Assisted living move for my elderly parents

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slee
Posts: 17
Joined: Wed Jan 30, 2008 9:30 am

Assisted living move for my elderly parents

Post by slee » Mon Jul 02, 2018 9:43 pm

Hi everyone, an apartment in assisted living has opened up in my parents' senior living facility. We have all agreed it is the right move at this time but I'm pretty much making the decisions regarding the lease review and finances so I'm asking generally if there are items in to specifically question/avoid. I've asked a number of questions regarding care but we haven't addressed costs and fees yet.

For background, my elderly parents have been in residing in an independent living apartment for a little over two years, a move prompted by them for health and social isolation reasons, and to be closer to me. Although it meant they would start to spend more than they took in, it seemed the best choice as it is a very expensive area and most other options were AL not independent. Months after moving in my father was diagnosed with mouth cancer and went through both surgery and radiation. At 87, he is thankfully still here but more frail and cognitively diminished after treatment. He asked me to take over all financial/insurance responsibilities. My mother has dementia, which has become more apparent in recent months, though she is still functioning reasonably well, and tries to take care of my father. There are other health/ability factors involved but these are the most relevant.

They have a long-term care policy that includes assisted living, with a max per day amount. I figure for what is left in LTC and their SS and pension, it would cover two years in AL without requiring the spending their assets. They do not have a high amount of savings but I calculate they may provide another four to five years of AL care without astronomic increases (which probably would occur with care level increases). Honestly, that's as far as I've gotten as life expectancy and who will survive the other are unpredictable (and difficult to focus on right now). I will be consulting our elder care lawyer to revise documents and discuss down-the-road care options and considerations. The lawyer is not available for the AL lease review at this time. I appreciate that my parents are in a position to be well cared for and still have each other after all these years (going on 65). I am working and financially secure and have no need or interest in their assets. And will help them out as needed. I just want to do what's best for them so they can have the best quality of life possible. Thanks for your consideration.

ResearchMed
Posts: 7473
Joined: Fri Dec 26, 2008 11:25 pm

Re: Assisted living move for my elderly parents

Post by ResearchMed » Mon Jul 02, 2018 9:59 pm

slee wrote:
Mon Jul 02, 2018 9:43 pm
Hi everyone, an apartment in assisted living has opened up in my parents' senior living facility. We have all agreed it is the right move at this time but I'm pretty much making the decisions regarding the lease review and finances so I'm asking generally if there are items in to specifically question/avoid. I've asked a number of questions regarding care but we haven't addressed costs and fees yet.

For background, my elderly parents have been in residing in an independent living apartment for a little over two years, a move prompted by them for health and social isolation reasons, and to be closer to me. Although it meant they would start to spend more than they took in, it seemed the best choice as it is a very expensive area and most other options were AL not independent. Months after moving in my father was diagnosed with mouth cancer and went through both surgery and radiation. At 87, he is thankfully still here but more frail and cognitively diminished after treatment. He asked me to take over all financial/insurance responsibilities. My mother has dementia, which has become more apparent in recent months, though she is still functioning reasonably well, and tries to take care of my father. There are other health/ability factors involved but these are the most relevant.

They have a long-term care policy that includes assisted living, with a max per day amount. I figure for what is left in LTC and their SS and pension, it would cover two years in AL without requiring the spending their assets. They do not have a high amount of savings but I calculate they may provide another four to five years of AL care without astronomic increases (which probably would occur with care level increases). Honestly, that's as far as I've gotten as life expectancy and who will survive the other are unpredictable (and difficult to focus on right now). I will be consulting our elder care lawyer to revise documents and discuss down-the-road care options and considerations. The lawyer is not available for the AL lease review at this time. I appreciate that my parents are in a position to be well cared for and still have each other after all these years (going on 65). I am working and financially secure and have no need or interest in their assets. And will help them out as needed. I just want to do what's best for them so they can have the best quality of life possible. Thanks for your consideration.
They are fortunate to have you to help them at this stage.

But you really do need that attorney *now*, or another one!

There might be issues about whether the ALF will "keep them" (in ALF or in skilled nursing or in memory care) if their funds run out.
If not, then THIS is the time to look for a place that will, while there are enough funds to "get into" a nicer facility.
These are among the things the attorney should already have been working on, so perhaps this part is indeed "done"?

(Have they already used up much of their LTC coverage? It doesn't sound like there is that much now.)

RM
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bklyn96
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Re: Assisted living move for my elderly parents

Post by bklyn96 » Tue Jul 03, 2018 4:06 am

Wishing you and your folks all the best!

When planning for costs and fees I suspect their LTC policy will only pay for some of their expenses. For example, my LTC policy with Northwestern states:
Qualified Long-Term Care Services do not include any of the following items: Physician's services; prescription or non-prescription medication; medical supplies; hospital services; laboratory services; durable medical equipment; transportation; and items furnished at the insured's request for beautification, comfort, convenience, or entertainment.

pshonore
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Re: Assisted living move for my elderly parents

Post by pshonore » Tue Jul 03, 2018 10:12 am

bklyn96 wrote:
Tue Jul 03, 2018 4:06 am
Wishing you and your folks all the best!

When planning for costs and fees I suspect their LTC policy will only pay for some of their expenses. For example, my LTC policy with Northwestern states:
Qualified Long-Term Care Services do not include any of the following items: Physician's services; prescription or non-prescription medication; medical supplies; hospital services; laboratory services; durable medical equipment; transportation; and items furnished at the insured's request for beautification, comfort, convenience, or entertainment.
But wouldn't Medicare pay for those with the exception of the non-pres drugs, beautification, etc.?

earlyout
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Re: Assisted living move for my elderly parents

Post by earlyout » Tue Jul 03, 2018 10:28 am

You mention that memory loss is already a problem so a move to memory care may be much sooner than you think. Does this ALF have a memory care unit? What criteria does this ALF use to decide if a person should move to memory care? What are the costs for memory care? Will your parents be separated when one of them requires memory care and what will that cost? What will it cost for both of them to be in memory care?

These and related questions must be explored before you sign a lease for the ALF. Seeing an elder care attorney now, rather than after you sign a lease, is strongly advised.

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Pajamas
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Re: Assisted living move for my elderly parents

Post by Pajamas » Tue Jul 03, 2018 10:33 am

ResearchMed wrote:
Mon Jul 02, 2018 9:59 pm

There might be issues about whether the ALF will "keep them" (in ALF or in skilled nursing or in memory care) if their funds run out.
That would be my primary concern. I would also want to know what happens if one needs a higher level of care than assisted living (skilled nursing, say) as well as what happens if they both do. Also would want to know how long their place would be held if they required hospitalization and rehab or similar.

It will be important to know how the facility is equipped to care for people with cognitive problems such as dementia. Might depend on the state and even the local situation, but there are sometimes very reliable assisted living facilities in a home-like setting that specialize in that.

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lthenderson
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Location: Iowa

Re: Assisted living move for my elderly parents

Post by lthenderson » Tue Jul 03, 2018 10:42 am

I helped my grandparents move into an independent living unit with attached assisted living and skill nursing units about a year and a half ago. While I think it is advisable to consult an elder care attorney before signing anything, the place my grandparents moved to had an adviser that went step by step through all these financial concerns that you mentioned. Believe it or not, you aren't the first person to worry about those things. So my advice would be to set up a meeting with that person in the senior living facility and ask away. Once you have everything explained to you and you understand, then you can consult with the attorney before signing.

dbr
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Re: Assisted living move for my elderly parents

Post by dbr » Tue Jul 03, 2018 1:43 pm

My experience is that a first stop for understanding terms and conditions and contingencies is indeed an advisor at the facility. This is not new to them.

slee
Posts: 17
Joined: Wed Jan 30, 2008 9:30 am

Re: Assisted living move for my elderly parents

Post by slee » Wed Jul 04, 2018 10:46 am

Thanks for all the responses! I have thought (worried) about some of the points raised and will give some more info as to what's informing this move. It's clear that I need to speak to an elder care lawyer before any move and will do so. There is pressure to move on this because this type AL 1 bd does not open up often; there is a wait list; and my folks are against moving elsewhere. I am concerned that if they do not move now, especially while my mom is clear enough, it will be a much more jarring situation later and with rushed options.

My parents do not want to live separately; they know people in IL who have a spouse in AL (which surprises them). At some point it may/will be necessary, but they strongly object when mentioned now and neither one is in that much better shape than the other. My father is so anxious (and depressed) and alleviating some of his stress (meds, assistance, food/weight loss) is a big priority. An AL dining room should be better able accommodate his food prep needs; make modifications so he can eat more comfortably and gain weight. My mom will likely eventually need memory care (there is a memory care floor). She is so devoted to my father and I think she will manage okay while she is with him and is currently capable (and enjoys) of going to activities in IL on her own. It seems there's an opportunity here to keep them together while in sufficient health by AL standards.

Regarding their LTC plan it states: "Subject to the Daily Payment Maximum, we will pay the expenses an Insured Person incurs for care and support services (including room and board, but not prescription drugs) provided by an Assisted Care Facility." When I called to say we are contemplating a move I was told they would do an assessment close to move-in date and that there may be a delay in assessment/payment (not surprised). There is roughly $130k left in the joint plan.

The AL apartment for both is about $8k per month, which is not that much more than their current rent & board for a spacious apartment. Other area AL are usually more expensive and for a smaller space. I believe this favorable pricing is due in part to mgmt knowing my parents, their doctor's input, and the resulting availability of my parents' desirable IL apartment.

Thanks again for your input. It's a difficult decision but I believe this will serve them best for now and I'll consult with the elder care lawyer to ensure as much as possible that we cover the bases with the contract and discuss potential future issues (veteran's benefits; Medicaid). Have a happy 4th everyone!

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