Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
Maybe you are seeing things in orange. I do not.
Nearly 19,000 NHS patients left waiting for three days in A&E over 12 months
- Thread starter hollydolly
- Start date
Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
MIL has been in a facility for almost two years. She can talk and argue and use Alex. That is it. One CNA to four patients, every room with bathroom with lift and hair station. One RN for 8 patients. MD, pharmacy, hospital transfer 24/7. Once she has used up her funds it will roll into a Medicaid slot. Walking distance from her daughter.
We found a similar set up for Mumsy one mile from our house. individual studios or 2 bedroom with kitchenette and everything from a la cart meals to pharmacy, hairdresser and individual cab services. From independent to final care levels.
it is in orange on my computer - but maybe different colour on other people's.
Anyway he means the poster's name which appears above the content of their post when they have been quoted- where it says 'so and so said' - or in this post 'Twostep said'
Some would say that Yes Minister was a truth that can only be told as fiction type of show.
VaughanJB
Scrappy VIP
I'm pleased that it worked out for you. Sadly, it's not a universal thing in the US, location location location. The number I gave is real I can assure you, since it was provided directly to me. Not all homes are bad, for sure.
Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
8k for full service care is a bargain especially when it rolls over to Medicaid.
We sat down and ran numbers. New and larger house including taxes/utilities/insurance plus closing costs for sale/purchase, upgrading yard and house to our needs, vehicle to suit needs, moving. Then lack of privacy in our own home. Having to be on alert 24/7 to prevent mishaps. Mumsy broke a hip and needed a replacement and broke/cracked several vertebrae having falls doing things she was told not to do an a constant basis.
Finding a good home is not easy anywhere. It takes research.
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
When did you live in the US and for how long? And what US healthcare did you experience that was "not good?" Generally speaking, I've received quite good health care in the US and I've lived here all my life.
Also, it depends on what you mean by "care home" - not a term we use. There are Assisted Livings, Board and Cares, Skilled Nursing Facilities and Nursing Homes. Various prices, and they serve different needs, some covered by Medicare/Medicaid, some private.
VaughanJB
Scrappy VIP
A bargain comparatively to others in the market, I guess. But I fail to see how 8K is a bargain. I mean seriously. How many people can afford 8K a month to care for a person? And my experience is that Medicaid won't cover that cost, or anything near it.
VaughanJB
Scrappy VIP
I left the US in the 2000's. I lived there for a more than 15 years.
If you can pay, health care can be good. Excellent even. But if money gets tight - and in retirement that's a given - it gets worse.
As for type of care - I'm talking dementia needing a lot of care. Medicaid covers an amount, but it's not a level of service that is good, imo. Location matters, I understand that. Just as the level of NHS care you get varies.
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
In most developed countries, dramatically increasing numbers of physically and/or mentally challenged people require several YEARS of high levels of care. We may be living longer, but those additional years are often sickly ones. Professional 24/7 care is costly to provide, there's just no way around it.
The piper has come to demand payment for our decades of westernized diets, sedentary lifestyles, all manner of substance abuses, and generally unhealthy habits. The price we're individually and collectively paying in personal misery and dollars? Heart disease, adult and childhood obesity, diabetes, COPD, gout, liver disease, cancers, and poor mobility are rising to dramatic levels.
When it comes to chronic diseases, Western health systems largely treats symptoms. Anti-inflammatories, diabetes 2 meds, pain relievers, and even surgeries like angioplasties, arterial stents, coronary or gastric bypasses, amputations, etc., are temporary patches. We may feel better in the moment but improvements in actual health are fleeting, at best.
Too many GPs are glorified pill dispensers because patients demand quick fixes. Surgeries and more complex problems are handled by specialists.
Example: A friend's husband suffers (literally suffers) from gout. His GP referred him to a specialist (rheumatologist), who prescribes pills to lower the level of uric acid in Fred's blood. Forget INSISTING that Fred eliminate or largely reduce the source of the problem by no longer ingesting meals 3X a day that cause/exacerbate the gout, or Fred taking it upon himself to do so. Nah... that's asking too much of a mere human.
So Fred takes pills that (of course) have side effects that must be managed with even more pills. This in addition to the plethora of other meds he already takes for all manner of medical conditions he has at the ripe old age of 70.
Sorry for the long post, but until we make serious lifestyle changes, taking greater responsibility for our own health, this situation is going to get a whole lot worse - and far more costly - before it gets any better.
The piper has come to demand payment for our decades of westernized diets, sedentary lifestyles, all manner of substance abuses, and generally unhealthy habits. The price we're individually and collectively paying in personal misery and dollars? Heart disease, adult and childhood obesity, diabetes, COPD, gout, liver disease, cancers, and poor mobility are rising to dramatic levels.
When it comes to chronic diseases, Western health systems largely treats symptoms. Anti-inflammatories, diabetes 2 meds, pain relievers, and even surgeries like angioplasties, arterial stents, coronary or gastric bypasses, amputations, etc., are temporary patches. We may feel better in the moment but improvements in actual health are fleeting, at best.
Too many GPs are glorified pill dispensers because patients demand quick fixes. Surgeries and more complex problems are handled by specialists.
Example: A friend's husband suffers (literally suffers) from gout. His GP referred him to a specialist (rheumatologist), who prescribes pills to lower the level of uric acid in Fred's blood. Forget INSISTING that Fred eliminate or largely reduce the source of the problem by no longer ingesting meals 3X a day that cause/exacerbate the gout, or Fred taking it upon himself to do so. Nah... that's asking too much of a mere human.
So Fred takes pills that (of course) have side effects that must be managed with even more pills. This in addition to the plethora of other meds he already takes for all manner of medical conditions he has at the ripe old age of 70.
Sorry for the long post, but until we make serious lifestyle changes, taking greater responsibility for our own health, this situation is going to get a whole lot worse - and far more costly - before it gets any better.
Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
For full care it is a bargain. I do not know what you mean by "my experience with Medicare". It is a maze and takes patience and determination to work ones way through but it does work.
Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
You have not lived in the US for the last quarter of a century?
Why is it a given that money getting tight in retirement is a given?
You seem to not understand the concept of Medicaid and nursing facilities. I have no reason to under NHS.
Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
StarSong - if you are dumb you got to be tough.
VaughanJB
Scrappy VIP
It's a bargain only if you factor in the financial cost at today's value. Tell me, how many families, do you think, could afford 8K of additional expenditure to care for ONE relative? As for Medicare - we must agree to disagree. It works, but not at an 8K a month level. MY experience with that is two weeks ago.
VaughanJB
Scrappy VIP
a) Correct. However, I have supported a family there all that time.
b) Because it's a fact. The average annual income of a retiree today is $23K. Medium income of over $50K.
c) I understand it very well. I last dealt with it last week. A quick search says (and I concur): "Depending on the type of care required, the average national cost of assisted living ranges from £2000 to £4500 in 2023, with hourly, daily, and weekly rates available." Further: "Medicaid doesn't pay for the cost of room and board in assisted living".
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
Your experience is second or third hand.
Medicaid generally kicks in when people's liquid assets are very nearly depleted, and rightfully so. If the government, i.e., the rest of us, are going to pay your bills, we'll only do it after you've kicked in to the best of your ability.
When someone needs dementia care, the ratio is rarely less than 6 patients to a caregiver, 24/7. At $20/hour, 1/6 of that salary that comes to $80/day or $2400/month. Those are just frontline caregivers.
Staff also includes kitchen help, maids and laundry workers, custodians, landscapers, facilities repair workers, administrators, and RNs. So at least another $3500/month there. Add in the cost of food, utilities, and other supplies, and you're hitting $8000/month before you know it.
If the patient involved needs this kind of care AND her assets are nearly depleted, most US states' Medicaid will pay for required care. It might not be at the plushest of facilities, but as often happens, beggars can't be choosers.
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
Please provide your source.
VaughanJB
Scrappy VIP
Please do a search yourself and post anything to the contrary.
VaughanJB
Scrappy VIP
I am sorry, but there's a whole lot of assumption there. What is a "caregiver" to you. Do you assume they are available, in every state, at the same price?
I don't need justification of the 8K amount. I get it. What I need is a way to have that paid by Medicaid. And define "required care".
As for "beggars can't be choosers", that says it all. Hey, throw them in the gutter, beggars can't be choosers....
Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
MIL is at 13k and moving to 15k and will be in her room on Medicaid.
Mumsy will be selfpay as she entrusted herself 100% in the hands of her daughter and SIL.
Twostep
Well-known Member
- Location
- Tiny town Oklahoma, OK
You posted that you left 25 years ago.
What do UK prices have to do with Medicare?
Again - where do you find the numbers on average retirement and income?
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
In this context, "caregiver" refers to people working in a facility who are responsible for front line care of residents/patients. Since you don't mention where you're talking about, I'm going by the City of Los Angeles's average caregiver wages (including employer contributions to FICA).
But since you agree $8K is justified there's no sense going down that rabbit hole.
Some states are more generous than others when it comes to Medicaid picking up tabs. Required care means a doctor determines a person needs facility level care. That, as compared to deciding Dad should move to Assisted Living because that's what makes his kids comfortable.
When I said "beggars can't be choosers," I meant only that there are many levels of care for the elderly, dementia care included. I would never suggest throwing anyone in the gutter and am insulted you would suggest I might. That doesn't mean I'm blind to financial realities.
I've toured many ALs, Convalescent Care, Skilled Nursing Facilities and similar when finding care for my mother and FIL. Some are bare-bones, others offer extraordinary luxury, including movie theaters, fine dining, and so forth. More choices when you're paying out of pocket (which we did). If relying on the government to pay for it, the likelihood is that you'll wind up with something less luxurious.
This isn't terribly different from what some on here with NH have talked about. If paying out of pocket for private insurance or private medical you get seen immediately. If on NH, it's often a whole different ballgame.
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
Services related to memory care may include, but are not limited to:
Medicaid generally pays 100% of the costs of a nursing home stay, including any memory care services provided in the scope of that care. It does not cover the cost of room and board in assisted living or dedicated memory care facilities. However, Medicaid may pay for some memory care services provided in these settings for eligible patients if the facility is Medicaid-approved.
There are two primary ways Medicaid pays for memory care:
Institutional Medicaid: In all states and Washington, D.C., Medicaid will pay for 100% of nursing home care for eligible adults with Alzheimer's or another type of dementia. This includes the cost of room and board as well as health care services, personal care services, meals, and any memory care services provided at the facility. Only nursing homes licensed and certified as a Medicaid Nursing Facility (NF) can accept Medicaid patients.
Home and Community-Based Services (HCBS): This Medicaid program allows people to receive certain long-term services in their home or in assisted living facilities, memory care facilities, adult day health care centers, and other community settings. HCBS coverage is provided in the form of 1915(c) waivers. Some waivers are reserved for people with dementia or other specific needs. To qualify for an HCBS waiver, you must first apply for Medicaid benefits.
Assessing your eligibility
The rules governing Medicaid eligibility are complex and vary from state to state. To apply for Medicaid-covered memory care, you must have income and assets that fall below certain limits. These limits change every year and depend on your marital status and the state in which you live. For 2023, the monthly income limit for most states is $2,742 for single individuals with countable assets of $2,000 or less. For married spouses (both applying), the income limit is $5,484 with countable assets of less than $3,000.
Whether you’re applying for nursing home Medicaid or an HCBS waiver, you must also show you require a certain level of care. For example, a Nursing Home Level of Care (NHLOC) assessment helps determine whether you need the level of care delivered in an institutional setting. Level-of-care requirements for waivers may be different than those for nursing home care. States are permitted to create additional criteria—such as age or diagnosis, for example—in order to reserve a waiver for a select population in need.
https://www.ncoa.org/article/does-medicaid-cover-memory-care/
- 24-hour supervision and nursing care
- Help with activities of daily living
- Medication management
- Social activities
- Memory-stimulating activities
- Physical activities
- Meals and snacks
- Mobility assistance
- Physical, occupational, and speech therapies
Does Medicaid cover memory care expenses?
What Medicaid covers in memory careMedicaid generally pays 100% of the costs of a nursing home stay, including any memory care services provided in the scope of that care. It does not cover the cost of room and board in assisted living or dedicated memory care facilities. However, Medicaid may pay for some memory care services provided in these settings for eligible patients if the facility is Medicaid-approved.
There are two primary ways Medicaid pays for memory care:
Institutional Medicaid: In all states and Washington, D.C., Medicaid will pay for 100% of nursing home care for eligible adults with Alzheimer's or another type of dementia. This includes the cost of room and board as well as health care services, personal care services, meals, and any memory care services provided at the facility. Only nursing homes licensed and certified as a Medicaid Nursing Facility (NF) can accept Medicaid patients.
Home and Community-Based Services (HCBS): This Medicaid program allows people to receive certain long-term services in their home or in assisted living facilities, memory care facilities, adult day health care centers, and other community settings. HCBS coverage is provided in the form of 1915(c) waivers. Some waivers are reserved for people with dementia or other specific needs. To qualify for an HCBS waiver, you must first apply for Medicaid benefits.
Assessing your eligibility
The rules governing Medicaid eligibility are complex and vary from state to state. To apply for Medicaid-covered memory care, you must have income and assets that fall below certain limits. These limits change every year and depend on your marital status and the state in which you live. For 2023, the monthly income limit for most states is $2,742 for single individuals with countable assets of $2,000 or less. For married spouses (both applying), the income limit is $5,484 with countable assets of less than $3,000.
Whether you’re applying for nursing home Medicaid or an HCBS waiver, you must also show you require a certain level of care. For example, a Nursing Home Level of Care (NHLOC) assessment helps determine whether you need the level of care delivered in an institutional setting. Level-of-care requirements for waivers may be different than those for nursing home care. States are permitted to create additional criteria—such as age or diagnosis, for example—in order to reserve a waiver for a select population in need.
https://www.ncoa.org/article/does-medicaid-cover-memory-care/
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
"On a monthly basis, the average income for U.S. adults 65 and older is $6,252. The median monthly income is $4,191."
Average Retirement Income in 2024 | The Motley Fool
So $75K annually average and $50K median.
This includes Social Security, pensions, salaries and investment income.
Another source:
- 65 to 69 years: $59,430 median income, $87,860 average income
- 70 to 74 years: $55,990 median income, $79,920 average income
- 75 years and over: $41,060 median income, $62,470 average income
I believe you're picking up the average annual SS benefit ($23K), which isn't the same as retirees' average income.
Social Security was neither intended nor portrayed to be the sole means of support in retirement years. It was suggested to be only one leg of a three legged retiree support stool. Savings/investments and pensions were the other two legs.
51 years ago (1974) the US government and banks began heavily touting Individual Retirement Accounts (IRAs) to help people save for retirement in special tax advantaged accounts. Since you lived in the US during the 80s and 90s, you may recall the annual springtime barrage of inducements and reminders for people to fund their IRAs.
