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

Protocol said:
This is going to be a large social / economic issue, and may require imaginative solutions.
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One imaginative solution might be encourage people to think about this long before it becomes a pressing issue, and making life choices with this in mind. When you have retired and the kids have moved out, move to a home that is suitable for growing old in. This means:
  • It's on one level, with no steps inside or to enter/exit.
  • It has a bathroom and toilet suitable for the mobility-impaired.
  • It has a no garden, or a small garden that will not be expensive to get maintained if you can no longer do it.
  • It is within easy walking distance of a grocery, a GP practice and a pharmacy.
  • It has an extra bedroom and bathroom so that a live-in companion is at least an option, if full-time attendance becomes necessary.
Look to a future in which you have a mobility impairment and don't have a driving licence, and think how you would live in the house in that situation. It is, of course, not a given that you will ever have a mobility impairment or be unable to drive, but there is a non-zero chance that one of these things will happen to you, or to your partner. And it would be shame to have to move to a retirement home because, although you could in principle live in your own home, you can't in reality live in the home that you actually have.
 
@TomEdison totally spot on. My parents house is no longer suitable, their window for moving has passed. As has the window for major renovations. Downstairs bathroom and bedroom are fine. But the kitchen is too narrow and has 2 steps down to it, theres another step to the garden, which then slopes away. The garden is a constant thorn in my side. There are not enough hours in the day to keep it as they did. And it upsets them and I resent it. They had the opportunity to move to a 3 bedroom 2 bathroom bungalow with a small flat garden, in the area a couple of years ago but my stupid brother talked them out of it… it was the same price as their 4 bedroom dormer bungalow with one bathroom and a bigger garden. He convinced them it was bad value. All about the money, not the practicalities.

As developments are more mixed now it should, be possible to stay near the family GP, local church etc and resize to a better property.
 
gledswood said:
Still enjoying our retirement. However a thought creeps in to my head, "What next"?
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It's going to depend on your needs as you age, and your needs will change. If you want to avoid the nursing home (at least for as long as possible) then look to adapt your home while you still have the capability to do so. As others have noted, you will reach a threshold where it is no longer possible to realistically change stuff. Also, if you change it now, you will have a lot of time to get used to it and not have to adapt to it during or after a crisis.

Aim for at least a downstairs room that will be the designated bedroom; maybe even kit it out as such. Install a downstairs accessible toilet and shower. If you can make the entrance of your house accessible (if it's not already) that would be brilliant.

In houses where this is not possible, the obvious answer is a stairlift, which is fine, but not something you will want in your house until you absolutely need it, which means change during or shortly after a crisis.

Care homes become necessary when your needs escalate to the point where you can't realistically be on your own without getting into difficulty with everyday things. You can stay in your own home with additional care (meals, care visits, overnight carers) but sometimes the care needs just become too much to supply outside a dedicated nursing home based setting.

That said, I've seen it said here before than only 1 in 20 of us will end our lives via a nursing home.
 
To the OP, while providing accomodation to a live in career is definitely a benefit with the ongoing housing mess in this country!

My concern would be the security risk and vetting of such a person. In terms of your property,valuables,personal care and how to terminate this arrangement.
 
As a child of elderly folks I can’t imagine finding someone that I’d trust. Local service providers offer a service they call hosted care. No idea what they charge.
 
This is one area I think the forthcoming modular building legislation could be of huge benefit.

A "live-in" carer may not wish to literally live in the same house, but a self contained modular home in the garden that had a emergency call system from the main house would be an ideal set-up.

Gives independence to both parties. It would also allow for a second person to be there if the primary carer is on holiday.

Much lower cost than nursing home and could be more appropriate
 
An excellent idea, re use the old granny flat.

The aforementioned garden that causes us so much grief is large, I might look into that. We’ve side access too. I have a feeling it’d be expensive but probably no more than a few months in a nursing home, or indeed a year on a cruise. And adding a second bathroom to the house for a live in carer would also be pricy and would lose a bedroom.

My parents care has been stable for a while, as summer holidays arrive e get constantly changing carers, they had 4 different people last week, all new to them and new to the job. It can’t be avoided but it’s stressful for everyone.
 
I wanted one of those little cabins/wooden rooms things to put in the back yard for myself when visiting family fairly regularly, it would have fit very easily and easy enough connection to services. I researched it before Covid times and the price was around 10k for what would do me, I was looking at smallest possible, one open plan room and bathroom. Then Covid happened and nothing could be done for ages, by the time I got back to looking at it I'd have no change from 30k! It's a pity as I'd really have loved it for the bit of separation and privacy but not at that price, I'm not even sure I could get it at that price now, some of the ads I see popping up show those prices even without the base and connection work which could add another 5k easily.
 
TomEdison said:
encourage people to think about this long before it becomes a pressing issue,
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I noticed when I lived in Switzerland that the city centres were full of young people, and old people. It was pointed out to me that it was because all the midde-aged people were out in the suburbs raising their families. Once that was done, they moved back, no need for bigger homes once the kids have flown the nest, reducing the need to drive, closer to amenities including medical services. I thought it was a very mature approach.
 
Having witnessed two close elderly relatives pass away in recent years, one at home and the other in hospital, I've very firmly decided that I intend to die at home (hopefully in the distant future!). Nothing will persuade me to enter a nursing home, and I will cheerfully spend all my money on home help over a nursing home.

TomEdison said:
When you have retired and the kids have moved out, move to a home that is suitable for growing old in. This means:
  • It's on one level, with no steps inside or to enter/exit.
  • It has a bathroom and toilet suitable for the mobility-impaired.
  • It has a no garden, or a small garden that will not be expensive to get maintained if you can no longer do it.
  • It is within easy walking distance of a grocery, a GP practice and a pharmacy.
  • It has an extra bedroom and bathroom so that a live-in companion is at least an option, if full-time attendance becomes necessary.
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In principle yes, but it's quite difficult to tick all of those boxes, even ignoring the fact that very many parents would want to host their descendants for Christmas etc, and of course they would need to sell their home not just their house.quite a lot can be done with alterations, including the stair climber and downstairsaccessible bathroom and bedroom.
 
The older suburbs of Dublin are quite well set up for retirement living. Some of them anyway. My parents could use a different house but they are happy with the local amenities. Transport to city centre is good too and local shopping centres are more than enough. But there is a lack of more suitable homes for smaller households. I think newer estate are more mixed in that sense. Around my parents it is mainly 3 bed or 4 bed houses with large gardens, few apartments and smaller houses are generally infill houses and not many of them. It is changing. A few Big Houses are being converted or demolished and more apartments are bing built.
 
BIG-notorious said:
In principle yes, but it's quite difficult to tick all of those boxes, even ignoring the fact that very many parents would want to host their descendants for Christmas etc, and of course they would need to sell their home not just their house.quite a lot can be done with alterations, including the stair climber and downstairsaccessible bathroom and bedroom.
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Sure. Some stuff you can do with alterations; other stuff requires a move, and which is which will vary from house to house. So there are some choices to be made here, and some compromises. The important thing is getting people to address these issues and make their choices, and act on them.

The "But I want to be able to host the family Christmas!" thing is interesting. Factors like this have great weight for some people, but if you think about it that's not entirely rational — you'll keep open the possiblity of hosting the next few family Christmases, as the cost of maybe having to move to a retirement home in later life? Seriously? That looks like a lousy trade-off. The hosting of the family Christmas is going to pass to the next generation at some point; before that point comes, think about how it fits into some bigger issues and time it in light of that.
Annieindublin said:
he older suburbs of Dublin are quite well set up for retirement living. Some of them anyway. My parents could use a different house but they are happy with the local amenities. Transport to city centre is good too and local shopping centres are more than enough. But there is a lack of more suitable homes for smaller households. I think newer estate are more mixed in that sense.
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Urban and inner suburban areas are generally optimal for elderly living — densely developed, so lots of facilities nearby; usually good transport links for those who don't drive; a good supply of smaller properties with small or no gardens. The main drawback is that a lot of properties are older, and may not be that friendly to the mobility-impaired — steps, narrow doors, that kind of thing. There's a cultural idea of "retiring to the country"; it sounds nice but in the long run it's doesn't always make for sustainable independent living.
 
this is back to the age-old and contentious down-sizing argument. Any attempts by the govt to encourage people to downsize to more suitable accommodation is framed as "forcing the elderly out of their homes" and besides there's a real dearth of suitable options. My folks are rattling around a 6 bed house with a huge garden in their 80s. They looked into downsizing when in their 60s but couldn't find anything suitable and now it's too late.
 
True the older properties around say rathmines are going to be difficult to renovate to suit less mobile residents. And of course they are very expensive now. My granny lived in Harold’s cross until she needed more care. Her house needed serious work to make it suitable. Would have been a good investment if her kids had done it up for her and kept it in the family. Not sure they’d have agreed on it though.
 
@shweeney … my parents too! Except they (I) found them a suitable place and brother convinced them it was a bad idea as they lost square footage and didn’t gain much cash. I could smack him!

We moved, have an apartment now. Not much equity extracted but we have no garden and a much easier maintenance schedule now. Secure gates and a lift to the top floor. Public transport and shops all nearby if we want to lose a car or two. Should see us out!
 
Annieindublin said:
my parents too! Except they (I) found them a suitable place and brother convinced them it was a bad idea as they lost square footage and didn’t gain much cash. I could smack him!
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I think my folks had the same misgivings about the idea, which put them off some of the places they looked at. They liked having the big garden and space in the house, now many of the rooms are closed up and the garden is an overgrown burden.
 
I am currently having these discussions with my parents and I am finding that I am talking to a wall. My parents are healthyish and very active elderly people. My father is 83 but they are still mostly taking care of a huge garden and a big house. They still travel abroad several times a year. They took the decision to build a new house on one level for their "old age", which I was delighted with. They had made big costly changes to their current home 6 years ago. However I never thought that would be enough to be able to live there on the longer terms. Now, despite being more practical than their current house, my father simply refused to make the new built fully accessible. There is still a step to enter... He also has decided that he would not move there unless absolutely necessary as it is too small and he would have nothing to do there. It's more than 100 square meters with a garage... Perhaps 300 meters from their current house. And a reasonably sized outdoor space. So I now know that the move will only happen if there is a crisis. At this stage, I find the lack of realistic approach to their old age really frustrating. I am well aware that they are very lucky. But I also know that at some point there will be some changes. On top of this, while I totally understand that these are their decisions, the refurbishment of their current home as well as the new built were expensive and really make no financial sense.
I personally hope I will adopt a more sensible approach when I grow older.
 
TomEdison said:
The "But I want to be able to host the family Christmas!" thing is interesting. Factors like this have great weight for some people, but if you think about it that's not entirely rational — you'll keep open the possiblity of hosting the next few family Christmases, as the cost of maybe having to move to a retirement home in later life?
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This! Maybe it is individual but I would be very happy to be hosted in my dotage rather than the other way around! And if I am living in the biggest home of all of us with just the two of us, that should tell me something!
 
@Premos we added a ramp to my parents house, cost a ridiculous amount but it is weatherproof, (not slippy when wet) and it can be removed. It took about a day to install it. The company assured us that they’d happily buy it back from us when it was no longer needed, I am betting they’ll actually charge a lot to remove it instead. But in any event it’s not attached to the building, won’t be difficult to to remove
 
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