I just returned from a holiday trip ‘up north’ to visit my parents and mother-in-law…..
Stop me if you have heard this story before…there are two sets of parents, my parents and my in-laws. My parents, both in their 80s, are cared for in a well-run retirement community and lead a very active lifestyle. This is despite the fact that my father continues to fight a two and a half decade old battle with a dread disease (leukemia). They travel together, volunteer and participate in activities held at the local adult community center. Life is good!
My mother-in-law, a single parent who raised several children, is also in her 80s. She also lives in a retirement home only not as reputable as the one that my parents live in. She receives the level of assistance her Medicaid assistance provides for, although there still exists a shortfall between her total expenses and the amount Medicaid reimburses. As a single mother, she successfully raised her children, who as adults, are hard pressed to reciprocate support for their aging mother, due to their own financial priorities and concerns.
So why is the living situation of my elderly birth parents different from that of my mother-in-law? There are many factors that go into deciding who lives comfortably in retirement and who stands at the mercy of the state or federal government for assistance and services. The situation I describe above is somewhat fictionalized but also represents some truth not only for my family but for the 1.5 million people age 65 and older who are residents of nursing homes.
The average daily cost of care for a semi-private or private nursing home room is $227-$258, based on current data from the John Hancock Life Insurance Company. Medicaid pays the nursing home costs for approximately 63% of all residents in the United States. The amount paid to these facilities by Medicaid has remained fairly constant at around 90% of total costs. This means that a person relying on Medicaid as their primary source of funding to meet their nursing home costs can expect limitations on their options for the type of care they need to maintain a lifestyle of dignity and comfort.
How Could Things be Different?
The biggest difference between how my parents are living and the living situation for my mother-in-law is the availability of options regarding their care. The situation for my mother and father living comfortably in a home of their choice, full of activities and choices is vastly different from that of my mother-in-law, whose choices are limited by her Medicaid reimbursement.
What did my parents do differently from my mother-in-law? There are many reasons for this, but a few ‘stick out’. My parents planned on retirement, which they did at age 58. My Mother-in-law was forced to retire because at age 79 her health would no longer allow her to work. My parents developed a plan for the eventuality that their aging would require financial resources in order to pay for their desired lifestyle. This plan included communicating with immediate family members to outline my parent’s wishes as desires as they got older and what we could do to ensure that those dreams were fulfilled. My mother-in-law’s plan all along was to “Work ‘til I die” (sound familiar?)… and she nearly made it. However, because her plan fell a ‘few years short’, and the fact that there was no ‘back up plan’, she now shares her remaining years in a unfamiliar bedroom with a stranger… as a Ward of the State.
Life has a tendency to “throw us a curve balls’ from time to time, but certainly as sons and daughters, nieces and nephews and other close family members it is our responsibility to have the conversation that none of us wants to have in order to make sure that those we love live life the way it should be lived. I, for one, let my mother -in-law down…for not initiating this conversation with her years ago.
What Can be Done to Change this Future?
Dickens wrote in A Tale of Two Cities, “It was the best of times, it was the worst of times… we had everything before us, we had nothing before us…” Dickens words aptly describe the contrast in circumstances between my parents and my mother-in-law. The present living situation of my two sets of parents calls attention to the need for more advanced planning and conversations that need to be had, even if they are difficult ones to have.
Relying on public sources of funding and the primary way to pay to meet long-term needs may be a shortsighted plan. If one family member can raise many, perhaps we should find a way for many to provide for one.
To learn more from this educator, click here (Todd D. Heckman).
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