Assisted living and nursing homes are so expensive, does anyone have any suggestions for alternative places?

the cost of care is incredible I agree... Is it possible to get homecare to help and keep her at home? I know it is not easy but it may be somewhat more cost effective!

I found a lady who charges 10 an hour she comes four days a week and bathes my mom and takes care of her in the morning and on Saturday she stays all day so we can go out not the best sisturation but we do are middle class mom had some money put away but most of that gone paying her bills and her trips to er not free and NH stays over the two years we have had many people from the agency paying 25 dollars per hour they come in shower her feed her and sit down read a book /or watch tv pretty much all the same except for the price. We pay the lady around 200 a week not the greatest because shes living with us but better then a nursing home where they either sit in a wheelchair or stay in bed and get two showers a week for 7000 a month

YOu need to check the laws in your state and it wouldn't be a bad idea to consult an elder care attorney. My mother in law has the following situation: She and my FIL worked their entire lives very diligently to prepare for retirement. They each had a pension for life -his with a big oil corporation and hers is a teacher's pension. Plus, he had social security. They inherited a bit of money which they gladly shared over their early retirement years with family, taking a cruise for their 50th, stuff like that. Also gifted my husband and his brother (only 2 siblings) and the grandkids occasionally. They also owned some stock in pretty solid companies, and owned their own home which was free and clear.
25 or so years ago, when they were in their 60's they took a trip out of the country and at that time my MIL insisted that both brothers be given POA and DPOA equally, as well as put them on the deed to the house, so all four (mom, dad and the two sons) equally owned the house. My MIL witnessed huge taxes paid on a family farm years ago and thought this was the way to protect whatever happened then from happening, although it was an ill conceived plan because, when her house was sold (which it did not have to be as a home is the only PROTECTED asset) the co owners who didn't occupy the house had to pay capital gains on it. Had she let it go into the estate that would not have been the case (his dad died 6 years ago and she is 92). The reason the house WAS sold is because my BIL lives in the same small town, has said he has not prepared for his own retirement and wanted her out, into a AL asap and all of her stuff sold. He forced this issue and my husband advised against it, but nobody listened to him.
Shortly after the AL, she fell down, necessitating that she move to nursing home. If you don't know, LTC is covered by Medicare while AL is not. Mentally she is still fine and we wish that she had stayed in her own home and used her long term care insurance and other assets to pay for the help she needed so she could stay in her familiar environment. But that was not to be.
She is now 92. The doctors say that she could live to 100! She has incontinence and other 'elder' health issues, but medication is amazing these days. I think she'd rather just 'go' but that isn't up to her. She still has $150,000, still receives her pensions (those total about $2800/mo) and her husband's social security. Her expenses are about $4000/mo and she pretty much covers that with ss and pension $$.
A HUGE issue for her has always been to 'leave something' to her family. Obviously my BIL is counting on that, and he was the one who basically forced her where she is and has been holding her purse strings. The thing she has a hard time understanding is that if she ran out of money she would have EXACTLY the same care she is getting now. Nothing would change if she were to need Medicaid. And she would still have lifetime income.
Nursing homes are experts at helping one go through their money. Since she and my FIL prepared so well, we have been urging her to gift $12,000 a year to family members. Even if it were all gone, we would set aside money for her extras, like massages, hair do's, etc. But she has it in her head that she doesn't want to be 'on the dole'. I am sorry, but it makes me so upset to see her stuck in this horrible place (she won't come live in our state and insists even after she complains that it is "ok" there). She really, I don't think, gets it that she could totally run out of money and things would be exactly like they are.
I would urge you to look into a) not selling your mother's home and all of her possessions in it and b) having her gift up to the allowed limit. You need a lawyer in your/her state, but you can help her have a decent quality of life and make her money work as well as possible for her. Personally, if at all possible I would find a nice assisted living situation and help for her there if she can't stay in her home with help and also urge her to gift her family. Once she runs out of money, she still can be cared for in a nursing home until she passes away. If she has to be in a nursing home due to health complications, then gifting to her family may give her joy to see what the fruits of her labor are going to during her lifetime. And then make sure her will is in place for 'real' property, ie, her home.

The alternative is reasonable and affordable care which does not exist in this country. We live in a for profit society where shareholders hold all the stakes. Medicaid could be more sustainable if the cost of caring for the elderly was more manageable. If seniors could afford the cost of their care, there would be no need to spend down all their assets to qualify for medicaid. No need for medicaid will sustain this program far into future generations.

I no longer take care of my mom she had a stoke and I guess dementia I've never seen anything like what she has one day she's in bed and so confused taking to people and seeing people that aren their next day she up in the wheelchair still a bit confused its a day to day challenge we talked to a senior care advocate she showed us care homes they have six residents and 24 hour care they do everything including their laundry we found a nice one for 2800.00 a month she's on hospice so the nurses come twice a week we could not afford a nursing home and I don't think the care is better see if you can talk to a senior advocate best of luck

Perhaps you can check out CCRCs or Continuing Care Retirement Communities. This is a residential retirement community that offers variety of medical and living services to patients who require supervision and continuous care. This type of community has assisted living facility, nursing home and independent living under one roof. However, there are three types of contracts for CCRC's and they are Life Care or Extended Contract, Modified Contract and Free-for-Service Contract. Since you're on a tight budget, it's best to consider the latter. It's initial enrollment fee may be lower but the services offered will be charged at their market rates. There's no harm in exploring your options, so might as well check out this community.

Can you give more details why she isn't qualified for medicaid? If you really don't qualify for medicaid, how old is your mother? If she is 65 y.o or older, she may be able to qualify for medicare's skilled care program, it may be limited but would be a great help for you and your family. Just remember that medicare focuses on health care and not long term care. And after you exhausted the help that medicare has to offer, you may opt to choose home care, it is less expensive because you do not have to pay for lodging..I also ready a lot of articles stating that the cheapest ALF are in Mexico, you may want to check on that if you are willing to relocate :)

To answer your questions: she is 81 years old and doesn't qualify for medicaid because she has a few bucks in the bank. You have to basically be destitute to qualify for medicaid. My dad working his butt off so she could have a few bucks and now she does, she is punished because of that. She is currently in AL now and it is costing four grand a month. When she has run out of money, that's when medicaid kicks in. Thanks US government for greedily taking our taxes, overpaying yourselves and stiffing elderly folks. Good job!
Wiling to relocate, but Mexico is too far. Thanks anyway!

I read often on this forum that in-home (hired) care is the least expensive option. My mom had 24 hour caretakers, and it cost $12,000/month. And this was in Texas where it is actually cheaper. I can't imagine what it would have cost in New Jersey or California. We finally found an excellent diaper that allowed her to make it through the night, and that let us stop one shift, which reduced the bill to $8,000/month. Still not inexpensive. A nursing home would have been cheaper.

Visit an eldercare attorney in your state ,to see the specific facts that pertain to your family. The first consultation is usually free.

Medicaid only began in 1965. Before then, families took care of their parents. Medicaid is a privilege that is designed to help thise for the less fortunate and predominantly with out families. It costs our country huge amounts of money and is abused by many who indeed have assets and wealthy offspring who can take care of them.
Perhaps changes should be made so that families who take in their aging parents and arrange for in-home care receive subsidies from the government to do so.
I think it would strenghten family values rather than abandoning parents to impersonal "care-giving" institutions.

I thought my brother wasn't able to get Medicaid he is 92 has a home with mortgage gets a navy $1,900 s.s $826 a month and he can't outside. My brother was put in a Nursing home and there can get Medicaid now, reason GROUP. Now from what they tell me is if your home you are in a group that can't always get it, but put in a nursing home makes it's a different group and income don't matter. I am trying to move him now closer to me the nursing homes know they can bill three months back also to Medicaid.

I'm sorry but I don't agree with the original poster's rant. Why should every other hard-working American have to pay for your mother's care?! She should sell her home and stocks and use that money to live on until it's gone. THEN, she can get on Medicaid. What you want is for her to leave all her hard-earned assets to you. It doesn't work that way. Be glad she has assets to use!

Yes, I realize that this is a very old thread, but, wanted to respond since its had recent action and I have input on this matter.

I don't know what Veterans benefits that allow a person with income over $2205.00 per month to get Medicaid. (I read the max for Medicaid LTC is $2205. for 2017.) Does this mean their veteran's retirement is exempt? I have read about the option of a Community Group Nursing Home for Veterans. I would be curious to know more about it. Having a home doesn't normally disqualify you from Medicaid LTC, but, their income would. Does anyone know the details on this as it relates to veterans?

When people apply for Medicaid long term care or other state benefits for long term care assistance (Medicaid like programs that cover AL and MC), there is a very intensive search by the Medicaid or state representative for assets and income. Every dime is explored and it's not just handed out without qualification. They require written documentation, bank statements, deeds, insurance policies, income verification, etc. They leave no stone unturned, so, I don't think that rich people are getting this benefit. Plus, the person's financial situation is reviewed annually. And if they do qualify, all of their income goes to the facility, with a modest amount left for them to cover all of their personal expenses, like $66.00 per month.

Medicaid is not for people who just want to get LTC to have a place to live. Most medically qualify as needed medical care and assistance with their activities. So many recipients are disabled or ill.

Even with savings and retirement benefits, many seniors will not be able to afford long term care for very long. It's very expensive. And eventually those who can afford private pay, will not be able to.

I would suggest if cost is of concern, you seek out small, rural facilities. You may even wish to research average costs online to see what states have lower costs. Though no one wants to relocate, some states have significantly lower costs for LTC. In the the state of NC, some LTC facilities that are located in rural and low populated communities have costs that are much lower than large cities. Some are as much as one-third the costs of some found in larger cities.

Here in the Cincinnati area we are getting nursing care for $6200/month (in a "care center"). I'm mentioning this because an early responder to this post mentioned paying over $7000/month for assisted living. My impression is that AL starts around $3000/month although it may be somewhat lower in some south central states.

once there in a place it's possible that then she would be able to get Medicaid if funds were gone, it is considered a difference group. my brother owns his home has navy pension and S.S but is able to get Medicaid because he in in a nursing home check it out never know

It depends on what your loved ones needs are so this would be a challenging question to answer with out knowing if your loved one has dementia, can live independently still or if they need 24 hr care?
If they need 24 hr care then those are you alternatives, assisted living homes and skilled nursing. Assisted living homes are economical if you do a shared room and stay under 15 bed facilities where the rates are lower. If they are not needing 24hr care try senior apartments where you can have a call bell assistance when needed and they also clean the apartment and assist with transportation via shuttle bus. Senior community housing is a great way to go and is affordable since it is based on their income. Check your local area on aging agency they will be able to assist you!
Also you can do a live in in exchange for room and board and have them help with care, cooking and cleaning for a stipend say of $1000-1200 per month thats often a good way to go just make sure they are Background checked and are safe to care for your loved one.
Best wishes!

I don't have a tv so I didn't watch last night's Panorama programme, but apparently one Californian family chose the solution of flying their elder to a small city in England and leaving him in a car park here with no ID.

!!!

I think it turned out okay for the elderly gentleman himself; several months later, he's now safely back in America. But perhaps more by luck than judgement? Plus investigations into the family are ongoing I gather, so I'm not actually recommending this.

Churchmouse had said something that suggests an additional possibility (no, not leaving someone in a car park!)--has anyone here considered nursing care or AL overseas? For someone who has essentially no family (or won't by the time they are old enough to need such care) or has no particular place they consider home, perhaps this might be an option. I've thought of this as a possibility, with an additional consideration that the food overseas might be more interesting and appealing than that offered in facilities in the US, particularly if one especially likes a particular cuisine. And I suspect that in many countries such care would be much less expensive than in the US, just as health care in general is generally less expensive overseas.

Back in the good old days, before women started working en masse, daughters and grandaughters took care of the aging parent or grandparent, who because preventive care was not common, usually didn't live as long as our seniors do today. I hope all the caregivers on this board either have or plan to buy Long Term Care insurance when they are around 60. I certainly have it--it isn't cheap, but that plus my pensions, savings and social security should take care of me when I need it. Medicare was not designed for people to live as long as they do, and it has never pretended to provide custodial care. Let's just hope we can hold onto its medical benefits!

I share your frustration KarenP...nothing but a kick in the ass for working hard all your life & being punished for getting sick. I get nauseous every day for what my Mother is going through & I am responsible for her now. I am my Mother's Mother now. My Father never took sick days off & saved $$ for what? They didn't get a chance to enjoy it. Life is not fair. Gov't has got to find answers to taking care of sick & elderly.

Why is it the "Government's job" to find answers? Government is just people in offices that think they know everything, but they're just as human as the rest of us. In fact, I suspect that there are other answers out there that aren't possible because of the regulations and systems now in place. I've seen enough to know that it's a tough situation for many families, and modern medicine is more expensive than what was available and done a generation or so ago. If a caregiver costs $15/hr (including taxes, etc), a standard work week is $360; a month is $2580. And that's just one shift! Add facility cost, food, etc .... there's nothing cheap here. I recall my nephew saying about 15 years ago that having my brother (who had Parkinson's) in a small condo next door, with one live-in caregiver, was costing about $14K per month. We do need some creative--but realistic --thought about this.
Currently I'm 76, still working, live with a daughter, take care of myself, health reasonably good. We sold my long-time house, and some investment properties, but money in the bank isn't making anything lately; even investing well is not magic. My kids, which include an accountant and a lawyer, are watching my assets, but hoping that my physical and mental health hang in there. Ideas, anybody???

Answer to the rant- people in countries where they elderly are cared for also pay 40-60 percent income tax. I know this because I have a daughter that lives in Europe. But if your mom spends all her money then she can qualify for medicade. It is what it is. Inheritance is a thing of the past.

People live long past their sell-by dates today, is why. They are given pills and remedies for all their ailments and diseases, and so they live on and on and on, feeling lousy, incontinent, with Alzheimers, and their exhausted, struggling 60 year old offspring HAVE to get them on Medicaid and into a facility. Of course there is no inheritance, every cent they have made over their long lives has to be used to keep them alive and well, what else is there?

It would be nice if the US had the same health and nursing home care insurance that is seen throughout the rest of the Western world--and maybe some of the Eastern, too. In the past, families had to take care of each other, but there were enough women without paying jobs to do it, and because medical care to prolong life at all costs had not advanced to the extent it has now. No one in my family has lived past their mid-80s, and only one had dementia and was taken care of by her granddaughter, my mother, because she had just had a baby and had to be at home anyway! But she got only supportive care, she was never taken to a doctor because Medicare insurance didn't exist then. When she quit eating, she gradually went into a coma and died. I was about 9 years old at the time. Today she would probably be thrown in prison for letting her great grandma died, but that was the way it was when you could no longer care for yourself. My father died of a heart attack at 63, my mother of cancer at 80, so I never had to deal with long term decline in either of them. My husband had vascular dementia and died a few days after a massive stroke, which I look upon as a blessing as his dementia could only have gotten worse. I don't want to be a burden to my children, so I have two LTC policies and a well-prepared beneficiary book with all my wishes and bank accounts listed. Probably it won't all go perfectly, but it's the best I or anyone can do.

Lassie, I wonder if you're still monitoring this? I loved your answer - wished I could click the "thumbs up" about a hundred times in quick succession! !!

Reading all this is absolutely terrifying. In this case, I am the one who will one day have no place to go if Medicaid funding is cut or altogether eliminated. I am 61, disabled, and have no family. I live in government housing now on SSI. The thought of EVER having to go into a nursing home scares me to death. I am also afraid of being homeless. I have multiple health issues and I know that day may someday come. What should I do...what CAN I DO, to ensure this doesn't happen to me if I am all alone? I am going to have a living will, for one thing, stating that if anything happens to me, I do NOT, under ANY circumstances, want to be kept alive. I'm in tears right now as all this has depressed me to no end. Good luck to everyone who is in such an untenable position.

Strength in numbers, Junebug2. Are you a member of a patients' self-help support group, or a lobbying special interest organisation? What does your social worker say?

The future is never certain for anyone. For those with less economic security or family support, it can get very frightening and I sympathise. But here's the thing. You can sit there and quail, or you can speak up. The results may not be any different (though who knows) but at least you'll have tried.

The VA has foster homes. Private homeowners allow their homes to be used for the residents. Usually no more than 3 veterans in a home. The doctors and therapists to the homes. My MIL worked for the state of FL and she says that the state has foster homes. Do not know anything about that or if other states do this.
Still requires money. VA has Aid and Attendance (money) to help with foster home cost. Don't know much else, except to follow the Medicaid plan, where the person's money is spent down to nothing so they qualify for Medicaid to pay for the nursing home. In my Aunt's case, she was already in a nursing home, and Medicaid only paid a set amount. So we had to pay the difference (834.oo) between what the nursing home charged and what Medicaid paid. You need to find out as much as possible about Medicaid. I was advised that my Aunt could keep her home, one car, and a burial policy. And she could not give away her money to family within five years of her entrance into a nursing home. So you really need to know what's what. Don't know if all states do this, but in FL you can find a business headed by a lawyer that will help you preserve your parents estate while qualifying the parent for Medicaid. Some take a dim view of this practice, but essentially, you become the DPOA and there is a contract between you and your parent to be her caregiver. It's still a big process. Personally, if you can get her in-home care, perhaps sharing duties with a qualified caregiver, that might be the most affordable. But most people work and care-giving wears you out!!
No matter what, it's tough to be a caregiver, and it's tough finding a way to pay for home care. Karen, it ain't easy and it ain't fair. You can be proud of your Dad doing right by his family and country. Your Mom is lucky to have you to care about what happens to her. Keep reading at this site and you may see how blessed you are compared to others in this same boat.

Frankly, we are just living too long, much longer than most of us (including the government) thought we would, and there used to be non-working women to care for the elderly parents and in-laws. My mother spent about a year caring for her grandmother with dementia (senility they called it then) in the 1940s, along with taking care of me and my then baby sister while my dad was in the army. But Grandma was not ever taken to a doctor, and when she became unable to eat, she faded away. My father died of a heart attack at 63 and my mother of cancer at 75--both of them would have probably been cured in today's medical climate and lived to develop dementia, Parkinson's or worse. I am almost 80 and exercise and eat healthy, but I sometimes wonder if as a result of that my children will be burdened with caring for me or spending down my resources (my husband died of a stroke at age 71). I am reasonably well off and have long term care insurance bought from my employer at a time when they were offering such things. But I hope and pray for a fatal heart attack or stroke and wonder if I shouldn't stop taking drugs to lower my cholesterol.