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Sculpin
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PostFri May 21, 2021 6:39 am 
cdestroyer wrote:
I have the VA/medicare for most of my care.

So did my father.  Then the one place in town that had "VA beds" said that none of those beds were available.  Since the facility made more money off the other beds, they had no interest in changing anything, even though they had a few open Medicare beds.  Fortunately a "VA bed" opened up before his 30 days of Medicare expired. So that experience left a sour taste.

And I learned the secret of hospice along the way.  When you make the decision to go into hospice - my father was conflicted - they load you up with so much morphine that you lose interest in eating.  The facility does it without any discussion with the family or patient.  I'm not saying that is necessarily a bad thing - hope I'm blissed out when I pass - but it was not what I was expecting based upon what was told to me beforehand.

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cdestroyer
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PostFri May 21, 2021 7:09 am 
I don't know what VA/beds is, apparently a local hospital with reserved space on a contract basis.. I meant a regular VA hospital.

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PostFri May 21, 2021 7:36 am 
cdestroyer wrote:
I meant a regular VA hospital.

You cannot stay in a hospital, they move you out as soon as you are stable.  The VA contracts with retirement homes.

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PostFri May 21, 2021 7:49 am 
I went back and edited my comment to remove where I said "I am really happy to see this new [mandatory LTC tax] bill!".

What a terrible bill.   shakehead.gif

https://www.coldstream.com/blog/2021/04/26/new-washington-state-long-term-care-act/

I can only guess that Medicaid was not providing as much revenue as the health care community wanted.  You know what gives it away?  The fact that you can only get care in Washington.  This is a guaranteed revenue stream to these LTC companies, which means they can do speculative investing based upon that guaranteed revenue.

The legislature should have instead gone after the predatory pricing and ridiculously high profit margins.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467918/#:~:text=Generally%2C%20the%20chains%20have%20large,problematic%20in%20all%20the%20countries.

"Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems."

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Roly Poly
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PostFri May 21, 2021 7:55 am 
Kim Brown and anyone else that has LTC insurance can you message me or post on here what carrier you used?  I want to get it.  My dogs all have pet insurance and Iíve seen it work!  Iím far far better off financially for having the pet insurance. So I donít want to take the chance on LTC expenses.  I read there are only 20 companies left.

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PostFri May 21, 2021 8:54 am 
The larger issue is being able to find a bed when it becomes time. A couple of years ago we searched all over from Seattle to Everett to find a spot immediately available for my mother and found nothing. The few private care homes we found I wouldn't put my dog at. As the Boomers have the need there are going to have to be a lot more built to keep up with the demand. As for my mother, she died at home which was ultimately what she wanted.

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PostFri May 21, 2021 9:17 am 
A friend of ours faced challenges finding a place for her mom.  Her mom was a veteran (WWII and Korea).  While her mom's money from the sale of her house she was in a private pay facility in Redmond,  but once her money ran out and they need a place that would accept Medicaid/VA benefits only they ended up only finding something in Everett.


Her care there was fine.

One thing we've observed with supporting aging/ailing family members is a person's personality plays a significant roll in how well cared for they are.    Many of the caregivers employed are immigrants.   Our friend's mom had the unfortunate combination of a "Dixie" mindset and caregivers who immigrated from west Africa.  She used the "N" word talking to them.   And then complained about their slowness in responding to her demands.    Another family member called the nurse in charge of his care the "C" word and similarly experienced slow service and an exactly by the rules.

My dad on the other hand was someone that was always respectful and even interested in hearing people's stories of how they came to US.    He got extra attention as a result.

Of course by the time someone is aging and losing their mental capacity,  they lose their filters and their inner ass#### or decency becomes revealed.

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Roly Poly
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PostFri May 21, 2021 2:55 pm 
What company did any of you use?

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Randito
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PostFri May 21, 2021 3:52 pm 
Roly Poly wrote:
What company did any of you use?

The policies my wife and I have are with Genworth.    They like collecting premiums.   I have no idea how good the coverage will be should we need to file a claim.   My parents,  mother-in-law had no such insurance.  Medicaid took care of my mom,  savings for my dad and mother-in-law.   My brother-in-law was in assisted living starting in his late 50s due to a stroke.   He had living and worked in Canada under a "resident alien" status since his 20s, but never became a Canadian citizen.   The Canadian system took excellent care of him, there was no concern about running out of benefits or his savings.

Unfortunately I did some checking and past age 45 it's very hard to get a work visa for Canada,  even if you work in a high demand,  high skill profession.   They want you paying taxes into their system quite a while before you might need to start drawing benefits.

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Anne Elk
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PostFri May 21, 2021 7:52 pm 
My mom had LTCI, not sure when she took out the policy, but it cost her something like $500/month.  I forget how many years payout covered, but she was good for the 4 years she was in a facility.  Needless to say, the older you are when you take out the policy, the higher the premium is.

This recent article put the issue of care quality into perspective.  And moreso than the article, the reader comments; sort by "reader picks" for the best comments.  What was noteworthy was people saying that the spendier places that appear higher quality on the surface, really weren't.  The link should let you past the paywall as I'm a subscriber and I hit the "share" option:

Covid forces families to re-thing nursing home care

It's all so depressing.  We're really quite an uncivilized country in the way we care for elders and orphans.  If I ever start realizing my mind is going, it might be better to head for the far north, push off on a floe and let the ice bears get me.  Also makes me wish I should have taken my past Canadian boyfriends more seriously.   rolleyes.gif

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"There are yahoos out there.  Itís why we canít have nice things."  - Tom Mahood
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PostFri May 21, 2021 10:23 pm 
Anne Elk wrote:
We're really quite an uncivilized country in the way we care for elders and orphans.

A good friend of mine was a Peace Corp Volunteer in Equador -- one of the concepts that the Equadorians had a hard time grasping was the idea that American's didn't live in multi-generational households.   "What do you mean you don't live with your parents and grandparents?"   When multi-generational households are the norm -- the concept of "long term care insurance" doesn't exist.

When my and my wife's folks were aging and both her brother's health was failing and our youngest had just left for college -- we considered converting our "empty nest" into a suitable facility for caring for all of them.   But after evaluating how much work would be involved -- even with hiring caregivers to do the "heavy lifting" we choose not to do that.   It would have been financially more efficient.     However in considering all the strong ego's involved -- it would have been a huge headache.

In dealing with my parent's care and dealing with my two older sisters in making decisions for there care -- I'll always be greatful for the guidance provided by the Social Workers we consulted.     It was really useful to have a professional third party involved to guide care decisions.     My older sisters both live in Alaska and had a somewhat frozen in time view of who are parents were based on who they were when they gradulated college and moved north.   I on the other hand had bought a house across the street from my folks.  It was great having them involved with my kids as they were growing up and it was easy to help them manage as they were getting in their '80s.

It was a huge relief getting my folks into assisted living -- my mom had a form of parkinsons and she needed to take medication several times a day to facilitate mobility.    I would come over in the morning and encourage her to take her medication, call her at lunch to remind her, visit in the evening.   -- but at the end of the week 1/4-1/3 of her medication would still be in her "pill matrix"   -- "I'll do it later",  "Your my son, you can't tell me what to do", etc.     But once she was in an assisted care facility -- her attitude was more like: "Well I guess I need to take my pills" and she became more mobile.    She greatly resisted moving to assisted living.   Two weeks after moving in however, she said "If I had known I could have ice cream every night, I wouldn't have put up such a fuss".

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Anne Elk
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PostSat May 22, 2021 12:18 am 
Randito wrote:
one of the concepts that the Equadorians had a hard time grasping was the idea that American's didn't live in multi-generational households.  "What do you mean you don't live with your parents and grandparents?"  When multi-generational households are the norm -- the concept of "long term care insurance" doesn't exist.

That was the way of most immigrant families to the USA & farm families until a few generations back.  My parents and grandparents lived with their parents until they got married.  Only one of my parents' siblings left home before marriage b/c he got a job in another state post-university.  The USA has started reverting back to multi-generational households again these last few decades b/c living alone has become so unaffordable for young folks.

I don't know if it's more common now for elders to be so debilitated mentally or physically that they need round the clock care. I suspect it may be, since people are living longer. Alzheimer's sure seems more prevalent.

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PostSat May 22, 2021 7:51 am 
The reason I got thinking about LTC, aside from the fact that Iím single and have no family is the care Iíve given my dogs since 2018.  I had a dog with lymphoma and it was an epic battle to manage the disease, take her to vet visits in Bellingham, manage the claims (she had insurance) and take care of her while she was taking chemotherapy (that is a treatment modality that I deeply regret in retrospect).  I basically gave up everything in my life to care for her.  She, being a dog (and not a human that might be difficult or ungrateful) was a joy to care for.  The bond deepened immensely.  But it was a realization of who would do that for me when my time comes?  No one.  So hence LTC.  My other dog got metastatic cancer right before the first one died, and a third and oldest dog has
degenerative myelopathy.  So I am entering my fourth summer of no backpacking, no trips further than I90.  But itís an insight in what is involved in caregiving.  In my case Iíve given up every aspect of my life for it, including quitting my job so I can care for them all.  So I understand what people put their loved ones in a facility.  It just gets to be too much.  My experience with my dogs had scared the bejeezus out of me regarding my own lack of preparation.  I too would want the ice floe that Ann Elk talks about.  Getting old or being seriously ill needs careful planning  ahead of time.  Caregiving is extraordinarily hard especially when you yourself are older.

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Sculpin
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PostSat May 22, 2021 8:40 am 
Roly Poly wrote:
Iím single and have no family

This is the part that you really need to think about.  When you say no family, I presume you mean no immediate family.  Someone up thread wrote that if you have no family, then there is no reason to get LTCI because you can allow your wealth to run out and then just go on Medicaid (which you paid for and don't let anyone tell you different).  The problem is that you could become a burden to siblings and parents, if there are any around.

But if there really is no one who would even consider shouldering the responsibility for your care - no family at all - then I would not get LTCI.  It is the knowledge that the inheritance for their children that folks worked all their lives to accumulate could be gone in a few short years of nursing home expenses that drives most Americans to get LTCI, I think.

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PostSat May 22, 2021 9:54 am 
Correct me if Iím working, but doesnít LTCI allow you to stay at home with help with ADL?  I guess thatís what motivates me the most, the idea of staying at home versus being put in a home.  Wow, this is all so depressing to think about but necessary.

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