters and I are going through a rough time with our (approx. 90 year old) folks.  They made no plans and insist they are fine in their home.  Recent circumstances indicate we will have to step in and make decisions for them that will be met with extreme anger and resistance.  And it will probably cost us a good bit of money.  As family we will certainly step up but there is always the thought that they could/should have made better plans.

I implore all of you not to burden your children by a lack of planning for your sunset years.  It is emotionally and financially draining for everyone involved.  This is not a topic I've seen discussed much here, that's why I'm asking what all you early FIRE folks have in mind.

[sol]

The Neptune Society charges about $500, which you can prepay at any age.  Alternately, you can always donate yourself to science for free as long as you don't mind med students using your dismembered member for juvenile pranks.

Oh, you meant before that?

[Pizzabrewer]

Wow.  OK that's one perspective.  I guess.

[Pizzabrewer]

Well like I said y'all are younger than me so I guess a flip answer is to be expected...

[marty998]

In Australia most people have their wealth tied up in their family home.

The general principle is that selling the home will fund appropriate aged care when it is required.

You are right though - dealing with stubborn oldies is not a lot of fun. Some will ned to be dragged kicking and screaming.

Best to talk them through it in a moment of lucidity.

Regarding mustachios though... most people here are exactly the type who forward plan. Don't think you should worry too much about us.

[Pizzabrewer]

Well that's what I'm asking. How much are you budgeting for this?

[marty998]

I'm 31. A lot can change in 40 years... there's a difference between forward planning and being way over zealous about it :)

[scottish]

I hope to fall off a mountain, crash a motorcycle or otherwise die in a rush of adrenaline when my mind starts to go.

However this didn't work for my mother, or my grandmother, so we're saving carefully just in case.   We're planning a 500K allocation at FIRE for medical and long term care expenses.    Hopefully this will grow substantially before we need to draw on it.

[Mustache ride]

My plan? The government will take care of me like they do with everybody that plans poorly.

[pbkmaine]

Assuming I live longer than my husband, when my quality of life tanks, I plan to end my life in a clinic in Switzerland.

[sol]

I'll go with the Smith and Wesson plan.

Please consider how selfish this is, when other people will have to clean up after you.

If you're going to end your life violently, do so at sea where disposal is automatic, children won't find your corpse, and nobody has to mop up your brains or transport your stinking fleshpile to a morgue or conduct an investigation.  Better yet, fill out the requisite paperwork and die peacefully in a facility designed to handle such things.

Gunshot suicides piss me off.  Don't be a dick.

[o2bfree]

My plan as a childless and currently single woman with no young family members is eventually downsize to a small single story condo or house that I can "age in place" - maybe one of those 55 plus active seniors kind of communities (my mom moved to one and it was great). Set myself up to live as independently and easily as long as possible and hire a helper or p/t caregiver if needed. If I get too sick or frail I need full time care I'll sell the place and go into a nursing home. Use all my assets to cover the costsvand then go on Medicaid (if it still exists) after I'm broke. Otherwise,,and more likely, I'll go with the Smith and Wesson plan.

Ditto. Though I'm married. But here's no telling how the care situation will play out. We joke about being ok with getting kicked to the curb in case of serious disability, so as not to trap the other in a nightmarish caregiver situation, but it's hard to know how that would feel until it happens. My mom cared for my dad for 5 years in her early 80s, and I was in awe of the strength she summoned to do so. Compassion and a sense of duty are powerful motivators.

But divorce for the purpose of sparing the well person's assets is not out of the question, whether or not the well person ends up as the caregiver.

Also, I may think about alternatives to the S&W plan, if it ever came to that, just to spare someone the mess.

[wenchsenior]

My plan as a childless and currently single woman with no young family members is eventually downsize to a small single story condo or house that I can "age in place" - maybe one of those 55 plus active seniors kind of communities (my mom moved to one and it was great). Set myself up to live as independently and easily as long as possible and hire a helper or p/t caregiver if needed. If I get too sick or frail I need full time care I'll sell the place and go into a nursing home. Use all my assets to cover the costsvand then go on Medicaid (if it still exists) after I'm broke. Otherwise,,and more likely, I'll go with the Smith and Wesson plan.

Ditto. Though I'm married. But here's no telling how the care situation will play out. We joke about being ok with getting kicked to the curb in case of serious disability, so as not to trap the other in a nightmarish caregiver situation, but it's hard to know how that would feel until it happens. My mom cared for my dad for 5 years in her early 80s, and I was in awe of the strength she summoned to do so. Compassion and a sense of duty are powerful motivators.

But divorce for the purpose of sparing the well person's assets is not out of the question, whether or not the well person ends up as the caregiver.

Also, I may think about alternatives to the S&W plan, if it ever came to that, just to spare someone the mess.

DH and I are kind of in the same place.  We have some LTC insurance on him, and are going to budget somewhere between 250 and 500K on top of base nest egg $ for medical care/LTC. How much depends on status of health care system and how long I can convince myself to keep working.

[TrMama]

I watched all 4 of my grandparents, and 3 of DH's grandparents die slow, painful, indignant deaths. None of them were short of money but all of them died awful deaths that I wouldn't have wished on anyone.

I've thought long and hard about how I want to meet my end and I'm very, very grateful to live in a place that recently legalized assisted death. I haven't yet decided exactly what functional losses will lead me to seek help, but I know I'll never go to a nursing home. I'll likely have enough to afford it, but there's no way I'll consent. If I need that level of care, then it's my time.

I'm not being glib, this really is my plan.

[o2bfree]

I watched all 4 of my grandparents, and 3 of DH's grandparents die slow, painful, indignant deaths. None of them were short of money but all of them died awful deaths that I wouldn't have wished on anyone.

The adult care places my dad was in all had people going this way, at $6000-$10,000 per month. I'd rather give my money to the Flat Earth Society than be sucked dry that way.

[sol]

One of my grandfathers spent the last month of his life in a hospital, gaunt and hopeless and roaming the halls with an IV stand while unable to control his bladder, and he absolutely hated that his own grown children had to see him in such weakened and vulnerable and desperate state.  He would have much preferred to die at least five years earlier.

One of my grandmothers spent the last few months of her life in a full time care facility, with a broken hip that was never going to heal.   They kept her pretty drugged up most of the time, for the pain of unset bones, but we could visit her and she was happy to see us.  She was bedridden but the bed was motorized and they could get her into enough of a seated position to eat in the dining hall with the other residents.  I played old songs for her, and we got to talk about stuff.  We got to say goodbye.  She knew she was never leaving that place alive, but it was absolutely a better way to die than my grandfather mentioned above.

These two experiences have led me to believe that a good hospice care situation is vastly preferable to extraordinary medical measures in a hospital.  Hospitals are not good places to die.  At least not if it takes a while.

My other grandfather went in for elective abdominal surgery at the age of 93 and never woke up.  He knew his odds weren't good.  There's been much discussion in the family about whether or not this was effectively a peaceful suicide.

[Pigeon]

I had two relatives in their 90s die a couple of months ago.  I don't know realistically how much real planning you can do for this.  You just don't know how you will be physically or mentally.  Having a lot of money gives you more options, but it doesn't really ensure you have a good situation.

My dad and stepmother had moved into a very nice senior apartment complex when he turned 90.  He was good for another 3 years, and then had a fall.  He had been showing mild dementia.  After the fall, he ended up in a nursing home and the dementia got exponentially worse.  He was private pay and the nursing home gets good marks, but it was horrible, he wanted to die, and it was a relief when he got pneumonia and died.

My MIL had lived in the family home and was adamant about not moving anywhere.  The last five or so years at home weren't good, as she'd gotten very isolated.  We live in town and visited as much as possible, but had kids to raise and she'd go a week at a time without seeing anyone else.  She was a very social person by nature and it was a bad decision to stay but we couldn't get her to budge.  She developed dementia and had to be moved to a memory care facility that was wonderful, until she died suddenly.  She  should have moved to a senior place with  more social interaction years ago.

The problem with the idea of living someplace with doctor assisted suicide is that you generally have to have a terminal diagnosis and have to be of sound mind.  Getting old and senile, with no clear fatal medical condition isn't going to help.

[gaja]

For the money side of things, I trust the welfare state not to put too much of a burden on my daughters. I'm much more afraid of my genetic predisposition for parkingson. Hopefully the genetic predisposition for cancer will get me first.

[pbkmaine]

https://en.m.wikipedia.org/wiki/Dignitas_(Swiss_non-profit_organisation)

http://dignitas.ch/index.php?option=com_content&view=article&id=20&Itemid=60&lang=en

[FIRE Artist]

My plan as a childless and currently single woman with no young family members is eventually downsize to a small single story condo or house that I can "age in place" - maybe one of those 55 plus active seniors kind of communities (my mom moved to one and it was great). Set myself up to live as independently and easily as long as possible and hire a helper or p/t caregiver if needed. If I get too sick or frail I need full time care I'll sell the place and go into a nursing home. Use all my assets to cover the costsvand then go on Medicaid (if it still exists) after I'm broke. Otherwise,,and more likely, I'll go with the Smith and Wesson plan.

This is exactly my plan, the Canadian version of course. My financial adviser told me to plan for my home equity to pay for my long term care, this plan still sounds good to me,

[Secretly Saving]

Well, I'm in my 30s, but both parents are already gone.  Seeing and experiencing all that has led me to  seriously consider all of the options for aging.  I haven't made any concrete plans, but I sure as hell am not getting a LTC policy.  That shit is a JOKE.  I will self insure.

[Dee18]

+1 to pbkmaine's plan of the Swiss solution.  When I first read read about that in the
New York Times I felt a great since of relief.

[MandalayVA]

I think in twenty years that more states will have "death with dignity" laws on the books, particularly once millennials start taking political office.

[bogart]

I'm sorry to hear about what you're dealing with on behalf of your parents.

I'm not that young, but I'm not that old, either.

My DH is noticeably older than me, and RE'd.  Basically, I'm his long-term care plan.  Obviously that may or may not work well.  We've been careful to approach remodels to our one-story home with an eye to aging in place, and with the exception of an accessible bathroom (but that could be retrofitted pretty readily if required), are pretty much there. 

Sometime between when I turn 50 and when I turn 60, I plan to identify a CFP to work with on managing my finances -- presumably just someone I pay an hourly rate at least initially, but I want to be sure I have someone who has a fiduciary responsibility and who can get to know who I am and what I want/do before I become unable to manage those things on my own.  I may also involve family members in that process, but it will depend on who's around and what their skill sets are -- lots of the ones who care about me and whose judgment I trust for e.g. life course and medical decisions aren't the ones I want managing my finances.

My sense is that the long-term care insurance market is not currently very sound, so I'm planning to self-insure there.  But yes, it will mean I work a lot longer and am much more cautious (think 2% rule instead of 4% rule) than many on these boards tend to do/be.

[Letj]

Assuming I live longer than my husband, when my quality of life tanks, I plan to end my life in a clinic in Switzerland.

Do you live in Switzerland now? If not, how you plan on getting on a plane? How do you execute this plan if your mind fails?

[pbkmaine]

Assuming I live longer than my husband, when my quality of life tanks, I plan to end my life in a clinic in Switzerland.

Do you live in Switzerland now? If not, how you plan on getting on a plane? How do you execute this plan if your mind fails?

I don't. In that case, one of my stepdaughters will make decisions for me, fully knowing my preferences for no medical intervention.

[Frankies Girl]

Married, no kids and no family members that will be considered heirs or otherwise involved in any way with our life/aging/death. If there's anything left over once we're both gone, it goes to charity.

We are currently only spending around 2-3% of our stash, and our old age is still around 20+ years out. So that, coupled with the idea that we're not trying to save anything for heirs and are good with spending down means we're not concerned with saving actual dollar amounts or percentages specifically for this.

So plans are pretty much exactly like Spartana's.

[BTDretire]

I think in twenty years that more states will have "death with dignity" laws on the books, particularly once millennials start taking political office.

  We know it's right to relieve our pet animals from their suffering,
but somehow society can't transfer that to their family members.

[merlin7676]

This is my fear....that the DH is gone and I'm alone, old, frail, and can't live alone anymore.   
I worked in a nursing home in college and let me tell you, I would never in a million years go to one. The people there were basically just waiting around to die.
With no kids and no younger family members, we plan on our money going to certain charities that we both like.
When it's time to go, it's time to go at that point I think.
That being said, I don't know of anyone on my mom's side who lived to be 70 and my dad was adopted so I have no idea how much of a life expectancy I can really estimate.

[retired?]

I had kids!  And I am trying to be very nice to them.

My FIL had parkinson's and I know he and my MIL had to do some machinations with their finances to qualify for certain rates or coverage so he could move into a facility for about three years.  It wasn't ideal, but my MIL couldn't take care of him at that point.

By machinations, I mean the sort people might do to maximize their financial aid for college.

My dad now has lung cancer.  Will probably live another 2 years at best.  That leaves my mom alone who is 70 now.  Lots of time to develop a network of friends and it's likely that either of my siblings or I will move near her.  We'd probably have to chip in if things got to be really bad with her.

[Pigeon]

I worked in a nursing home in college and let me tell you, I would never in a million years go to one. The people there were basically just waiting around to die.

I'd love to believe it works like that.

The thing is, from what I've seen nursing homes are full of people who feel exactly like this.  Nobody plans to be there.  Being opposed to going to one doesn't mean you won't end up in one.  Dementia is insidious.  You're mildly cognitively impaired one day, but still enjoying life and aging in place.  Then out of the blue, you fall, break a hip and get sent to a rehab.  Before you know it, your dementia has racheted up and you're in a nursing home.

[o2bfree]

I worked in a nursing home in college and let me tell you, I would never in a million years go to one. The people there were basically just waiting around to die.

I'd love to believe it works like that.

The thing is, from what I've seen nursing homes are full of people who feel exactly like this.  Nobody plans to be there.  Being opposed to going to one doesn't mean you won't end up in one.  Dementia is insidious.  You're mildly cognitively impaired one day, but still enjoying life and aging in place.  Then out of the blue, you fall, break a hip and get sent to a rehab.  Before you know it, your dementia has racheted up and you're in a nursing home.

So true, this happened to my grandmother. She was living alone and seemed to be doing ok, but then she fell and broke her wrist. She had to stay with mom and dad during recovery, and that change really jolted her, revealing full-on dementia. Within a couple months she could no longer care for herself and had to go into a care facility, where she died a few weeks later. Possibly, that was the best outcome.

The elderly mind can be quite fragile. An injury, bladder infection, post-operative cognitive decline due to anesthesia, or a change in living arrangements can send it over the edge, temporarily or permanently.

[sol]

My great uncle moved into a big senior care facility that had multiple care options, from personal apartments to a locked down memory ward.  I thought it was awesome.  Like the world's greatest college dorm.

They had the option of communal dining, and the food was awesome and you could eat ice cream at every meal.  They had a full schedule of events, like in-house musical guests, bingo, pinochle, casino field trips, a game room and library, old music, a chapel, veteran's recognition events, etc.  The staff seemed helpful, and was mostly young women that my uncle flagrantly sexually harassed as he slowly went senile, until only male staff would go to his unit.  I thought it was about the ideal situation for aging in place, since you could move into progressively more supervised living arrangements in the same facility as you aged and needed more support.  Much better than feeling isolated staying in your home, and then falling and breaking something and having to suddenly change everything.

I have such fond memories of communal living agreements in college, I sort of look forward to getting back into a senior care facility someday.  Hopefully there will be slightly less hazing.

[Cali Nonya]

Drat, this is a topic which is very fraught since many people have very strong views.

I am one of the "death with dignity" supporters and along with several above am hoping that the US changes the laws before my time. 
For singletons with no children like me, this is sort of a logical thing.  But I will go ahead and throw this one out there: it's complicated when it's your parents who have that plan.

No matter what you agree with logically, you don't ever want someone you love gone.  I have relatives in Europe who have opted for euthanasia where it is legal, and my family is used to accepting those types of decisions, but even if your mind agrees, it's hard on your heart hurts loosing a loved one (and it's hard accepting that desire to go before hand).

[Dicey]

My great uncle moved into a big senior care facility that had multiple care options, from personal apartments to a locked down memory ward.  I thought it was awesome.  Like the world's greatest college dorm.

They had the option of communal dining, and the food was awesome and you could eat ice cream at every meal.  They had a full schedule of events, like in-house musical guests, bingo, pinochle, casino field trips, a game room and library, old music, a chapel, veteran's recognition events, etc.  The staff seemed helpful, and was mostly young women that my uncle flagrantly sexually harassed as he slowly went senile, until only male staff would go to his unit.  I thought it was about the ideal situation for aging in place, since you could move into progressively more supervised living arrangements in the same facility as you aged and needed more support.  Much better than feeling isolated staying in your home, and then falling and breaking something and having to suddenly change everything.

I have such fond memories of communal living agreements in college, I sort of look forward to getting back into a senior care facility someday.  Hopefully there will be slightly less hazing.

My thoughts exactly. There's a huge difference between places people chose to live vs. the kind for people who have no options left. Choosing to move to the first type of community is by far the braver choice. Sure, they cost a fuck-ton of money, but that's what it's for, right?

[Hotstreak]

My great uncle moved into a big senior care facility that had multiple care options, from personal apartments to a locked down memory ward.  I thought it was awesome.  Like the world's greatest college dorm.

They had the option of communal dining, and the food was awesome and you could eat ice cream at every meal.  They had a full schedule of events, like in-house musical guests, bingo, pinochle, casino field trips, a game room and library, old music, a chapel, veteran's recognition events, etc.  The staff seemed helpful, and was mostly young women that my uncle flagrantly sexually harassed as he slowly went senile, until only male staff would go to his unit.  I thought it was about the ideal situation for aging in place, since you could move into progressively more supervised living arrangements in the same facility as you aged and needed more support.  Much better than feeling isolated staying in your home, and then falling and breaking something and having to suddenly change everything.

I have such fond memories of communal living agreements in college, I sort of look forward to getting back into a senior care facility someday.  Hopefully there will be slightly less hazing.

My thoughts exactly. There's a huge difference between places people chose to live vs. the kind for people who have no options left. Choosing to move to the first type of community is by far the braver choice. Sure, they cost a fuck-ton of money, but that's what it's for, right?

Absolutely.  My grandparents, in their early 90's just moved in to a facility like that at a cost of around $5,000/month per person.  They have enough money to stay there for a long time, and they are happier than they have been in at least a decade.  The meals being prepared, the weekly room cleaning, laundry, a variety of daily activities both on site and a shuttle ride away, no yardwork.  The place is really amazing.  They fire up the shuttles Sunday morning and drive residents to their respective churches, and pick them up when service is over.  I need to afford a place like that when I start having trouble taking care of myself.

[2Birds1Stone]

I plan on hookers and blow (with a healthy dose of viagra).

[MOD NOTE:  Duuuuude.  C'mon.]

[oldladystache]

My great uncle moved into a big senior care facility that had multiple care options, from personal apartments to a locked down memory ward.  I thought it was awesome.  Like the world's greatest college dorm.

They had the option of communal dining, and the food was awesome and you could eat ice cream at every meal.  They had a full schedule of events, like in-house musical guests, bingo, pinochle, casino field trips, a game room and library, old music, a chapel, veteran's recognition events, etc.  The staff seemed helpful, and was mostly young women that my uncle flagrantly sexually harassed as he slowly went senile, until only male staff would go to his unit.  I thought it was about the ideal situation for aging in place, since you could move into progressively more supervised living arrangements in the same facility as you aged and needed more support.  Much better than feeling isolated staying in your home, and then falling and breaking something and having to suddenly change everything.

I have such fond memories of communal living agreements in college, I sort of look forward to getting back into a senior care facility someday.  Hopefully there will be slightly less hazing.

My thoughts exactly. There's a huge difference between places people chose to live vs. the kind for people who have no options left. Choosing to move to the first type of community is by far the braver choice. Sure, they cost a fuck-ton of money, but that's what it's for, right?

My dad's in a place like that. They are really good to him, and he's happy there.

After his mini stroke (or whatever it was) my brother and I stayed with him for several weeks, but we couldn't entertain him, and it wasn't fun for anyone.

It's sponsored by his church, and it has a waiting list a mile long. My parents put themselves on the list probably 30 years ahead of time, so when he needed it it was there for him. I put myself on the list recently so I can have that option.

If I ever need to go there I'll have to put up with the religiousness, but it will be worth it for the good loving care. I know it's good because I spend a lot of time there and I've gotten to know a lot of the residents and staff.

Yes, it costs a lot, but it's worth it. And we can afford it.

But I'd rather die.

[accolay]

Assuming I live longer than my husband, when my quality of life tanks, I plan to end my life in a clinic in Switzerland.

Do you live in Switzerland now? If not, how you plan on getting on a plane? How do you execute this plan if your mind fails?

I don't. In that case, one of my stepdaughters will make decisions for me, fully knowing my preferences for no medical intervention.

Best to make out the paperwork and have your requests in writing with witnesses. People get funny when their loved ones are sick, and sometimes even with the paperwork, the family screws it up.

My plan is to make my self DNR/DNI/no feeding tube if anything serious happens i.e. if I cannot make my needs known. Let nature take its course. Also with any big cervical fractures. I'm ok with being a para, but no quad please. I fear losing the ability to wipe my own ass.

Otherwise I plan on living the best, healthiest life I that is in my power, have enough money to eat good food and have good friends and family.

[sol]

I fear losing the ability to wipe my own ass.

I've been there, and it's not as bad as you fear.  I wouldn't make any irreversible decisions based on your expectation of events you haven't yet experienced.  You never really know how much horribleness you can deal with until you don't have any other option but to deal with it.

[pbkmaine]

Assuming I live longer than my husband, when my quality of life tanks, I plan to end my life in a clinic in Switzerland.

Do you live in Switzerland now? If not, how you plan on getting on a plane? How do you execute this plan if your mind fails?

I don't. In that case, one of my stepdaughters will make decisions for me, fully knowing my preferences for no medical intervention.

Best to make out the paperwork and have your requests in writing with witnesses. People get funny when their loved ones are sick, and sometimes even with the paperwork, the family screws it up.

My plan is to make my self DNR/DNI/no feeding tube if anything serious happens i.e. if I cannot make my needs known. Let nature take its course. Also with any big cervical fractures. I'm ok with being a para, but no quad please. I fear losing the ability to wipe my own ass.

Otherwise I plan on living the best, healthiest life I that is in my power, have enough money to eat good food and have good friends and family.

Done. Very good advice.

[BTDretire]

My plan is to make my self DNR/DNI/no feeding tube if anything serious happens i.e. if I cannot make my needs known. Let nature take its course.

My mother had a DNR when she went into the hospital with breathing problems.
The staff said to her, "you have a DNR, do you want us to intubate you?" She said yes, I guess she did not want to die not being able to breathe.
 She had another 6 months at home, much of it in a hospital bed moved in to the living room. My sister moved in and took care of her.

[TartanTallulah]

I'm not all that old (early 50s) and in good health, as is my husband, but I'm only too aware that nothing can be taken for granted. At the moment, the most important things I can do are to make sure "my business is in order" - making a will, making sure my husband or other executors are clear about what financial and professional dealings I have and where to find them, and, at some stage, setting up a Lasting Power of Attorney and making decisions about end of life care, which, I'm sure, will change over time, as has happened with my parents.

My parents are both still alive, in their late 70s, and active and independent; life expectancy calculators suggest they could be around for another 15 years. They're orderly people and have taken steps to ensure that when the time comes I won't have a load of historical/sentimental tchotchkes to rehome and that if one of them needs care at home their house could be adapted very quickly. They considered downsizing but feel this would be more upheaval than it's worth, and it's not as if their current house is massive. They've discussed their plans for their estate with me (their assets are simple but our family structure, though not sprawling, is a little complicated) and I'm trying to persuade them to give me, as the person most likely to take responsibility for their care in old age, Lasting Power of Attorney. In the past they've always been like, "Oh, no, you're not getting at our money while we're still alive," but I'll keep mentioning the subject from time to time.

As far as assisted dying goes, my mother had a brush with death a few years ago as the result of a complication of a routine operation, and at the time she told the doctors in intensive care that she wanted to be allowed to die, and the consultant told us that they were obliged to respect her wishes. With the full support of the family, my father said that this should be overruled, and she made a determined and spectacular recovery. And as time has passed, my father's previous insistence that he should be euthanised if he becomes physically dependent has melted away.

[Pizzabrewer]

It's interesting the comments this thread has inspired.  My real question, perhaps not clearly stated, was simply for those of you planning on early FIRE have you included end-of-life expenses (nursing home, etc) in your calculations?  If so, how much have you budgeted?

All the other discussions (assisted suicide, etc) are interesting tangents though.

[Padonak]

Mid/late 30s here, single, no children, no plans to have any.

I will not set aside any money for a nursing home. 8-10K per month? No way I'm paying that.

My plan is to have a "safety buffer" in my portfolio to make sure I don't run out of money when I'm old. Also a small social security and a couple of very small (almost negligible) defined benefit pensions.

What happens if I get too old and frail and have to move to a nursing home? I'm fine spending the remainder of my "safety buffer" on the first few months or even a couple of years in a home (if required) and then going on Medicaid. Even if it means sharing a room in a shitty facility.

This is a conscious choice. I'd rather retire by 40 and enjoy my active years than spend my last years rotting in a nice $10K/month private room with medical care.

Assisted suicide and the Smith and Wesson retirement plan are not off the table, either.

[Pigeon]

Mid/late 30s here, single, no children, no plans to have any.

I will not set aside any money for a nursing home. 8-10K per month? No way I'm paying that.

My plan is to have a "safety buffer" in my portfolio to make sure I don't run out of money when I'm old. Also a small social security and a couple of very small (almost negligible) defined benefit pensions.

What happens if I get too old and frail and have to move to a nursing home? I'm fine spending the remainder of my "safety buffer" on the first few months or even a couple of years in a home (if required) and then going on Medicaid. Even if it means sharing a room in a shitty facility.

This is a conscious choice. I'd rather retire by 40 and enjoy my active years than spend my last years rotting in a nice $10K/month private room with medical care.

Assisted suicide and the Smith and Wesson retirement plan are not off the table, either.

I think this situation is somewhat easier for single people.  If you are married, the remaining spouse is in a bad position, since they are left very little before Medicaid kicks in.

[DavidAnnArbor]

I hope to age in place at my house. I'll probably have to do things to the home to make it elderly friendly, maybe a wheel chair accessible bathroom, with wheel chair accessible shower, grab bars, etc.  And I'll probably have to hire someone to assist me.
As things progress worse I would probably end up in a nursing home, though I would not really want that.

The option of an all inclusive senior center is another appealing possibility.

[Pigeon]

Also wanted to add that while the single childless person might be better off when it comes to financing nursing home care because they are free to use up all their assets and income for that, they might have many more old age expenses pre-nursing home than married people with kids do as they will likely have to pay for some help/care giving that may normally done by a spouse or kids. Stuff like cooking, cleaning, shopping, going to drs appts and other places, handling finances, grooming, bathing,  etc...

No doubt. I just think it's awful to make the other spouse live in poverty while watching their loved one languish in a nursing home.

[okits]

No specific plans, yet.  I can't guess how long my DH will want to work, even after we are FI (but he has indicated a desire to keep going for a while, in some capacity), so we might save a buffer without consciously planning to do so.   It wouldn't surprise me if we inherited something from our parents (we both come by our LBYM conservativeness honestly).  There are a non-negligible number of retirement calculator outcomes where your assets snowball into eight figures, even after decades of ER (in which case, fancy nursing home is totally affordable).  Even my FIRE budget is a spitball, because we are early into our sandwich-generation phase and can't accurately foresee how that (and the associated expenses) will evolve.

And as time has passed, my father's previous insistence that he should be euthanised if he becomes physically dependent has melted away.

I fear losing the ability to wipe my own ass.

I've been there, and it's not as bad as you fear.  I wouldn't make any irreversible decisions based on your expectation of events you haven't yet experienced.  You never really know how much horribleness you can deal with until you don't have any other option but to deal with it.

I think the tendency to hold onto life, even if you're in a scenario you previously considered unbearable, is very strong.  Being in an ill or dependent state also changes a person's feelings and perceptions, too.  A while back someone posted the NY Times article about Sandy Bem and I found it extraordinary because she actually made a plan, stuck to it through the personality changes of her illness, maintained self-awareness of her health situation, was frank with her loved ones (no pretending or nursing her pride), and carried it out.

[Wise Virgin]

My great uncle moved into a big senior care facility that had multiple care options, from personal apartments to a locked down memory ward.  I thought it was awesome.  Like the world's greatest college dorm.

They had the option of communal dining, and the food was awesome and you could eat ice cream at every meal.  They had a full schedule of events, like in-house musical guests, bingo, pinochle, casino field trips, a game room and library, old music, a chapel, veteran's recognition events, etc.  The staff seemed helpful, and was mostly young women that my uncle flagrantly sexually harassed as he slowly went senile, until only male staff would go to his unit.  I thought it was about the ideal situation for aging in place, since you could move into progressively more supervised living arrangements in the same facility as you aged and needed more support.  Much better than feeling isolated staying in your home, and then falling and breaking something and having to suddenly change everything.

I have such fond memories of communal living agreements in college, I sort of look forward to getting back into a senior care facility someday.  Hopefully there will be slightly less hazing.

My thoughts exactly. There's a huge difference between places people chose to live vs. the kind for people who have no options left. Choosing to move to the first type of community is by far the braver choice. Sure, they cost a fuck-ton of money, but that's what it's for, right?

My dad's in a place like that. They are really good to him, and he's happy there.

After his mini stroke (or whatever it was) my brother and I stayed with him for several weeks, but we couldn't entertain him, and it wasn't fun for anyone.

It's sponsored by his church, and it has a waiting list a mile long. My parents put themselves on the list probably 30 years ahead of time, so when he needed it it was there for him. I put myself on the list recently so I can have that option.

If I ever need to go there I'll have to put up with the religiousness, but it will be worth it for the good loving care. I know it's good because I spend a lot of time there and I've gotten to know a lot of the residents and staff.

Yes, it costs a lot, but it's worth it. And we can afford it.

But I'd rather die.

It just sounds so odd to me that this facility was so good 30 years ago your parent put himself on the waiting list; it's so good today that he has gone there and is very happy there, and you are so grateful for it; and you are sure that however many decades later when you need it, it will be the same kind of place with the same good care, so you put your name on the waiting list - yet you say you would "have to put up with the religiousness, but it will be worth it for the good loving care."

I will offer this: the amazing stability of the goodness of this institution and the people in it is religion.

Can you think of a secular place where this expectation could last 50 years?

Religion takes care of the dying because it sees them as persons who still have important work to do in this world before they cross to the next. Persons have dignity until they naturally die, because God made them. You can trust a person who believes this to take care of you - 30 years ago, today, and decades in the future.

There isn't any really good secular answer to the problem of aging and dying - thus you have desperate talk about gunshots and Swiss clinics and jokes about hookers and blow on this thread. We all know that secular institutions cannot be trusted with our aging selves.

There is our family; there are our friends; and there are those of religious sensibility. Only they will not see us as a wrinkly old has-been who might have been something once, but now should really just die already.

So how about some respect for the people who love God, and not talk about having to put up with them? Just so you can get some "good care" from them? Thank you.