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My mom is 80 and not in terrible health, but has depression issues and does not get out or move much. She lives alone and we have found her depression is much worse when alone for long periods of time. We have looked into IL near her in NH and have been told that an apartment is available next month. The monthly rate is very high at around 9K. When doing some rough math, I calculate she will run out of money in about 8 years. This place will not take medicaid so she would have to be moved to nursing home when she runs out of money. I would hate to do that to her since she has already said to us that being put in a nursing home would be her worst fear. I hate to try to figure out how much time she has because you never know. Do we put her in the IL now or wait some time until she really needs it? Btw - there are 3 of children, 2 out of state and 1 living 2 hours away. Moving in with any of us is not an option.

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We wouldn’t do it - she’s too young. Also, the rate will go up.

Other options might be spending some of her money on planned activities of some sort. Keep looking for other living options. Does she feel well enough to do things and just doesn’t want to?

Also, if it hasn’t been done yet, maybe consider a review of her medications with a geriatrician. You can do your own research, as well. Age and lifestyle changes how medications work, and she may be either off or over-medicated or on a drug not appropriate for an elder.

(I mention this because we thought my mom (78) was “fading”/dwindling due to chronic illness. Turns out she was seriously over prescribed for hypertension/statins and her general practitioner just keep renewing prescriptions for…well, way too many years [no comment]. She says she feels like a new woman - appetite back, more interested in doing things and back to running under her own steam. If you can get a list of your mom’s medications and doses, it’s worth checking. You have to be your own advocate these days, medical staff are so overwhelmed and “guidelines” run the show.)
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When doing your calculations have you figured how long she can stay where she is? By that I mean paying rent / mortgage if there is any...paying property taxes, homeowners insurance, gas bill, electric bill, water, sewer, garbage, food, general yearly maintenance like mowing, shoveling, plowing, painting. And if she is driving the car maintenance, gas, insurance since most IL / AL facilities have vans that will take residents to stores, doctor appointments, outings etc. so she would not really need a vehicle. If all those expenses are added back into her account would her assets last longer?

Even if you had a "caregiver" or in this case a companion come in 1 or 2 days a week the cost would be far less than IL facility.

If she is better around people and activities would she do better with attending an Adult Day Program a few days a week? She would be with other people, she would have activities. Most pick up a participant in the morning, a lunch and snack are provided and they are returned home in the afternoon.

Would she Volunteer someplace? The local Senior Center (either as a Volunteer or just to go for activities) Local Schools need Volunteers to help with a variety of projects. I Volunteer at a local Hospice. Food Pantries need Volunteers.

One other point...you say "Do we "put" her in the IL now or wait until she really needs it?"
I guess the BIG question is does your mom WANT to go into an AL facility? You can't just "put" her in one. If she is cognizant she has a say in where she lives.
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Lisa6896 Feb 5, 2024
Thanks. She is pretty much living off of pension, SS and annuity payouts now so she can live comfortably where she is. It's a 55+ community. When doing my math for the IL place I factored in the expenses she would no longer have but since it's so high a monthly fee it's going to deplete her saved money pretty quickly which makes us all nervous. Thanks for the suggestion of an adult day program. we've mentioned it to her but it's something she needs to decide to do herself and never seems to want to do these things. We've mentioned volunteering also but she doesn't ever push herself to get out and do these things. You are correct, I should be using the term "put". It's her choice too but she often relies on us to make decisions for her lately.
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Does she have a house to sell?

My mother lived in a mountain home in NC, alone. She refused to go into AL near my brother & I, so we laid in the weeds and waited, she had a small stroke and then was afraid to stay alone at night. We swooped her up.

Placed her in an AL near us, sold her house, with her SS and from the sale of her house, she had 8 years of money to pay for her facility.

She is 4 years into it.

My mother loves AL, so much to do, new friends, activities and more! Seniors need socialization with people their own age. This is vital.

She will turn 99 this month. If she runs out of money, she will go on Medicaid, this home accepts it after the resident has been there 5 years or more. We wanted a home that had this type of step up program. If she had to be moved to MC, she could, NH all in one facility.

Me, I am not a waiter, I am a planner, I did not want to wait until it was an emergency and have to take what was available.

Good Luck!
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Lisa6896 Feb 5, 2024
Thanks. I've factored the house selling into my numbers. Still only about 8 years. I wish there were places nearby that accept Medicaid but unfortunately, we haven't found one but will continue to look.
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I should have added that you need to look at facilities that WILL accept Medicaid. You never know what will happen.
Also the facility should also have Memory Care as well as Skilled Nursing or at least will be able to care for your mom is Skilled Nursing should be necessary. (some facilities will keep a resident as they decline if they were mobile when they became a resident)
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There are seniors apartment complexes and communities that do not provide IL amenities, I'd consider that first.
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I think this is very high. This is as high as MC. What does she GET for this? I would imagine food and transportation. Even at that this is above and beyond most ALF. And as to IL, it seems to me that often the needs are high enough that the senior should have chosen ALF instead of IL where they often remain quite isolated.

That is just my perspective offhand.
I personally would try such services as A Place For Mom. Many people say they get overwhelmingly pesty, but you can always say "Mom just went on Medicaid" and there won't be further calls.
Do know you will have to supply assets. My brother and I when we were searching described him as 1M on the hoof. If you have any history/knowlege of farming you will understand.
Still, you will be visited with a lot of choices, a lot of virtual tours. Real tours if wanted. And price comparisons.

Again, to me, for ALF apartment I think this is a LOT. I don't of course know what it includes, but it is in the realm of memory care cost and will eat the money up. I would continue to get a good base of choices. And wish you the best.
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Lisa6896 Feb 5, 2024
Thanks. She would get 3 meals a day, planned activities, transportation to appointments, 1 BR apartment. AL would be about 1500 higher so it's only going to get more expensive.
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9k is awful high for Independent living where you are still on your own. Assisted living maybe which I would pick but one that excepts Medicaid at some point. In my State, you pay at least two years privately and then can apply for Medicaid. So, if you go with AL, pick one who takes Medicaid.
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San42756 Feb 8, 2024
Medicaid will not pay for assisted living. I just found this out. My mom ran out of money and now has to go into a nursing home. That’s all Medicaid will pay for. My mom was in private pay memory care.
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There are ILs and there are ILs. Fancy new construction ILs with large fancy apartments around the greater Denver area cost as much as $9K a month. Older high rise buildings, like the one I found for my folks, cost in the neighborhood of $3K a month and have everything needed for a comfortable life. But nothing glitzy or glamorous, and no price tag to go with it. I suggest you look harder for a reasonably priced IL for mom to extend her money for a much longer period of time.

Best of luck.
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Thatbis rathr a high price similar to memory care. There is a carepatrol.com in your state but you can check how close. Your state has rural areas. It is a free service that will meet with you and take you to different places in your area. They make their money by the facility paying a finders fee
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Thanks everyone for your thoughtful comments. We decided to hold off for now because we are really worried about the money running out. We are working on helping to solve the things that cause her the most stress in the short term and still looking at other options for the future. I too thought the rates were high but being in NH there are not a lot of nice options and we want it to be a place she is happy in. One of the short term solutions we are pursuing is installing an alarm system at her house. She says she is most lonely and afraid at night and doesn't sleep well. Not sleeping well leads to her being tired all the time and feeds her depression more. Hopefully if we can get her sleeping better at night it can improve those other areas. I know this doesn't solve everything but is a start. We want her to be active and do more social activities but she needs to do that herself. When we make suggestions on things she should do she responds that maybe she'll do it but never does. It's hard.
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lealonnie1 Feb 5, 2024
Has your mothers depression been addressed? Because if not, she can live in the most expensive place on earth and STILL do nothing and STILL be unhappy! When my mother was suffering depression I called her PCP and told him her symptoms. He put her on Wellbutrin right away and she had great results. Started going out again and involving herself in activities, etc.
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I feel for you. I’m going through same . 😥🙏😩
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I'm surprised at that price for IL. I know you'd like to have a decision that will cover all of her last years, but as your say, you just don't know. It seems not quite the time for a move, rather to have a caregiver come in a couple days a week and see if a senior bus will pick her up for senior center activities if she doesn't drive. I'm 75 and go to tai chi classes and sometimes teach drawing at the senior center in my city. It's hoppin' over there. It's so much fun. After retiring from the interactions provided by students and colleagues I really need to occasionally be around people, other than my few close friends and sons. I could never get my grandmother or mother to go there, but Grandma went to adult day care and enjoyed it. I can tell you that just walking into class after spending 3 or 4 days at home is so uplifting. If your mom doesn't cook much, she could have meals delivered. Eventually, maybe look into assisted living for her if she still seems to need more interaction.
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Moxies Feb 12, 2024
An alarm system is good. We had one with very nice staff at the station. You might try calling them and see how they are. In addition, there are watches and pendants you can wear that respond with a human (do make sure of that) when you contact them. They can also detect when you fall, if you do not respond to the person who checks on you, they will call 911 and others you might designate, like yourself.. That might make her feel more secure as well.
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Can you find a place that will take her all the way to the end?

At least in my state, most of the ILs, ALs and MCs, will take her all the way to the end, even if it means that she goes on Medicare. However, there is a minimum time she has to be there prior to the "need".

Another option is to not sell her existing house assuming her house is completely paid off and is in a place with house prices trending upwards, and rent it (and use a property manager so that it doesn't become a burden to you). When she runs out of money, take a 2nd mortgage on the home to fund her remaining time.

Just thoughts....
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$9K sounds very high for IL, and even if in a prime real estate urban downtown would need to be super fancy to justify $9K. Maybe this one is, but it may be worth comparing it to a few others to see what else is available and if $9K is worth it.
As you mention, costs will likely rise over time , so you want to pace out the spending and not risk running out too soon.
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Great point also to consider a place that can accomodate IL, all the way to MC in the same facility. Having that ability may justify paying slightly more...
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Woah. $9K for independent living is a LOT. And for an 80 year old in decent health, eight years may not even get her to where she qualifies for skilled nursing and Medicaid. BTW, a "nursing home" is usually all Medicaid will pay for.

The other thing is IL doesn't force anyone to join in the activities. Just having them available may not induce a depressed person to take advantage. If she's not inclined to be social now, I don't think an independent living community will change that.

I'd start with her doctor. You don't mention whether she's being treated for her depression. That's probably the first step before any other interventions will help.
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I live in my own condo and will stay independent there until at least 80. However, with IL to NH costs so high, its possible that I may be forced into NH care like my poor Mom was 11 years ago. No one ever knows what will happen. Just stay as active as possible as long as possible.
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Lisa6896: Your mother's primary care physician should be addressing her depression and prescribing medication(s).
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I am not familiar with your area, but my mom is in IL for 2600 a month. IL, not AL of course, Hard to imagine IL being 9K a month anywhere
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Moxies Feb 12, 2024
Sadly not, it is easily than and more in the Seattle area-not including a large down payment.
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I found myself in a similar situation a few years ago. I looked into quite a few independent living with follow-on assisted living & memory care, due to my age. The newer facilities were over the top for me--starting at 6 and 7 thousand a month.
I looked at my bank accounts, and determined I would run out of money in a few years, and I was just under 80. So, I bit the dust and looked at a very old facility run by Brookdale. Oh, yes, some Brookdale facilities are very old. But, when I had my husband in memory care in one of Brookdale facilities in Phoenix, AZ, I found it well kept and the staff very attentive, professional, hard workers, kind and caring.
I kept in the back of my mind the facility also had Independent Living. After a few years of being a widow and actually not participating in any activities in my home area, I looked into Independent Living with follow-on assisted living and memory care in the same complex. I found an old Brookdale place, kind of run down, but sold to an independent buyer and fixed up to be a really nice facility.
When I was ready to make the move I looked at several newer facilities in my area, and decided I should actually take the old Brookdale place, rather than the newer facilities in the same area. My money would go a lot farther. I am very pleased at this place, do the research, look at your income now and x number years from now, depending on how old you are, and life expectancy. I was 80 when I looked into this type Independent living. Now I am going on 84, have lived here 3 years, and like it very much. There are a lot of activities to participate in, learning for people our age, music every Friday, wonderful real chef prepared meals, laundry facilities at our disposal, included weekly cleaning, many activities and daily outings by community bus and private car/driver for medical appointments. I looked at all of these services at each of the new and old facilities before choosing the lower cost. If I had chosen a newer place, at a cost of $7000 or more a month, $6000 a month, or even $5000 a month, I would be out of money in a few years. So, I bit my tongue, got my mind to operate the math, and decided I needed to take this older place. I do not cook. I did not choose an apartment with a full kitchen, although I do have a very small kitchen with cabinets, double sink, range top on a counter and microwave, housekeeping once a week, transportation to outings, doctor appointments, business appointments, shopping, It is not fancy. But,. we do have entertainment every Friday at Happy Hour (limited liquor, but variety of soft drinks), entertainment, clean campus, transportation to local stores several times a week, transportation to medical appointments, or to places like shopping center, banks, theaters, plays. We have entertainment every Friday for "happy hour", Dining Room, laundry in apartment buildings on each floor, annual cleaning of windows, carpets, all landscaping, even on my fenced in yard (not all are fenced in); a lot of everyday crafts, speakers, demonstrations, community activities with games, lectures, weekend TV movies or movies in the library. Entertainment every Friday, speakers, football pools, 2 meals a day (can pay extra $$ for a 3rd meal, most of us don't eat 3 meals a day). What I like best, is we feel like family. If one of us is missing at a meal, one of us will knock on the door to see if the person is okay. I have been at the same dinner table for 3 years now, and the 6 of us feel like family , making sure we are okay, someone calls us or knocks on the door to see if we need help; there are games and lectures throughout the day, entertainment Friday afternoon at happy hour, serving wine, beer, soda, snacks, and music entertainment. There are so many activities throughout any given day, you cannot be lonely. However, you can also stay in your room, don't participate in activities, order meals to your room for a fee.
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Di1961 Feb 12, 2024
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If mom can live independently, it would be less expensive for her to move closer to any of her children in a small apartment or condo. Use the savings to get her involved in community activities - YMCA, local faith group (something like a Bible study that meets during the day), events for seniors hosted by the community, classes at the local community college, and even day program at senior facility. Many large-ish towns even have transportation services for seniors.
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