projecting future costs and availability of funds

Only thing I know if I self paid the money would be gone so fast then he would have to go on medicaid. It is so expensive!. Either you are rich enough to be able to afford it or poor enough to be able to go the medicaid route without losing anything. The middle group is the ones that pull their hair out trying to figure it out

you may also want to consult a CELA (yes, I know we always say that - insert eye roll). The reason I say it here is because I found my investment guy to be clueless about longterm care in our state. The CELA was able to help me move assets legally out my husband’s name and into mine using a Medicaid compliant annuity. We’re solidly middle class, but we were able to qualify him for Medicaid through careful planning. Not saying your investment person will be clueless but mine would have steered me very wrong.

I strongly recommend a CELA lawyer. There are ways to legally shelter some of your assets, and to qualify your LO for Medicaid assistance. Memory care expenses are horrific.

That depends on state you live in correct!

in answer to your original question about a future budget… you include all income and savings your loved one has, and all expenses your loved one will be responsible for.

My parents have been in an AL for 5 years, so here’s this for an example.

Income

Social security ( each) average of 2% increase a year. But so will the Medicare premium that is deducted before the money goes to your checking account.

Pension ( each) a pittance for mom, neither increases ever.

Their savings - including the money from the sale of their home ( they moved into a camper). They had cashed out their 401k long ago and put everything in a lowly interest bearing checking account. Don’t bother budgeting for interest income

Expenses

Rent at AL - second person charge, first person charge goes up at least 5% every year. Sometimes an unexpected increase due to inflation or ‘whatever’.

Health insurance -Medicare supplement - goes up at least 10% every year. Dental, eye insurance.

Any medical, dental, eye bill that isn’t covered by insurance. Including the bill at the local pharmacy that delivers to the AL.

Car/car insurance/maintenance - some people in AL still drive.

Cell phone or landline.

Groceries - snacks, personal hygiene, hearing aid batteries, depends etc. AL supplies none of this.

Clothing and other items like it.

Haircuts.

Any item they might buy on an outing.

Roku, Netflix, cable, etc.

Net result - income was less than expenses. They began using their savings the day they moved into the AL. They were up to pulling $2000 a month out of savings when he died in February this year and mom needed $1200 a month since then. The ‘savings’ would have been gone in two more years.

@fmb

Excellent point about the extra care charge. Mom’s AL changed from all inclusive to additional charges a year or so ago. She just got moved from the base rate to Level 2 in October. I had to ask what that meant. Shower help, dressing help, bringing meals to her room. The charge landed as soon as she went on hospice. However I think the shower and dressing help preceded that, but they just weren’t charging her. Around the date she went on hospice, she started refusing to go to the dining hall and within a few days all meals were being delivered to her. She’s been on hospice 5 weeks.

I could not make it through the last 3 weeks or the coming week ( I hope it’s only 1 more) without hospice, the AL nurse and the resident CNA and aid ( those two positions are on every shift). I’d gladly pay multiple times the extra monthly charge of $200 for the two on one care she’s getting, while they also take care of everyone else.

This is a very needed, and quite frankly, frightening topic.

It seems to me that all of the budgeting advice being given by financial advisors ought to include saving for nursing care starting in one's 20s. Let's see how far that goes. Young people are struggling to just move out of their parents' house. It wasn't easy for us older people either, but today's youth have it much harder.

The immense expense of nursing/memory care cannot realistically be budgeted and planned in advance. A few very lucky ones out there have long term care insurance, but most of us will be scrambling to figure it out on demand. For most of us, it might as well cost a million dollars a month.

An elder law attorney and financial advisor are necessary to help us put together a plan. I will offer this: Many retired people do plan on spending money travelling and enjoying their golden years. When dementia enters the scene, those plans end anyway, so those funds can go toward care. This is heartbreaking; no one wants to spend their life savings on care when they had dreams of retirement bliss. However, at least there is a source of funds, even if not quite enough. After much kicking and screaming (at the death of a dream), I promise you that logic will set in and you will come up with a plan.

You may need to give up something and downsize. You may need to search far and wide for a more affordable facility. There are so many variables, and many of us here have cobbled together very different solutions to the same problem.

I learned years ago that the Cavalry is Not Coming, and that includes the financial Cavalry. If you Google "how to pay for memory care," the solutions are as painful as the problem itself. "Sell the house." "Tap retirement funds." "Ask family for help." "Apply for Medicaid." UGH. Wow, artificial intelligence telling me how to slowly go broke. Gee whiz.

I feel for everyone in this ordeal. But I like to give solid, hopeful advice, so here you go.

Consider all income: Social Security, pensions, etc. Now look at your own expenses, plus nursing/memory care for your loved one.

Any monthly shortfall must be pulled from retirement accounts and savings. Do some quick math to get an idea how long your funds will last. Take this information to your elder care attorney and financial advisor and let them help you protect your funds and/or make your funds last as long as possible.

Much Love, Bill_2001

So much truth here. Many of our PWD have a clear diagnosis of Alzheimer's or FTD or another specific dementia. Some - like my DH - have delusions and psychoses that make living at home incredibly difficult and dangerous, with frequent "escapes" and angry, fearful episodes. My DH has been in MC now for 8 months, though I planned to keep him at home. For couples like us, there is no financial help beyond our savings and Social security - and a very small long term care policy purchased years ago. Imagine if you were diagnosed with any other disease that needed treatment, such as cancer. Can you imagine being told - That disease? Sorry, its not covered and you will have to pay for any necessary treatment out of pocket. That is our situation, if we have a PWD we care for that needs full time care for his and our safety. It's the same if your LO needs physical care you can't provide, or you need sleep to continue care giving. Medicare won't pay for the help you need. Oddly, it will pay for expensive new drugs, but not physical care. I hope someday Medicare will pay for physical care for PWD in Stages 6 and 7 - it seems like that is a reasonable thing to hope for!

I ditto on everything fmb writes. When touring facilities in the beginning, it never entered my mind to ask questions about lifts, 2 person transfers and what happens when the patient becomes incontinent, immobile, can't stand, needs a catheter or even if they will allow them to be bedridden. What happens if they have a fall or needs to go to the hospital or rehab, Ask what exactly does aging in place mean to that facility. When you're touring facilities in the earlier stages, it's normal to be more interested in the food, activities and care of DH in his current state especially when you have no idea what's going to happen or even understand the progression of this awful disease. Tour guides will probably not volunteer this information so you must ask questions.