Beyond Retirement - Nursing Home v Hotel v........

Still enjoying our retirement. However a thought creeps in to my head, "What next"?

I watched my father move from his home at aged 89 to a nursing home. We would visit him and I have to say it was the most depressing sight that I have ever witnessed. Paying over €1k per week plus expenses for everything. A money making/grabbing machine with little customer service. He hated it.

I figure we could stay in a nice hotel for a similar amount of money with hotel style customer service. There would be nil onsite health care but if we could still manage to get about, wash and dress ourselves we would be O.K.? Do people do this?

How about a Retirement Village set up? Small one bedroomed cottage type thing with independent living plus someone on-site to keep an eye on us and visits by nurse/doctor as needs be.

Stay in own house and give spare room to live-in person to do chores and help out with meals and other stuff.

Just interested in people's views on this as I wish to avoid the traditional nursing home route at all costs...

I remember reading that Ben and Nora, the founders of Dunnes Stores, lived in a room in the Shelbourne Hotel for years after retiring.

(Reportedly, they refused to allow the hotel management to re-decorate the room for years on end, because they didn't want to relocate!)

I am envious of some (wealthy) American relatives who seem to have found a good balance.

Own homes (apartments) but with the option of a dining room, activities, housekeeping services and some medical support, eg physiotherapist, nurse on site,

I am not aware of similar facilities here, I think there are some in the UK. My father in law in England was considering one but it was very expensive and he was reluctant to use his assets (house) to fund it. He passed before it was a serious consideration, ironically if he had made the move he would probably be still alive!

I think the desire to pass on generational wealth here would make people hesitant as they are going to be expensive. But I wonder as nursing homes are phenomenally expensive so I can’t see how a retirement home could be more expensive

Bit like where the Thursday Murder Club books are set.

Retirement style village/complex are a great idea but not many of them here, my uncle was involved in setting up one years ago in Enniscorthy I think. We really don't have sufficient population to have one everywhere we would like it, most people won't want to move far, it's not like US where at least the Miami weather would tempt you to move!

I don't know the answer, it's a depressing thought! My father 'luckily' died just as he was getting to the stage of needing a nursing home, it would have been awful as he definitely would not have liked it so grateful for small mercies.

There were certainly some attempts to build some of those American style retirement homes during the Tiger years, one in west Limerick and one in Carlow/Kildare borders that I am aware of but nothing every came of them.

There are sheltered housing schemes that might be an option

TBH, if I end up in a nursing home, I prefer not to know I was there.

Peanuts20 said:

There were certainly some attempts to build some of those American style retirement homes during the Tiger years, one in west Limerick and one in Carlow/Kildare borders that I am aware of but nothing every came of them.

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There is one in Cavan. It has a good reputation.

gledswood said:

I figure we could stay in a nice hotel for a similar amount of money with hotel style customer service. There would be nil onsite health care but if we could still manage to get about, wash and dress ourselves we would be O.K.? Do people do this?

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As noted, it used to be an option for the very wealthy to spend their declining years, but it's more expensive than a retirement home, once you start paying hotel costs for all your meals, your laundry, etc, and you get a much lower level of service and supervision than in even the lousier retirement homes. The truth is that almost everyone who moves into a retirement home needs a higher level of support and care than a hotel can provide. In the past, people who moved into a hotel did so mainly because they didn't want the faff of managing a house, rather than because they were frail.

gledswood said:

How about a Retirement Village set up? Small one bedroomed cottage type thing with independent living plus someone on-site to keep an eye on us and visits by nurse/doctor as needs be.

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You do find these in other countries, but they tend to be more expensive than a conventional retirement home (they cost more to provide) and the usual business model is that you have to buy your way in — as in, you pay a large capital sum for a lease on a unit, and you then pay a high rent/service charge which to cover the cost of the support services the village offers. In the Irish market, where so many people are concerned about leaving an inheritance for their children, I suspect they are not likely to find many takers. You also have the problem that if you develop a higher level of dependency than they can cater to (and a non-trivial proportion of their customers will do this) then they ask you to leave, and you have to move to a high-dependency retirement facility, but with considerably less assets to fund it than you had at the time you moved into the retirement village.

gledswood said:

Stay in own house and give spare room to live-in person to do chores and help out with meals and other stuff.

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This can work, if you find the right live-in person. But you need to be somebody who is satisfied with attendance/support morning and evening only, since the person is certain to have a job, because you are not provding them with an income.

It may only work as a transitional thing. As you age, you may require a higher level of attendance than morning and evenings (once you get to a certain level of frailty where say, you can't get up if you fall, you can't be left alone all day) or you may requires personal care, asistance with showering and toileting, that kind of thing. At that point what you need is a live-in carer who has to be paid a proper wage to do what is a very tough, and very responsible job. Again, if you find the right carer it can work, but it's not that much cheaper than a nursing home (and the Fair Deal is not available to assist in funding it).

TomEdison said:

At that point what you need is a live-in carer who has to be paid a proper wage to do what is a very tough, and very responsible job

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We have a 5 bedroomed house with an en-suite attached to a couple of the bedrooms. We also have a few reception rooms where the live-in carer could have their own private space. So it could be a comfortable set up for someone.

This would not cost us anything to provide. Could the cost of the accommodation be offset against the wage that you would be paying the person.

Our property is in a nice coastal area of south county Dublin, where rents are astronomical.

We are not cash rich but have the benefit of the property.

gledswood said:

This would not cost us anything to provide. Could the cost of the accommodation be offset against the wage that you would be paying the person.

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If you meet someone who is qualified for the job, wants the job and is in need of accommodation, possibly. But the stars really have to align for that. Plus, bear in mind that the companion doesn't care that your area is desirable and rents there are high; the only reason they would consider living in your area is to care for you; if they didn't have the job with you they'd likely be living in some less swish are, so what they save by living with you is the cost of living there, not the cost of living in your neighbourhood. So be realistic about the maximum you could offset against wages, even in the bet possible circumstances.

Bottom line here is that it's a seller's market, because there are more people who want this level of attendance than there are people offering it. I think in very round figures terms you're looking at a wage of maybe €50k plus free bed and board for a live-in companion of this kind, plus further costs to provide weekend and holiday cover unless family can step in and cover those needs themselves.

It is, as I say, in the same ball-park as retirement home care, but it offers the obvious advantage of keeping you in your own home, giving you more control over your life, not disrupting your social and community network, etc, so if you can afford it it's definitely worth considering. And if there's two of you it costs considerably less than both going into a retirement home would cost.

If you're not cash-rich but own your home outright, one way to finance this would be to reverse-mortgage the home to secure a loan and then draw down on the loan as required to pay the carer. When The Time Comes your estate repays the loan plus accumulated interest out of the sale proceeds of the house. So of course you're eating into any potential inheritance for your kids by doing that.

(And, you know, go for it. It's your house and it should be used first and foremost for your benefit. But a lot of people feel strongly about leaving something to their children, which I get.)

I read a few times about retirees living on a cruise ship full time at similar cost of / instead of retirement homes. Everything you need in one place including medical care (except for emergency hospital needs i imagine).

just throwing it out there.
50

My sister met a few people who did the cruise full time.

50andOut said:

I read a few times about retirees living on a cruise ship full time at similar cost of / instead of retirement homes. Everything you need in one place including medical care (except for emergency hospital needs i imagine).

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And burial at sea - no undertaker costs.

Sleep with the fishes.

gledswood said:

Stay in own house and give spare room to live-in person to do chores and help out with meals and other stuff.

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This gets my vote. Least cost and disturbance.
I already have 2 paying guests, and when I broke my wrist they were very helpful.

A friends mum has a reasonable set up but lots of moving parts…

HSE provide home care, 2 visits a day 7 days a week. Max home help hours are I think 21 so that’s 3 hours a day. Helps her get washed and dressed and will do a few jobs like put the breakfast stuff in the dishwasher, some are better than others. And hours can vary, unfair to leave her waiting until 10 for breakfast but also she won’t want someone there at 8am. Nor does she want her main meal at 3pm if that is the schedule.
Kids do shopping, medical appointments, and cook meals or leave meals for carer to reheat/serve up.
Paid cleaner comes once a week, she does a thorough job and the carers and family do the rest.

Live-in person gets a room rent free in return for being there at night, or letting kids know if she’s out. She’ll do occasional evening meals or tidy up the kitchen. She has a full time job and is out every day. She has a bedroom and small sitting room and her own bathroom and access to the kitchen, laundry etc. She’s not a carer but is security for the old lady and a safety net for the kids. Means they don’t have to stay over every night as the mum is worried about being on her own. She has restricted mobility and her hearing isn’t great.

It’s been going well but current live-in is returning to Philippines in July for 3 months. So all bets are off for a while.

This is their second live in, first one didn’t work out. She was never in (kids checked in of course) and had friends over too often.

Must be in the air. A neighbour was asking me to look over a plan she’s drawn up for her aunty. Needs a bit of help around the house and has a spare room.
She thought she could rent out a room for a reduced rent and get the help as well.

But she wanted someone to pay rent to live in one small room and also do about 21 hours a week work and be there at night. Even at minimum wage that is a grand a month. Plus overnights. She won’t get it for free let alone find someone to pay. She’s gone back to the drawing board.

This is going to be a large social / economic issue, and may require imaginative solutions.

There may be many people:
(1) who need social care
(2) who don't want to go to a nursing home, or aren't suitable for a nursing home (not dependent enough yet)
(3) who have something that has become valuable and scarce: spare bedrooms
(4) or others with spare bedrooms and financial assets
(5) whose dependents live far away in Ireland

The mix of policies around tax relief / carer's payments / Fair Deal / CGT will have to be re-imagined.

I think the key factor is going to be the supply of people who want to live in someone else's home while working for them.

This used, as we know, to be a common enough arrangement; middle class people and above often had one or more live-in domestic servants, which is essentially what we're talking about here. But this stopped happening two to three generations ago, as less onerous and better-paying jobs became available — hence "the servant problem", much talked about between the wars until the middle classes came to accept the new reality. (At one point the UK tried to solve the problem by having a special working visa for people who would come to the UK to do domestic service; it was largely availed of by refugees from Hitler's Germany, which tells you something about how desperate people had to be before they would avail of it.)

I'm not saying nobody is willing to do this work; my mother (aged 92) has a live-in companion, so they do exist. But the supply of people willing to do this work is limited, and as a result they don't have to do it for free bed and board , or even for minimum wage plus free bed and board.

People willing and suitable to do this work can easily get jobs in retirement homes, where they have much greater personal freedom, a better work-life balance, more support from colleagues and some degree of career structure with training and promotion opportunities. That's what they will compare your offer to, so the package that you provide has to be competetive in that light.

This centre in Kinsale sounds interesting. I can't comment on the quality as I just saw it from the outside and had a look around the grounds. But it has both apartments for semi-independent living and a care home close by - including dementia and palliative care options. There is also a GP surgery on site. From the outside at least the apartments look homely:

"Haven Bay Care Centre comprises of 35 architecturally designed one and two bedroom apartments ideally suited to those who wish to live independently but who may require some support. The occupants of the apartments are invited to participate in all healthcare and recreational activities within the Care Centre.

Included in the package is a Caretaker service with an option of daily visits to each apartment.
The Care Centre complex facilitates individuals to live independently for as long as possible in a safe, secure and supportive environment."

I have no idea of costs but I imagine it would be steep.

Another example: