How Much Do You think You Need to Retire/What Age Will You/Spouse Retire: General Retirement Issues (Part 2)

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Went through this with my mother a couple years ago. Three different living situations. Independent living which is basically an apartment. Typically attached to a larger facility which has meals, social events, etc. No stated levels of service other than certain facilities include on meal a day and you can buy additional a la carte. Small kitchens typically included.

There is assisted living which typically is also an apartment though kitchen often doesn’t include a stove/oven (just a microwave and small fridge). Though that can vary. 3 meals a day are often included in the cost. Then there are levels of service. Assistance with bathing, getting dressed, etc. Help with meds. Increased levels of service cost more. With both independent and assisted living, you bring your own furniture (you can also find furnished units which allow respite stay up to a month).

Then there is nursing care. Rooms are more like a hospital room. Level of care is much higher. As is the cost.

You can also add in memory care which adds services related to memory/cognitive issues. It often is basically a locked ward because of wander concerns.

Some facilities have all three. Some will have two or more. If a facility offers nursing care it will have actual nurses. Assisted and independent living only facilities typically to not have nurses on staff. Nursing facilities are more regulated than are independent or assisted living facilities.

Medicare doesn’t pay for long term care costs. It will pay for brief rehab stays in nursing facilities.

Medicaid will pay for nursing care but not independent or assisted living. So often times people end of living at home until they need nursing care because they do not have the funds to pay until medicaid will cover. Medicaid also will not pay for private rooms which means you will have a roommate.

Much of this likely varies by facility. What I have seen dealing with issues with my parents (my mom passed away a couple years ago) and now with my father. My mother needed physical care but my father has memory/cognitive issues.

Some facilities are better than others. Service levels/quality of service as well as physical facilities vary. From what I have seen many of the public spaces (libraries, meeting rooms, etc.) are rarely used. Seems to me more making families feel better about putting mom/dad there and reality that by time people go there, they are often times in bad shape such that using such facilities is not on the table.

Different people in different parts of the country have different experiences.

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We also found major differences in facilities. We were specifically looking for memory care. One place, brand new, looked amazing. It was like a Nantucket beach house vibe but no one used the public spaces and the residents basically sat in the their rooms and watched TV all day. I never saw people interacting any of the times I visited.

The place where we ultimately picked for my mom, was across from the ocean in FL and had a “resort” vibe. The residents were not allowed to stay in their rooms after breakfast. They had an activity schedule for the entire day and they moved the residents from the main room, to the outdoor courtyard, to the smaller rooms, to other parts of the facility. For ambulatory residents, they took a field trip once/week - my mom did everything from go out to lunch at restaurants to the zoo to boat rides. There was always music playing in the facility, they danced, had live musicians, pet therapy, etc…

I won’t lie and say that it wasn’t a rough transition for my mom for the first few weeks but once she was settled, she was always smiling. There was a lot more stimulation for her than at home, she gained weight because she loved going to the dining room for her meals, etc…

It wasn’t cheap but knowing that she could stay there if the money ran out was a blessing. And frankly I’m not sure we would have picked a different place even if we had known there were basically unlimited funds.

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Perhaps an important factor in selecting an elder care place is how well it handled COVID-19, both pre and post vaccine.

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Expect that will vary by person just like responses to Covid have varied. We have people here who have essentially not left home for 18 months and others who have lived very close to normal during that time and everywhere in between.

Looking at options for my dad, not sure I found one that had issues with Covid (one or two cases at most and many reported none). Varies obviously as significant percentages of deaths (particularly initially) were in congregate living facilities.

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Maybe needs another thread, but I’m really curious what posters see (or would prefer) for their own future. Unless we push for, or even create alternatives now, we’ll have (or our children will have) the same choices for us, as we have for our parents. That may be fine - or not.

Most my contemporaries believe or want to live in their home, or a retirment condo forever. Yet we’re seeing that’s unlikely unless we build support systems to do so. Personally I love the “Village” concept (started in Boston?), that allows that option for longer. But doubting my own community would support something like that.

If I need more help, my next choice would be a group-type residential home if well run and staffed, that serves as an assisted living envirnoment, but on a much smaller, less institutional scale. But then I think something larger with more options would be nice. I’ve read about small group homes established by friends. Not sure they would all be friends as time progressed, but it sounds like an interesting concept.

I really don’t want a For-Profit institution of any type. Many of our local independent/assisted living options follow that model. I just don’t believe they ultimately have the resident top in their minds for decisions.

There is one local not-for-profit organization that consistently has high marks for their residential options, but the waiting list is L.O.N.G (as in many years). When does one jump on board for something like that? DH wants nothing to do with a retirement type community (independent or otherwise). Says it is filled with all OLD people :wink:

Your thoughts for yourselves?

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We’ve talked extensively about this since we have an only child who we do not want to depend on for caregiving. My preference is to move into a retirement community with graduated levels of care.

Of course the key is knowing the “when”. This depends on so many health factors that it is impossible to predict. My mom was dx was Alz in her late 60s and needed memory care at the age of 76. My grandparents, mom’s parents, lived independently until my grandfather was in his early 90s. My inlaws are in their early 80s and doing great in their own condo and not needing any additional support.

I think the second one of us needs assistance (either physically or mentally), it will be time to initiate moving.

We have a lovely place in our current town but where we go will probably depend on where our daughter is living and if she is settled or not. I speak from experience that it was very difficult having to get on a plane whenever there was a problem. Much easier if we relocated closer to her when we are that age but that may not be feasible either.

Crystal balls would sure be handy for retirement planing!

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We are hoping to stay where we are until the end. The prior owners built a four room in-law suite right on a river bank and moved for 6 months and a day every year to Florida and their youngest daughter lived in the main house. When we bought the house, ShawD said, “When my BF and I have kids, we will move back from California and move into the main house and you guys can live in the in-law suite. When our kids are young, you can help take care of them. When you get older, I will take care of you.” Not sure that if ShawD and her BF are going to get married or if they would choose to follow ShawD’s plan, but upstairs the main house has five BRs (one that is now my office) and three bathrooms. There are also two other rooms that could be BRs. So we could have easily have live-in help. We are doing a major renovation of the main house but not the BR areas this fall/winter.

My 97 yo mother lived in our childhood house until 92 or 93 and then moved to an apartment, but my unmarried brother ended up living there a lot of the time (and, we discovered, was doing a lot for her that enabled her to stay somewhat independent). At age 95, she moved to independent living facility (has a kitchen but does not feel comfortable cooking anymore) near my sister (and surgeon BIL) and my brother moved nearby as well. There is an a la carte menu for help. She could shift to assisted living and then there is a nursing facility. She is very independent but we do have people check that she has taken her pills and that she is eating if she has meals brought to her room rather than eating in the dining room. The independent living facility had no hospitalizations or deaths from COVID. I think early on the nursing facility had some deaths, but the management was terrific. No one could visit for a fair bit of time but, while it wasn’t easy for my mother, they really did a good job of keeping people safe.

My 89 yo MIL continues to live independently, although she just lost her partner for the last 15 years. She has a city apartment (tiny), a large country house and a house in FL. Her energy level has declined a lot (and wasn’t helped by trying to take care of her declining partner). I think she would move full-time to the country house if it weren’t so isolated (on 125 acres). We put an elevator into the FL house when we were there last winter. I don’t think she has a plan of any kind (actually, she has never planned in her whole life, so why start now). But, I think she’d like to live out her days walking in the country (we got her an Apple watch so that she can call for help if she falls and I think it detects falls as well) and picking flowers at her country house and walking on the beach in FL. I don’t know what will actually happen. She has been an avid bicycler and used to say that when she got old, she would just ride of a cliff. She is in a jurisdiction that allows for certain kinds of assisted deaths and that is what her partner chose.

I fear living when my mind is not functioning or I am in constant pain. I would probably be happy for a bike ride off a cliff when I have passed my Sell By date, but I don’t know how I will feel at the time.

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My husband and I dealt with the transition of both of our parents to senior care communities. It is not easy. I won’t go into all the details of finances, selling homes, ending driving privileges, etc…but we are going to do our best to make things easier for our children.

For us, finances are covered…by living frugally, investing early and a lot of luck. My husband (with the MBA) has the knowledge, ability and desire…so he manages our money. And as others have mentioned, Bogleheads is a very good resource.

Selling our home is ‘down the road’ for us, since we love where we live. We’re in our 50s and live in the Chicago area…both kids live within an hour’s drive.

kjofkw asked, what we are planning for ourselves.

First, my husband and I are doing our best to maintain a healthy lifestyle that includes daily exercise and self care that includes doctor appts (internist, dentist, dermatologist, etc) and recommended diagnostics.

Second, we talk a lot about what is important to us as we age. Dealing with our aging parents and the the deaths of our fathers was educational. We definitely learned from our experiences and have been very forthcoming with our children. They were about 16/18 yrs of age when we started discussing issues with their grandparents. We talk/talked freely around them about options and the reasoning behind our decisions and actions.

This is an observation we’ve made: Some people seem to be afraid and/or embarrassed about the issues of aging…whether you’re dealing with physical, mental or a combined decline. However we are of the opinion that ‘knowledge is power’ and ‘an ounce of prevention is worth a pound of cure’. I could go into more detail but these cliches have been true for us. Talking, not only within our family, but also to others contributed to our knowledge base and helped us in the decision making process.

Third, we realize that senior care as an industry is evolving. We saw changes from when I moved my parents into a senior community as ‘independent living’ residents to several years later when my in-laws needed to transition from the home they had lived in for over 50 years. We’ve told our kids that when they see cognitive and/or physical decline that concerns them, they need to tell us. We want them to use our experience with their grandparents to sway/coerce us to visit and gather information about what is available at that point. A course of action will follow based on current conditions and our previous experience.

Lastly, we’ve already discussed a little about our finances and health preferences with our now, young adult children…they’re post-college but under 30. They know where the “death book” is located. (Fingers crossed, we don’t go soon, because we definitely have not downsized our belongings yet.)

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Highly recommend Being Mortal if y’all haven’t read it. It covers some of the history of assisted living and gives lots of food for thought. The most important thing I took from it is that we try to put our parents into places we think WE would like, not what they want.

ETA: We didn’t put my late dad in a nursing home/assisted living facility before his death at 91 and won’t put my mom in one either. It’s a Hispanic cultural thing. It’s probably the one cultural thing that has stuck with me even though I was raised in a primarily Anglo environment. Well, that and El Ojo!

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H and I hope we’ll be able to remain in the house we’re building until we’re collected by the funeral home. It’s one story with 36" doors, a couple of wide halls, and zero thresholds so it will be easy to navigate with a walker or wheelchair. The guest bedrooms each have their own bathroom, which may be used for a future caretaker.

There aren’t any good nursing home facilities in the area and the assisted living places are not appealing. There is a university with a well-regarded nursing program nearby, so we’ve wondered about hiring one or two nursing students to live-in should the need arise. There also seem to be more companies offering various levels of in-home care that’s a combination of housekeeping, errand running and assistance with daily activities. That may be sufficient.

I do not want to live for years with Alzheimer’s the way two of our parents did, and H agrees. How we’ll cope with other health problems remains to be seen, but at some point we’re likely to take matters into our own hands.

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Yes,this discussion also got me thinking back to the excellent Being Mortal book. It was interesting to read about the original concept of independent living as last-stop apartment, where you lock the doors and have helper available. The evolution to multi-stage facilities does make some sense, but obviously most of us prefer as little intervention as possible.

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My parents had health challenges but were able to live on their own until the end. My dad was just at the point of needing assistance when he died in his sleep. He was fortunate, IMO.

My in laws always said that they would never leave their house. But in their early 90’s, even with hired help, they decided it was too difficult. Basically, they lived in their kitchen area & rarely left other than to sleep or use the bathroom. They toured senior/assisted living facilities & chose a local one that had just opened. We only have good things to say about the facility. The staff was incredible when my FIL was on hospice. The only issue is that they chose to stay in their community, which is about 3 hours from my SIL & 13.5 hours from us. It’s not ideal for the family to visit regularly & to run errands for her. But she didn’t want to leave, so everyone makes it work. The staff makes sure she socializes, and we are able to text several of them to get the lowdown on how she REALLY is.

I would prefer to be like my dad & just not wake up when I am at the point of needing too much help. But life doesn’t always work that way. So … If I live a very long time, I hope to be like my friend’s mom, who lives by herself in a ranch style house in my neighborhood. She is 99, almost 100. She weeds her garden, cooks her own meals, is active at church & with friends. My friend & her sister live in the area, and they help her out … but it’s not really burdensome, because she doesn’t need a lot of help.

H & I do all we can to try to stay as healthy as possible, but we know that things happen. We’ll deal with what comes, and hopefully we’ve saved enough that we can cover the costs associated with getting necessary help.

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momofboiler1 -that sounds like an amazing place for your mom!!

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My mom bloomed in her independent living facility (with assisted living, skilled nursing and memory care as needed). We didn’t realize how isolated she had become caring for my dad in his last years. Her advice is that you need to make the move before you need to make the move to embrace the change.

H’s mom aged at home until she passed away last year. It was rough (and expensive) at the end. Covid certainly complicated things.

H & I prefer my mom’s path. Hopefully we’re decades away from that move.

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Yes our rehab/skilled care facility has a ‘balance’ of private pay on the skilled care side, and when one runs out of funds it becomes Medicaid paying for continued skilled care. So it would be good to move her to the other facility, because if she runs into medical crisis and needs skilled care, to find a bed somewhere to have her be able to get into…We have patients (we call them residents) who qualify for some rehab days after a hospitalization but can no longer go home, go back to assisted living, etc due to the level of care they need. Then they continue on our skilled care part of our facility. IDK about the details - the social worker or administrator folks at the facility can give you details with your parent’s specific details.

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When I graduated nursing in Milwaukee in 1978, they had these type of facilities - and they are becoming more and more prevalent. We had some nursing training/exposure at that time.

Some higher end facilities have you ‘buy in’ and get 90% of your buy in money back at death.

You have given a very good summary/overview.

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Impact of Covid on social security and Medicare:

https://www.seattletimes.com/nation-world/nation-politics/social-security-and-medicare-funds-remain-under-pressure/

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You are so right on making the move before you need to make the move.

My mom’s path was complicated by her lack of ability to understand her deficits and my sister’s mental health challenges. When the final crisis occurred with her using the stove inappropriately, we moved her to a facility. She resented the hell out of it, as well as attempts to keep her safe. She died partially due to medical neglect (an ER visit would have turned her around) the first month of Covid lockdown, though I see it as a blessing in disguise at age 97. Moving before her mobility was compromised by oxygen and her ability to socialize impaired could have made living at the facility far more pleasant for all concerned.

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This is such a great explanation and pretty dead on. Where she is now has independent and assisted. She can pay another $1000 or so for assisted, move apartments, get 3 meals a day, since no oven, but then from there, ugh, everything is an upcharge and this place just nickels and dimes so that by the time you’re done, you could actually be paying not just $1,000 more, but $4k more/month. The other place, which is similar but has most things provided, although some extra care is $1,200 more I think than where she is now and includes a lot of the stuff, but as she ultimately may need help bathing, changing, etc then they charge $500/mo more which is doable in the interim, but once she runs out of $ she pays zero as opposed to being kicked to the curb and going to a facility where as you said it, probably with a roommate and having not much of a say, or be able to take all her own sh*t! I am sure that is probably what the biggest selling point of this was to her because that was one point my husband kept hitting home to her about. She’s also currently in a rehab place that medicare is paying for 30 days which is one of the best ones around and all she keeps saying is how bad service is, lol. What do you expect? It’s not the Ritz. But then there you go, my husband had the perfect example of also what she can expect if she doesn’t move. I think the other issue is that she isn’t well liked at her current place, she is very hostile and bossy towards people and had acts superior to everyone else. Sadly, we were told that they would do whatever they could to try to get her to stay and not leave, but ironically when my husband called to tell them she was leaving (she agreed to go to the other place on Monday, yay!) they gave no resistance, did not try to convince him to keep there, etc. Now what does that say about how they felt about her leaving? Oy vey! Very sad!!

@ucbalumnus You’re 100% right and this was actually one of the first questions on my list when we met with them and how they are dealing with it now. The policies vary by place, but are dictated by county.

@kjofkw It’s definitely hard on kids, especially when parents are stubborn. I definitely want to have a plan. In my husband’s case his mother really has no $ and has always been stubborn and not a lavish spender per se, but just spent money on junk unncessarily when she shouldn’t have. She also didn’t have the best advice as far as investing and that would have saved her a lot of money along the way. She moved here (Chicago) from NY about 2 years after his father died and bought a place sometime around 1992 ish. She moved to that independent facility place in 2017. Can you believe in all that time she never refinanced her mortgage? The place only cost about $70k to begin with, but when she sold it, she was still paying a large mortgage (relative to the value of the place) and that was just dumb. Her mortgage was in the $600’s. She had something like a 7% rate!!! When rates were like 3%. I could’ve killed my husband when I found this out - we only got married in 2012. How dumb could they have been. The place could’ve been paid off years before. Instead, after all the expenses, etc. she basically got about $45k out of that condo. Sold it for only a couple thousand more than she paid. That’s how they were in the building. Anyway, my parents will NOT move. They live in a huge house and I’m going to be stuck with it. THere are too many valuables to just let someone else rifle through it also. My MIL at least has nothing that anyone wants, it’s all junk but my parents ugh. They’re 80 and 83 my mom has stage 4 lung cancer and good luck ever getting her to get rid of anything anyway. So…I wanted to downsize a couple years ago and start looking, but my kids won’t let me as of now. So we’ll see where they all end up after college and then decide what to do from there. I wouldn’t mind a social like place, but I also want my own space and privacy. Covid locked down a lot of these places and no one was coming in or out and people had to stay in their apartments. I wouldn’t like that either. Although it wasn’t much different than staying in our houses, we at least weren’t told in the same manner what we could and couldn’t do.

@momofboiler1 You’re so smart to be so considerate of your daughter and thinking about it. My H is an only child and the stuff being spewed at him is just awful. There is no time like the present that he wishes he had a sibling, but he doesn’t and it all falls on him, and hence he gets blamed for everything. The latest what she blamed him for making her move to Chicago, which he never told her to do, but she has some dementia and the things coming out of her mouth are just over the top. I’m nervous he will turn out like her and that is pretty scary to me. :frowning:

@88jm19 Love what you’re doing with your kids. Of course my kids tell me my memory is going all the time, lol. But it’s more in the way that I repeat myself, but that’s because I have 4 kids and don’t always remember who I tell what to since they’re all in different locations. My husband has been on me for so long to redo my estate plan and I really have to do it. It has not been redone since my divorce in 2008 and other than our prenup there’s nothing that dictates anything for my husband and how I want things to be for him. Some of my assets go to him like my 401k but it has to be spelled out more thoroughly in any case in my plan, but it’s also time to update it since my 83 year old father should not be my executor any longer and my kids don’t need guardians anymore either, etc. My parents when we were adults and annually since update us on finances which is helpful. Sometimes it’s too much because I really don’t need to know all the details as I have a general gist of the setup etc. But we get a “memo” every year and we know where all the important documents are. Fortunately some years back both my parents planned and paid for their funerals in full. They didn’t want us to be burdened with that task and this way their wishes will be met. Even down to the limousine to take us to the cemetery after the funerals. Creepy I know, but good planning in the end.

Lastly, what I didn’t mention before, is that they call this place she is going supportive care. Not sure what that really means but we’ll take it. She agreed and that was huge. It’s a littler further for us than the current place but she shouldn’t be intimidated by people there like where she is now, afterall most of them don’t have $ either. If they did, they wouldn’t be there. My husband is going to be stuck driving her around everywhere to certain appointments because she won’t want to move to palces near her but it is what it is and he will have to deal with it. His biggest concern was that they would kick her out based on her behavior and attitude and they won’t. The next biggest concern is to make sure she doesn’t continue to live in the filth and clutter that she had been living in and just knows he has to go into the apartment more often than the last one and regularly clean out stuff. He is not confrontational at all, but that is a result of his growing up with an abusive father and avoiding those situations. She’s lucky she has him because he’s all she has and she is the most unappreciative person there is. She’s fell the first week of August and his kids have not even called her once. Unbelievable. But, once she dies I’m sure they’ll be looking to see what she left them! A big fat zero! That will be a funny day.

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My grandmother moved to a retirement community that had a continuum of care. She was 94 and moved directly to assisted living, thinking she would one day need assistance. She really never did. She was super healthy and had some good genes, BUT, I think one of the reasons she lived to 98 and felt good every day, was that she was getting and eating 3 full meals a day (vs just making a sandwich for lunch, for ex) and a lot of social interaction.

Her place was not cheap, but if you qualified to get in, once you were in, they would never kick you out. You put $X down and paid a monthly fee. If you ran out of money, they went into the $X downpayment and if you went thru that, they did NOT kick you out. If they did not go into that $X downpayment, it went back to your estate.

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