Hunting for Super Person

By Mark Ackerman, PA

In the Early 2000’s I happened to know a guy who was a real estate developer. Mostly, this guy bought up land and put in apartment complexes. One day, after seeing one of his complexes going in near my neighborhood, I ran into him and asked him how much he was asking for each unit. “A thousand dollars a month” he said. “Wow” I said, “How can you get that rent? And, how can you justify that much money for an apartment when the average home mortgage is about the same cost? Wouldn’t people rather buy a house?” Without hesitation he told me how poor the housing market was and how that had led people to seek apartment living situations. And then, he told me, “I charge $1000 per month so the tenets will respect their apartment more and won’t beat it up. I’m tired of fixing all the damage that renters do in my apartments.” I guess I was pretty naive about his business but it sure seemed like a lot of money.
Now, fast-forward to today. This past weekend I was in Wenatchee, Washington helping some elderly relatives find an independent living facility that had a step up program to assisted living. Basically, these facilities are apartments for retired elderly people that offer a few perks like meals in a dining hall and transportation to medical appointments. I was shocked to find out the costs. Of the five places we looked at, the average cost was $4400 per month. This figure was for a 1 bedroom, 1 bathroom 750 square foot apartment for 2 people.
So again, I found out that I was pretty naïve and have had a recent education in senior living situations. Besides being shocked by the monthly price, I was also shocked by a couple of other items. For starters, these places all had a lot of other fees. For example:
There is a different fee for 1 person living in the same apartment and a higher fee for two people living in the facility. The second occupant fee was on the order $550 to $850 per month.
There is also a move-in fee. At the places we looked at, the move-in fee ranged anywhere from $2000 to $5000 just to get into the place.
There are typically waiting fees. Just to get on a waiting list, there is typically anywhere from a $500 to $2000 fee just to get your name on the list. Sometimes these fees are refundable and sometimes not.
Another fee that surprised me is how much it cost to have a small pet with you- anywhere from a one- time $500 fee to a $1500 fee with an additional $50/month.
In addition to all of this, each place admitted that the yearly base fee would almost always go up. This was on the average of 4-6% per year.
So you can see where senior living can be a pretty expensive proposition. The costs are high even if you don’t need much help. But, when you do need help, is when things get even more expensive. Between independent living and needing a skilled nurse to take care of you during the day is this area called “Assisted Living.” To be clear, “assisted living” is when you can do some things independently but need help with other aspects of living. Traditionally, these things are call “Activities of Daily Living” and are composed of 5 essential skills. They are:
1. Being able to dress yourself without help.
2. Being able to ambulate without help.
3. Being able to take your medication without help.
4. Being able to feed yourself without help. And,
5. Being able to bathe yourself without help.
If you can’t do one of these things in its entirety, then you qualify for assisted living. Of course, transitioning from independent to assisted living is going to cost more money. Sometimes, long-term care insurance can help with that cost but other times, it is on your own that you need to procure that help; each care facility charges a little bit differently for these services. Some homes do it on a point system, where each thing you need help with has a separate charge. Other homes break the charges up into categories of escalating need. From my experience there seems to be anywhere from 4 to 8 different categories that a resident falls into. At the minimum, each category incurred an additional charge of at least $200 per month.
So the reason I am bringing this information forward is not to get anyone upset about the charges. There is nothing that is going to change any of that. And, there are some situations that are going to require assisted living through no fault of your own. Many people have memory problems or car accidents that put them in these situations. Let’s face it, nobody asks to be ill and we can’t always avoid being put in these situations. Nobody is Super Person. We can’t all be physically, mentally and financially healthy enough at the end of our lives to live without sacrifices.
My point though, is that we should all strive to get, and to stay, healthy. Get your physical therapy done before you need to be in a home. Get your podiatry done before you need assisted living. Stop smoking long before you are forced to do it simply because of cost. Do your “fit and fall” class long before you fall and hurt yourself and your need for care becomes emergent. Do yourself a favor by evaluating your current activities of daily living so that you can make a plan to sustain your ability to live independently as long as possible.
Lastly, while the real estate developer I once knew was concerned about people beating up his apartments, I am concerned about patients beating up their bodies. The costs of assisted living are high because often times we become reckless and beat up our bodies. We forget that Kryptonite comes in more forms than just geological ones and that puts us in a position where we need to pay someone to come in and take care of us. Not all the damage is repairable and despite my hunting for Super Person, I have not found them yet. So be kind to your bodies, the better job we all do of staying healthy as we age, the more independent we can be and the less expensive we will live.