As we age, we’re all going to have slightly, or drastically, different experiences with our health. That was the case with my three grandparents. Each one taught me something different about the costs, choices, and trade-offs you’ll face. I’ll be going through a few lessons from each of them, as well as some action items at the end.
Lessons From George
1. You might be too proud to move in with relatives. George, my Dad’s Dad, didn’t want to move in with us, he didn’t want to impose. So when it was time, he moved into a community assisted living facility.
2. Community assisted living can be a pretty sweet deal. He had his own nice room with a living room and bedroom, small kitchenette, etc. It was very nice. And he had community activities, meals, outings, and was able to make friends with the other residents. All things considered, it was a pretty nice setup.
3. Downside: it wasn’t cheap. I don’t remember the pricing for it, but it was in Los Angeles so I would imagine it was around $10K/month in today’s dollars.
Lessons From Pat
4. There’s a lot of talk about dementia, Alzheimer’s, Parkinson’s, etc. Those are mental diseases. But your body could give out before your mind. Pat was mentally healthy and sharp for the duration of her life, but her body gave out on her physically which meant she was confined to a wheelchair in her last years.
5. You could be physically impaired for many years. The average long-term care need is around 3.7 years for women and 2.2 years for men. Pat needed fairly extensive help for almost 6 years until she passed away. That extended duration is costly. Is that the norm? Nope, but it could happen to you.
6. A reverse mortgage is not a dirty word. For people who have lots of equity, don’t want to deplete their investments (or don’t have much), or for people who don’t have any legacy goals, this is something to look into. There is a cost, and there are restrictions, but they can be a lifeline for people who want to stay where they are and need extra money.
7. Long-term care insurance, which frankly, at their current price points, is a gamble. Do you fork over a lot of money for an insurance policy that you may never need? Or do you assume the risk and have to be prepared to pay for it out of cash, investments, or real estate equity?
lessons from Don
8. You could live longer than you think. Don made it to 101.5 years! George made it to 91, as did Pat. If you’re 50 now, and healthy, if we continue to have some medical advances, it could be a much more common scenario where people make it to 90 and some even 100. So we’ve got to be prepared for a long life.
9. You could be able to live at home for the entirety of your life. Most long-term care talk is around nursing homes, but you could have some good genes and good luck and be able to live at home, with assistance from family and care workers coming to your house on some type of regular schedule.
10. If your kids are not close by, expect to pay a lot out of pocket for health care workers and general maintenance of the house. Amazon deliveries and grocery deliveries will be essential, assuming it’s too much to go to the store when you need something. You’ll also need someone to check if you have enough household goods. My mom and aunt did all of this for Don, their father, and the reality was that this was an unpaid, part-time job that lasted for years. So if your kids don’t live in the same area as you, you’re going to have to pay someone to help you out.
Action Items
All Three
If you need help, it’s going to be expensive. Unless you die quickly. Start the conversation now about where you’ll come up with this money. Do you want to share the costs with an insurance company, or do you want to pay for 100% of the bill through cash, investments, or real estate assets?
George
Have honest conversations with your adult children about living arrangements before you need care. Would you want to move in with them? Would they want to have you in? Don’t assume on either end; think it through and make the best decision for you.
Pat
If you have significant home equity and/or limited other assets, research reverse mortgage options now, not when you’re in crisis mode.
Also, add strength training to your weekly routine. We are all losing muscle every year after 30, and it accelerates after age 50. So lift some weights 2-3 times a week to keep as much muscle as possible as you age.
Don
If you want to age in place but your children live far away, start building a local support network and budget for professional services well before you need them. If your children live close by, see if they’d be able to help doing things that you won’t be capable of doing later. But of course don’t take it for granted that they can or will help. Either way, having this conversation sooner than later will be beneficial for all parties.
Watching my grandparents taught me that there’s no single ‘right’ way to handle long-term care. And the health journey that we all go through will be different. But there is a wrong way: waiting until you’re in crisis to figure it out. So have those conversations right now so you can put together the best plan while you still have choices.