4 ms·

When my mother passed last September, about 30 miles (~50 kilometers) west of Boston, private onsite hospice care cost about $400-ish a day. It's about the cost

When my mother passed last September, about 30 miles (~50 kilometers) west of Boston, private onsite hospice care cost about $400-ish a day. It's about the cost of staying in a fancy hotel. The state also covers the cost when you are on your final days, (there's a specific medical term,) but for longer-term stays, (weeks, months,) you have to pay out of pocket. Being "on hospice" when you are in your last months (again I don't remember the medical term), in Massachusetts is free. The family is responsible for the round-the-clock care, though. The real difficulty isn't the money: The state is very good at placing people who can't pay. The people who get squeezed are those of us who want an inheritance, or the spouses who need to keep money for their own end-of-life needs, yet are unable or unwilling to take time off from our lives. In my case my dad was under quite a bit of emotional stress, and when he's in that state, he gets irrational and can't make a decision. My mom was clearly in her last few days, but he was afraid he'd have to pay for many weeks or months of onsite hospice stay out of his own pocket. Even if that happened, he still had her brand-new Lexus and his own 1-year-old Highlander, a much larger house than he needs...

ejb999 4y ago
>>The people who get squeezed are those of us who want an inheritance You just said the quiet part out loud, and is my biggest gripe about sob stories like this - it is almost always about the children resenting the fact that some of their parents money is going to be spent on their elder care when they would prefer 'someone else' pick up the bill, so that they get a bigger inheritance.
- gwbas1c 4y ago
  Yeah, on the last day she was in the house, the social workers came to evaluate her to see if we would pay, or the state would pay. They determined that we should pay. The (cough) mistake that we made was we gave her painkillers before the visit because she was writhing in pain. If the social workers saw the writhing, they would have picked up the tab. (The hospice later retroactively admitted her so we paid nothing.) Edit: And I don't regret giving my mom painkillers. But, I had to make a point to my Dad that the social workers saw his nice, well kept house, all of our nice cars, pictures from nice vacations, ect, and decided that $400-$1200 to keep Mom comfortable was well within our budget.
mindslight 4y ago
idk that you should be fully putting this on your dad as if his was an unreasonable desire. It's a cruel fact that under our system, a lack of money means a lack of agency. Once you're out of money, the state options have massive cracks to fall through. The way I understand it (pre-hospice) - once he ran out of the ability to pay for help and couldn't keep up a facade of "full time care" himself, the state's answer would have been to ship her off to a nursing home regardless of what they both wanted. And FWIW selling a $30k car will cover like two months of part-time care.
- gwbas1c 4y ago
  My mom only had a few days to live. Her digestive system stopped working. He was being quite irrational about it, because the longest people live in that state is 3 weeks. (A lot of people are irrational in similar situations.) And a brand new Lexus sells for much more than $30k.
  - mindslight 4y ago
    Sorry, I had missed the part where it was definitely your mom's last days. My own mom was deathly scared of my dad passing and her not having enough money to pay for years at a private nursing home, having seen the (lack of) care patients get at the ones the state pays for. She ended up passing before my dad, who I then had to push into spending money to take care of himself because he had become so used to scrimping for her. So my general point is that someone not wanting to have their own financial situation severely destroyed by long term care of an ailing spouse isn't categorically unreasonable. And as far as the next generation - you can either accept that medical vultures will devour your parents' estate and you'll get nothing, or you can step up and take responsibility for their care when the time comes, and perhaps inherit something. Your parent's quality of life will generally be much better if you do step up, but it's not the kind of job that can just be outsourced as we've become accustomed to with everything else these days. (and obviously this advice is modulo one's specific relationship with their parents) I'm sorry for your loss, and hope things are going alright between you and your dad.
    - 4y ago
antisthenes 4y ago
> The people who get squeezed are those of us who want an inheritance There's the world's smallest violin playing for these people. The amount of delusional privilege to be in a position where you not only expect an inheritance, but also expect a certain amount of the inheritance, and yet refuse to care for your elderly is mind-blowing. It's on par with parents who kick out their adult children out at 18 years out of the house. Those 2 groups of people will firmly be labeled as pieces of shit in my mind and no amount of arguments will ever sway that position.
- oneoff786 4y ago
  So if a doc recommends a $1M expense to keep my drugged out dad alive for another day, as I a piece of shit for saying that does not make sense?
  - gwbas1c 4y ago
    Doctors don't make those kinds of recommendations.
    - oneoff786 4y ago
      It is hyperbole for sure, but there are plenty of real world cases where I would find the cost benefit not worth it. Personally I would find the cost benefit not worth it for any situation that has me lying feebly on opioids until I die. But the point remains. If you can’t agree with the hyperbole then you’re in the wrong making grand blanket statements about the way things work and saying nothing can convince you otherwise
      - gwbas1c 4y ago
        > It is hyperbole for sure, but there are plenty of real world cases where I would find the cost benefit not worth it. I married a doctor. That doesn't happen. What does happen is that the loved ones, or social workers, push for the doctors to do everything possible, even when the doctors know that it's a futile situation. When people encounter loss they do not behave rationally. > Personally I would find the cost benefit not worth it for any situation that has me lying feebly on opioids until I die. "lying feebly on opioids until I die" is what happens when someone's body is shutting down from a painful condition like cancer. Hopefully you're lucky and die in your sleep of old age. Unfortunately, assisted suicide is illegal in most places. Generally what's legal is to let nature take its course, and your caregivers, (who can be trusted family members) decide how often to give you opioids. It's well known that painkillers at the end of life accelerate death, so as long as your wishes are known to the people giving you painkillers, the "lying feebly on opioids until I die" can be very short. (Read between the lines.)

ejb999 4y ago

>>The people who get squeezed are those of us who want an inheritance You just said the quiet part out loud, and is my biggest gripe about sob stories like this - it is almost always about the children resenting the fact that some of their parents money is going to be spent on their elder care when they would prefer 'someone else' pick up the bill, so that they get a bigger inheritance.

gwbas1c 4y ago
Yeah, on the last day she was in the house, the social workers came to evaluate her to see if we would pay, or the state would pay. They determined that we should pay. The (cough) mistake that we made was we gave her painkillers before the visit because she was writhing in pain. If the social workers saw the writhing, they would have picked up the tab. (The hospice later retroactively admitted her so we paid nothing.) Edit: And I don't regret giving my mom painkillers. But, I had to make a point to my Dad that the social workers saw his nice, well kept house, all of our nice cars, pictures from nice vacations, ect, and decided that $400-$1200 to keep Mom comfortable was well within our budget.

mindslight 4y ago

idk that you should be fully putting this on your dad as if his was an unreasonable desire. It's a cruel fact that under our system, a lack of money means a lack of agency. Once you're out of money, the state options have massive cracks to fall through. The way I understand it (pre-hospice) - once he ran out of the ability to pay for help and couldn't keep up a facade of "full time care" himself, the state's answer would have been to ship her off to a nursing home regardless of what they both wanted. And FWIW selling a $30k car will cover like two months of part-time care.

gwbas1c 4y ago
My mom only had a few days to live. Her digestive system stopped working. He was being quite irrational about it, because the longest people live in that state is 3 weeks. (A lot of people are irrational in similar situations.) And a brand new Lexus sells for much more than $30k.
- mindslight 4y ago
  Sorry, I had missed the part where it was definitely your mom's last days. My own mom was deathly scared of my dad passing and her not having enough money to pay for years at a private nursing home, having seen the (lack of) care patients get at the ones the state pays for. She ended up passing before my dad, who I then had to push into spending money to take care of himself because he had become so used to scrimping for her. So my general point is that someone not wanting to have their own financial situation severely destroyed by long term care of an ailing spouse isn't categorically unreasonable. And as far as the next generation - you can either accept that medical vultures will devour your parents' estate and you'll get nothing, or you can step up and take responsibility for their care when the time comes, and perhaps inherit something. Your parent's quality of life will generally be much better if you do step up, but it's not the kind of job that can just be outsourced as we've become accustomed to with everything else these days. (and obviously this advice is modulo one's specific relationship with their parents) I'm sorry for your loss, and hope things are going alright between you and your dad.
  - 4y ago

antisthenes 4y ago

> The people who get squeezed are those of us who want an inheritance There's the world's smallest violin playing for these people. The amount of delusional privilege to be in a position where you not only expect an inheritance, but also expect a certain amount of the inheritance, and yet refuse to care for your elderly is mind-blowing. It's on par with parents who kick out their adult children out at 18 years out of the house. Those 2 groups of people will firmly be labeled as pieces of shit in my mind and no amount of arguments will ever sway that position.

oneoff786 4y ago
So if a doc recommends a $1M expense to keep my drugged out dad alive for another day, as I a piece of shit for saying that does not make sense?
- gwbas1c 4y ago
  Doctors don't make those kinds of recommendations.
  - oneoff786 4y ago
    It is hyperbole for sure, but there are plenty of real world cases where I would find the cost benefit not worth it. Personally I would find the cost benefit not worth it for any situation that has me lying feebly on opioids until I die. But the point remains. If you can’t agree with the hyperbole then you’re in the wrong making grand blanket statements about the way things work and saying nothing can convince you otherwise
    - gwbas1c 4y ago
      > It is hyperbole for sure, but there are plenty of real world cases where I would find the cost benefit not worth it. I married a doctor. That doesn't happen. What does happen is that the loved ones, or social workers, push for the doctors to do everything possible, even when the doctors know that it's a futile situation. When people encounter loss they do not behave rationally. > Personally I would find the cost benefit not worth it for any situation that has me lying feebly on opioids until I die. "lying feebly on opioids until I die" is what happens when someone's body is shutting down from a painful condition like cancer. Hopefully you're lucky and die in your sleep of old age. Unfortunately, assisted suicide is illegal in most places. Generally what's legal is to let nature take its course, and your caregivers, (who can be trusted family members) decide how often to give you opioids. It's well known that painkillers at the end of life accelerate death, so as long as your wishes are known to the people giving you painkillers, the "lying feebly on opioids until I die" can be very short. (Read between the lines.)