The Costs of Quality of Life In Our Later Years
Everyone measures quality of life differently but the underlying concern for many older people is how long their money will last? Aging and health conditions may dictate the type of accommodations and amount of support you need now or down the road. However, quality of life does not need to be measured by where you live but more by the effort you put into caring for yourself and planning for the right supports to be around you including type and frequency of that support.
Whatever our situation we also need to draw on our inner strength to find comfort and solace if our lifestyle is not as expected. Basically, we need to toughen up.
What is it that holds us back from having a good quality of life as we age then? Some of it is denial, and refusing to deal with our chronic aches and pains, loss of mobility, loss of hearing and loss of eyesight as well as simple activities such as cooking for ourselves and cleaning. We either need to have the ability to pay to relieve the stress of these issues, or have other family or community resources and our quality of life can improve dramatically.
I have seen the biggest turnaround in the quality of life for people who participate in fitness and social programs. Those who receive in-home physiotherapy get and use hearing aids that work well, have cataract surgery, knee replacements and hip replacements all with a good rehabilitation programs and continued physiotherapy after they come home. These are all without exception of course to each individual unique circumstances but the simple rule of thumb is plan to pay for these support services.
Rehab twice a week may cost anywhere from $50 to $150 per visit and a companion twice a week may cost anywhere from $25.00 to $40.00 per hour and usually expects to work for a minimum of 3 hours.
Having a family member who is a good advocate for you, who makes an effort to understand and ask questions re medical issues, and who knows how to access resources when needed is a bonus. You can’t always expect a family member to fit into this role. In addition, hiring a companion to give your family member a break, is important, someone who is equal to you as a peer to have engaging conversations with and has the ability to drive.
The common questions asked are, where will I live? What is available? How much will it cost? These are not simple questions to answer because there are many variables. Here are just a few questions to consider.
- what is your income level
- do you have retirement savings or access to other capital
- what community do you want to live in
- what are your health conditions
- what are your expectations in relation to your future health needs as you age
- how soon do you want to move and do you have family or anyone to support you
In Canada and the Province of B.C. our social system provides us with most of our medical expenses and offers subsidized housing and care if we are lower income.
Accessing independent or assisted housing can be confusing. There are many access points to the different types of housing including, subsidized, private, co-op housing, cohousing, market rental housing, and low-income housing. Some of the entry points may be through the health authorities, or BC Housing, or directly through the homes and other various housing societies. There is not one central point where you have access to all. You can go on line to Seniors Services Society, or call BC211 or call a local seniors centre for information or ask for help from a professional housing specialist. Beware of the ones who don’t charge but are paid a referral fee by some of the private assisted living homes.
Here are rough numbers but they will give you an idea of where you fit in. The health authority will do a financial assessment to let you know if you qualify.
Residential Long Term Care (LTC)
Subsidized Residential LTC, is meant for people on lower income. Most people going into LTC today are requiring acute levels of care, meaning a higher level of medical, social and physical support. The rents are capped at 80% of income to ensure the client has at least the minimum of $325.00 per month spending money. This subsidized amount includes support for bathing, dressing, meals, and most medications and housekeeping including laundry. You will pay extra for physio, haircuts, podiatry, out trips, some entertainment and if you want a specific type of personal care item that isn’t supplied by the home.
The minimum monthly rate is adjusted each year based on changes to the Old Age Security/Guaranteed Income Supplement (OAS/GIS) rate as of July 1 of the previous year. For 2019, the minimum monthly rate for a client receiving long-term care services is $1,162.80 per month.
The maximum client rate is adjusted each year based on changes to the Consumer Price Index over the previous year. For 2019, the maximum monthly rate for a client receiving long-term care services is $3,377.10 per month
At approximately $19,500.00 annual income 80% of your income is used to cover the minimum rent at $1,162.00 per month, if you are earning less there is a rate reduction application used. The rate is calculated to deduct 80% of income to a maximum payment of $3,377.00 which roughly works out to annual income of about approximately $44,000.00. However, there are many variables based on your level of need and urgency and availability.
If you and your spouse are sharing a room in a long-term care home and are both in receipt of the Guaranteed Income Supplement (GIS) benefit at the married rate, your monthly rate will be calculated based on your after tax income, subject to a minimum and maximum monthly rate. For 2019, the minimum monthly rate for a couple sharing a room and both in receipt of the GIS benefit at the married rate is $808.15 per month per person.
It used to be that if you were earning $100,000 per year you could still live in subsidized care and not pay more than $3,377.00 per month. Before the aging population began to escalate rapidly people with higher incomes and lower needs regularly lived in subsidized residential care.
What’s Happening Now
Now with such a high demand for beds people with high needs for residential care earning income of roughly $45,000 + are being pushed to stay at home with support or into private pay residential care at a cost of approximately $10,000 + for extra services per month. At that price you will need to withdraw approximately $60,000 to $70,000 per year, if you have it, from your capital to supplement the cost of the private Residential/Long Term Care home. There are extra charges incurred for any added services you use in the home, it varies from home to home. When your money runs out the private care home will ask you to leave and you will then qualify for subsidized residential care.
Living in Your Own Home
The cost of caregivers and the quality of care you receive varies greatly. You have a choice and you need to speak up when you are not happy. You can hire privately not through a care
company but beware you need to do your own police check and this person is not accountable to anyone so if there is a problem you have no one to turn to without some research. You may get this type of private caregiver for $15.00 or $25.00 per hour.
I have written an article that touches on some topics, originally published in the Scrivener Magazine called It Takes a Savvy Senior to Avoid Financial Fraud and Other Abuses. You will find it linked here on my website
If your income is less than approximately $32,000 per year, you may qualify for free caregiver services from the health authority but know their time is maxed at 30 minutes including transportation time. The time they arrive is not always the best time for you and sometimes they are late or early, it is unpredictable or it may not be the service you need in the moment but they say sorry can’t do it if it’s not on the care plan.
Hiring through a private company is approximately $30 + per hour plus or minus depending on their qualifications or the type of care, you need, ranging from companion care to nursing care. Some companies charge the same rate across all levels of service. They usually ask for a minimum visit of 3 hours. Overnight care can be based on awake hours or sleep hours, best to check with the individual companies but between full day and night care can easily add up to $600 + for 24 hour care. You need to get creative with care supports if you want to bring the costs down. Some people are quite happy hiring through agencies and foreign worker programs, there are options and there are pros and cons based on your individual expectations. Knowing that the cost of full time care at home, can be near the cost of living in a private residential care home gives pause to consider both options carefully. Consider the cost of equipment such a hospital beds, lifts etc.
Independent and Assisted Living
The subsidized assisted living rate caps at 70% of your income. I often suggest using SAFER if your income is low to help give you a little extra financial support.
The average monthly cost is about $2,700.00 to $3,500 but varies greatly from provider to provider and region to region. The higher end homes can range from $3,500.00 to $5,000.00 per month. Assisted living includes meals and fall alert with assistance from emergency response as well as flat laundry and light housekeeping.
Unfortunately, we are really struggling with a shortage of housing for seniors and it is predicted to get worse as the numbers of the aging population continues to grow and the cost of land in BC remains high.
There is truth to the old saying that it takes a village to care. We see more and more family, friends and neighbours pulling together to support one another. The cost of quality of life is somewhat subjective when it comes to paying for supports while we are still active. Get involved and continue the conversations on how we can support quality of life for the infirmed with or without a million plus dollars in our bank accounts.
….with care, integrity and heart in mind for you.