How Much Does It Cost?

A few days ago when I visited my grandmother, I commented about something I did not intend to purchase, and she said, tearfully (and with just a touch of melodrama), "Besides... you're already out so much money on me."  I assured her that everything was okay and that I was not "out a lot of money" on her.  But in reality, there are "incidental expenses" that come with placement in an Assisted Living Facilities (ALFs) or Skilled Care Nursing Facilities (commonly known as "nursing homes") - above and beyond basic room and board.  And this was the topic of a telephone interview with a writer for Smart Money Magazine today.

Regardless of whether the resident is "full private pay" or there is some level of assistance from Medicaid or another financial aid program, there will be expenses that are not covered in the basic room and board fee.  For my grandmother, these include:

• hair care - shampoo and set, haircuts, and permanents
• manicures
• toiletries - from skin cream to body lotion to makeup, toothpaste and OTC medications
• clothing
• subscriptions - newspapers and magazines.  My grandmother's ALF does provide a subscription to the local newspaper, but it is shared, and my grandmother was not getting access to it often, so she asked for her own personal subscription, which she subsequently shares with other residents.
• extra snacks - healthy snacks are provided at the ALF, along with beverages like coffee, tea, and fruit juice.  However, my grandmother likes to keep candy in her room, as well as soft drinks, Ensure, and tea for her nightly "tea time" with fellow residents.
• postage stamps and stationery
• bird seed - my grandmother has a bird feeder outside her window that we keep filled.  She enjoys many hours watching the birds feed at her window.
• private telephone - my grandmother has basic telephone service in her room, and she enjoys being able to speak with family members and friends from the privacy of her room, whenever she wishes.
• "spending money" - occasionally the residents who are able will shop at Wal-Mart or go out to eat.  My grandmother needs a little cash on hand for these outings.
• medication - while my grandmother has Medicare Part D prescription drug coverage, there is a copay of about $15 per month.  If an additional medication is prescribed that the plan doesn't cover, this is another expense.  When my grandmother got sick with the stomach flu a few months ago, the medication ordered by her physician caused her bill to more than double for that month.  Her dentist sometimes prescribes a rinse for her gums... and this is an out-of-pocket expense, also.

The writer also wanted to explore the incidental expenses associated with the care of our little ones.  While our situation is somewhat different than many, i.e. Timothy is not with us all the time, we still provide many things for his care when he does visit.  I have spoken with other "grandparents" and aunts and uncles who echo my comments that their little ones arrive "with the clothes on their backs," and everything is provided for their stay... diapers, formula, clothing, toys, crib, high chair, car seat, and much more. 

I told the writer that I have almost NEVER paid full retail for any purchase... I shop consignment/thrift stores, use coupons and end-of-season sales, and purchase nearly-new items at garage sales.  But still, it adds up.  Diapers alone can cost $25 a month or more, depending on how often Timothy visits.

The bottom line to our discussion was that making "Smart Money" decisions with regard to being in the Sandwich Generation takes planning and preparation... and a budget.  Failing to plan means planning to fail.  And quite frankly, most people are not thinking about the expenses associated with long-term care for a number of reasons:

• this is an unpleasant subject
• they are too busy getting through the daily grind
• they don't think it will happen to them
• the seniors don't want to talk about it

I am glad that people are beginning to recognize that this is an important issue that must be addressed.  I have spoken with many friends in recent weeks who are suddenly thrust into making some major decisions for their elderly loved ones, and the expense -  particularly that of "incidentals" - has been a daunting revelation.  Now is the time to plan, so that wise decisions are made and you don't end up compromising your own livelihood in the process!

I don't have any clue if/when the article will run... stay tuned. Meanwhile, start taking a look at your own situation.  Where is there potential for you to face a situation where you are suddenly faced with the care of babies or small children... or more likely, an elderly loved one.  Are you taking the necessary steps to be adequately prepared?  Isn't it time you did?