Why are the costs for nursing care and long-term care beyond what is affordable?

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Why are the costs for nursing care and long-term care beyond what is affordable?

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I do not know the state you are in but in several state there are adult foster care homes where up to 6 people stay, have their own room and is very reasonable. This is what Terryjack 1 is referring to. As an OT, I can tell you these are, for the most part, are very good. My mother hospiced in one, when we could no longer take care of her at home. It does really depend on what your father needs, which is going to be things like medication management, toileting, (incontinence ?) feeding, bed mobility, bathing and dressing and what level of support he needs for these activities . Most places require people to be assist of one. While I am not a big fan of AARP, they can be a source of great information.

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It's expensive no matter where you go. ALF is less expensive than a nursing home. Nursing homes have nurses on duty 24/7 which is just a part of the cost. If your dad doesn't have the funds to pay for a nursing home, then he may qualify for long term care Medicaid. If he qualifies then Medicaid will pay the majority of the cost. Check with your local area agency on aging for more info on nursing homes and 'waiver' or home and community based programs. If your dad is in the nursing home for a certain length of time and has Medicaid, then he may be able to move back into an assisted living facility and the waiver would help pay for it. I see a lot of facilities that are 'chains', only for profit and even the non profit facilities charge as much or more than other facilities. There isn't an easy solution, but the AAA may be able to answer some of your questions. Good Luck, your dad is lucky to have you to help him.

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"malloryg8r" here's a clue for you, nobody is interested in your rant about your retirement years and how much you deserve them.

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Look into board and care and steer clear of "nursing homes" . You can get a privite room in some board and cares for a little more money. You much better care in a family like setting in a board and care 6 bed facility. You just have to look around and find the right one. At most nursing homes the cost is astronomical and the care is not good. They don't have the staff to care for all of the residents in a timely manner in my experience and they should be avoided. It takes a little time and research no matter what you choose but don't let the "Nurse" fool you.

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While I don't disagree with other comments, I think StarGazer summed it up very succinctly. Mallory also makes some very good points about consumerism and the lack of money for old age care.

People are living longer and developing more health problems, some of which are beyond the ability of caregivers to manage at home. Commercial providers see a need, move in, and establish a foothold. Some attorneys have focused on asset management specifically designed to open up Medicaid qualification for people, enlarging the pool of potential facility residents. Elderly folks bring in dollars for commercial enterprises.

But it's not just the elderly who are becoming profit centers. As individuals, we are as well. Think about all the data being collected on us, whether we're caregivers or not. If you read privacy policies and terms of service for websites, you'll find references to data gathering, third party use, etc., etc.

People and our data are the hot commodities now. Marketers want that data, and they get it.

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The nursing home my mother was in charged $410 per day. The AL she was going to be in charged $12, 600 per month and yes, the space was no bigger than a bedroom.

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Brand-new facilities will eat $130,000 to $145,000 per room in start-up costs–or about $11 million for an average-sized location with 80 units... all-in costs include buying the land, design, construction, furniture and equipment, sales and marketing [as of 2007 article in Forbes Magazine].

As Mallory had mentioned above the cost of running a nursing home, especially employees... sales to liability insurance, property taxes and utility bills. Accountants and lawyers. Security and maintenance [interior and exterior], housekeeping and laundry service, and transportation services.

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My husband had Alzheimer's. I put him in memory unit of an assisted living facility. When he couldn't walk any more and other issues, it was suggested to have his doctor call in hospice. As long as my husband was under hospice care, they said he could stay at the assisted living until he passed. Not sure if alf 'knew' his health was going down hill quickly or not, but hospice was there for his last 3 months. alf did not want to lose him as a resident of course, so that's why they suggested hospice. So very glad I didn't have to move him, and pay twice as much as we already were.

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Well welcome to the healthcare industry. If you do not take good care of yourself before you get older, then you will probably need services. No one wants to pay at the end of their lives, but leave him where he is since funds are low. It is expensive because you have to pay all the professional people who went to school to get an education and probably are still paying for their student loans (like me).

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It has nothing to do with the physical building, and little to do with the number of patients in a room, and everything to do with paying all the workers. If you have 60 patients in a facility that must be staffed with 2 or 3 RN'S 24/7 (not just on call but actually working there, awake) all of a sudden you don't just have 3 x $85,000/yearly salary PLUS health ins, pensions, union benefits, paid time off which must be covered by another nurse, etc. Their actual reimbursement takes up what is paid by about 5-6 residents. Then there's all the LPN's, health aides, maintenance staff, laundry staff, professional chef & kitchen staff, marketing staff & office helpers, just add up all those workers' paychecks and you start to realize how it costs $90,000 a year. Plus they have to have insurance, keep the roof from leaking, and maybe update their furnace & air conditioning every so often. My wish is not that the government would pay for a billion people's bills every year, but that every single teenager was taught every single year in school, to Save Save Save and get their financial Priorities straight. It IS possible to get your education and buy a modest home AND do ALL of that without ONE PENNY of government handouts. I've done it and my kids are doing it. It's called WORK and Living Within Your Means. No one needs a $10,000 vacation every year, two Big Screen TV'S and a 3-car garage. Your kids want an I-phone? Let them work for it. They want to drive your car? Let them pay for it. You want to retire at 65 with another 40 years of luxury? I hope you planned & saved for that Priviledge, because No One has a Right to steal MY hard-earned & SAVED money which I have crimped and saved for my own "retirement" (which won't come until 70 and won't be anything fancy). Buy LTC insurance and buy the inflation riders. Keep yourself healthy. Don't waste money on frivolous crap you can't live without. If everyone did this, we would still have a few that by reason of being extremely disabled, or severe disease would require government help. But by far, there are too many mooches living off gov't who are setting a huge bad example and the cycle just continues.

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While no one wants to broach this subject, I have with my children as I look to the future. At age 75, I want no further treatments to extend my life. I want palliative care only. I work with the elderly and have for 30 years and I was caregiver for both my parents who have passed away. I have seen what chronic illness does for people and their families. My children cannot care for me, and and we have no means of paying for corporate medical costs of AL or NH. In fact we would be lucky to pay to co-pays etc of Medicare that are being proposed for baby boomers. This is a quality of life issue coupled with financial one. Not easy and my view does not mean true for others. However, we cannot continue down this path.

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I did quit my job to care for family members. I paid off my home in 2005, I'm 58, and do commissioned artwork from home (which is not nearly enough to pay for anything.) I'm full time with Mom here, 92, multiple medical concerns, but still a sharp lady. All utilities and auto costs are approx. $900 a month. Prior excursion to care for younger sister (bone marrow transplant) out of state cost me the 401K to keep my house and leave the state. For now we are ok. Mom's SS of $1300 pays her seven doctors, meds, and personal needs. She has no assets, qualifies for NADA. I own the house (all 1100 sq ft) so I'm out as well. We can drive to docs, we have groceries and electric. I consider that quite an accomplishment considering the circumstances. Since the beginning of time, people age, become infirm, die. Family members in a group took turns taking care of them. Only in this our MODERN ADVANCED society do we have unimaginable financial burdens to continue our lifestyle of 'privilege'. I say that with a smirk, because it's been five years of full-time no-real-income, no
'respite' and no-projected-future-for-me-lifestyle. I just CANNOT consider delegating my Mom to government-paid stressed-out strangers in a warehouse-style facility ! What if she's thirsty but can't find the word? She's embarrassed to no end if the poops her pants- and it's just us here ! Every time I get frustrated, every time I want to pull out my hair over an old story about my ex-husband that goes on repeatedly EVERY day...(at breakfast !!!) and how much she hates him, and how much she hates her father, and blah, blah, blah...I envision her alone and afraid with (maybe even kind) strangers, with (like you described) several people in a room (when she is afraid of anyone coming into this house...) I put on my big-girl pants, suck it up and move on to another day. ALL 63 million of us here in the US of A need to start emailing our congressmen. (Not just me, thank you.) Generations of folks who have not paid into the system get more 'assistance' than those of us who pay taxes. I will leave this adventure (fourth family member cared for) with the hope that these years have galvanized experiences in me that will somehow benefit my ENTRY BACK INTO THE WORKPLACE IN MY SIXTIES.

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It is ridiculous the cost of NH's but it is because of all the staff (in my opinion too many doing to much specialty/limited care, etc). My dad was in 2 different NH (now in AL) and the staff - OMG you have one person to do one thing, the health care system is in terrible trouble and unfortunately the sick/elderly are paying the high cost. Living out your remaining days/months/years wasting away in a NH is NO way to go out of this life. There are limited options, in my case there is no way on earth I would tolerate my dad living in my home, when he runs out of money and still alive he'll just have to be a ward of the state. No love loss with between my dad and me. Watch out for pill pushing doctors in these facilities also.

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The costs are probably related to the overall healthcare costs in the US which, as everyone knows, are very high--so high that travel advisories issued by other countries make a point of warning about medical costs if traveling to the US.

I thought it would be interesting to look at childcare rates, thinking that care for an infant would have some similarities to care for an elderly person. I found that childcare rates are from about $100 to $200 per week (depending upon area, of course). This would mean ca. $5K to $10K per year. From what I can determine, typically there is no nursing staff. However, this is generally for weekday daytime hours and not 24/7, so AL rates of ca. $30K per year don't seem so unreasonable. Nursing homes, because of their additional costs, can be expected to cost much more, but whether $70K or more per year is "reasonable" for a nursing home is difficult to answer without taking into account all the additional regulations and requirements.

I suspect a big part of the issue is that some elderly people require some assistance for daily living but aren't quite competent enough to take their medications--that is, a nursing home may be "overkill" (no pun intended!) for some elderly who need slightly more than AL provides. Is it possible for someone to be admitted into AL with the understanding that a family member or other person will visit make certain the resident takes his/her medication?

I suspect a huge part of the cost has to do with preventing and insuring against medical liability issues in the American "land of lawsuits"!

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We do not value the elderly. We, as a country, have our priorities all screwed up. Yes, I agree there is a better level of care (I hope) in a nursing facility. I know the care back in the day was horrid - hence these Independent & Assisted Living places cropped up to fill in with different levels of care. But once it a person goes into a nursing home, unless you pay privately, it is like a hospital but for much of the time they put the person in a wheelchair & leave them in it all day. I hope you can find someplace that is worthy of your father. This inevitability scares me for my Mother, my spouse, my friends and quite frankly for myself.

Good luck, stay strong. Reach out to friends for comfort. Best of luck. Keep us posted.

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My Mom is 87 and just recently in the past couple of months has needed someone to stay with her at all times. She uses a walker now and is a higher risk for falls since she has issues with iron deficency anemia that we are trying to stablize. Her red blood levels were so low she passed out. (She may need Procrit shots or iron infusions.) She has also been having memory issues-most likeky onset of dementia. She has partial seizure disorder that is under control, CHF, CKD, neuropathy, osteoarthritis, COPD (on oxygen), GERD, High Blood Pressure, gout and high Cholesterol. Fortunately she is not diabetic or incontinent. She no longer cooks, cleans or pays her own bills. I do that for her. The scary part is she could never afford any assisted living or nursing home costs. It's all outrageously priced. Who can really afford the costs?! My husband and sister take turns caring for her each day while I am working a full time job. There is someone here 24/7 with her. I am fortunate to have this help for her and especially hearing about some of the conditions and problems with room sharing in NH and the costs of AL. If I had to quit my job and care for her I would. My pay is less than the costs to place her somewhere, so she could afford at least to cover my debts while caring for her at home. I hloe it does not come to this, but I have thought about it. I just pray we can continue caring for our Mom in her last years at home.

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Is your father a veteran ? If so aid & assistance may be available.

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As long as we continue to believe, as a country, that it's okay to make a profit off the sick and the elderly, the costs will be exorbitant.

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Yes it is about the nursing care, doors are open and there are checks done rregularly for patient safety. However, after working in both as a healthcare professional, I agree the cost is not worth it. I agree that you need to determine what your dad actually needs and see if it can be provided at a lower costs at an AL that can provide that service. This might mean that your dad does use a call light for help. It might mean that if you have particular times he needs help, you pay private duty. good luck! My father was falling and hallucinating and we could not get his AL to continue with him and my father went through nearly all his savings in skilled care. We did find one with private room for $350 day!!!

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I was fortunate and able to keep my Mom in AL for the entire duration of her final 18 months. And yes, it was half the cost of the nursing homes. But as part of my research, I did find that different AL's offered different services. You've offered no info on your Dad's issues/age but my first thought is for you to check a variety of ALs that may provide what is needed at less cost. Having said that, if he truly needs skilled nursing, then that is where he should be. After his funds run out, he can apply for medicaid.

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Assisted Living does not provide nearly as high a level of care as a Nursing Home. The NH will have RN's on 24/7, more aides and an actual MD on staff. You can get a private room only in a private pay nursing home.

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Why are the costs for nursing care and long-term care beyond what is affordable?

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