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Senior care is brutally expensive. Boomers aren’t ready.

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Long-term care options are too expensive for middle-income Americans, narrowing options for millions of seniors

March 18, 2023 at 6:00 a.m. EDT


"Beth Roper, left, helps her husband, Doug Roper, get comfortable on a bench with the assistance of their daughter, Kathyrn Roper, at a locked memory care facility in Poquoson, Va., where Doug Roper lives. He has Alzheimer’s disease, and his care costs nearly $6,000 a month. (Michael S. Williamson/The Washington

Beth Roper had already sold her husband Doug’s boat and his pickup truck. Her daughter sends $500 a month or more. But it was nowhere near enough to pay the $5,950-a-month bill at Doug’s assisted-living facility. So last year, Roper, 65, abandoned her own plans to retire.

To the public school librarian from Poquoson, Va., it feels like a betrayal of a social contract. Doug Roper, a longtime high school history teacher and wrestling coach, has a pension and Social Security. The Ropers own a home; they have savings. Yet the expense of Doug’s residential Alzheimer’s care poses a grave threat to their middle-class nest egg. At nearly $72,000, a year in assisted living for Doug, 67, costs more than her $64,000 annual salary.

“It’s devastating,” she said. “You can’t wrap your head around it.”

A wave of Americans has been reaching retirement age largely unprepared for the extraordinary costs of specialized care. These aging baby boomers — 73 million strong, the oldest of whom turn 77 this year — pose an unprecedented challenge to the U.S. economy, as individual families shoulder an increasingly ruinous financial burden with little help from stalemated policymakers in Washington.

The dilemma is particularly vexing for those in the economic middle. They can’t afford the high costs of care on their own, yet their resources are too high for them to qualify for federal safety-net insurance. An estimated 18 million middle-income boomers will require care for moderate to severe needs but be unable to pay for it, according to an analysis of the gap by the Center for Retirement Research at Boston College.

“It’s this really enormous financial bomb sitting out there that most people are just hoping won’t hit them,” said Marc A. Cohen, co-director of the LeadingAge LTSS Center at the University of Massachusetts at Boston. “There’s an incredible amount of confusion and denial.”

It’s no surprise that people put off decisions about how to get by during the final years and decades of life; it’s unpleasant to consider, and in the United States, there are few good options. Home care aides are in short supply. Nursing homes are seen as overly institutional and cater to the most disabled.

Assisted-living facilities, the fastest-growing category of elderly care, provide an independent, homelike environment for seniors who need some help with day-to-day functions. Chandeliers, comfy sofas, wood paneling and plush carpets are standard in common areas. You can get your own apartment with your own bathroom. But it starts at $60,000 a year on average, according to the National Investment Center for Seniors Housing & Care (NIC) — and costs go up as residents age and need more care. Locked units for dementia patients, which increasingly are being established within assisted-living facilities or as stand-alone facilities, run more than $80,000 a year on average.

Decades of neglect in nursing homes spur Biden plan for staff mandates

Long-term care costs represent “the single largest financial risk” facing seniors and their families, the National Council on Aging and UMass Boston researchers said in a 2020 report.

“It has to be addressed because ultimately it will be a societal crisis. These are the schoolteachers and the firefighters, the working people who take care of all of us, who cannot afford the [senior housing] that is being built out there right now,” said Beth Mace, chief economist for NIC, a leading data and analytics firm that participated in the study.

Polls show the vast majority of people would prefer aging in place, in their own home. But median costs for 40 hours a week of assistance from a care aide in the home, for things like bathing, dressing, eating and toileting, run over $56,000 a year. A shortage of home care aides, moreover, was exacerbated by the pandemic.

Seniors are stuck home alone as health aides flee for higher-paying jobs."

Much more with a lot of related hotlinks here:


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