Deciding to Move

             Also available: Spreadsheet, slides, PDF of slides.

               Hard to get up to speed on all the things to look for. And then you never (you hope) have to use this education again.

              This talk doesn’t have any conclusions, just some thoughts about the process of making the big decision.

              Will use Skyline and Horizon House for examples of differences. Leave it to you to add on more columns.

         I’m not a financial consultant, just a professor who likes to analyze processes and their dynamics.

         Wrote this talk on the evening after we signed the papers and wrote the big check, while fresh in mind.

Professors tend to talk in 50-minute blocks of time, but will make an exception here.

            Why?

             You wouldn’t be here if you hadn’t progressed beyond Why.

            When?

             Similarly, you’ve already figured out that you can’t just “Wait until I need it.”

             Move before you lose your energy or it will be twice as hard on your spouse.

            Where?

             Avoid having to move yet again, should you need more services.

             Don’t want to lose your new friends.

So let us assume you have progressed to looking at places with both Independent Living and Assisted Living under the same roof (or, as at Skyline, over the same basement).

 

Healthcare Considerations

              Is there “Medicare A” Skilled Nursing for post-op care? (Not at Horizon House.)

              Is there a nurse on call 24/7 to make urgent house calls, not just a Day Clinic? (Horizon House has 24/7 RN to call; Skyline just calls 911 and lets the medics sort it out.)

              Do physicians keep office hours on-site an afternoon a week? Dentists? Social Workers? (Horizon House does.)

 



“Community” Considerations

             “You’ve got to keep making new friends….” But a community gives you more than that.

             Such things, not the theological reassurances, are why a lot of nonbelievers belong to a church (25% atheists!).

             Shared values, caring for others, community projects, outreach….

 

So you will need to spend time talking to residents. Go visit, over and over.

                   Ask them for stories of something that didn’t work out well for someone.

                   Ask them how the healthcare works in practice. Any disappointed expectations?

                   Ask them how responsive the Administration is. Do they just respond to problems by making more rules?

 

 

The Residents tend to be boosters….

                If they like you, they will hope that you will move in.

                They’ve made their big decision and may be justifying it to themselves.

                 Since that’s true no matter where you visit, it doesn’t give you differences to go on.

                 You have to dig for the differences, the ones you can’t just tabulate in a comparison table.

 

Getting Past the Stock Answers

 

It’s not that you can’t get a straight answer from a resident or marketing person.

                   But they do tend to talk in generalities suitable for visitors. They will tell you Policy when what you need to know is the Practice.

                   You have to convince them that you need to know where the problems are, in order to do a fair comparison.

 

Dig for the Differences

                  So ask the officers of the Residents’ Council what issues they have been taking up with the powers-that-be.

                  Were they put off? Told the Board of Trustees would never buy it?

                  Do they describe the Administration as eager to please, willing to be flexible?

Doing the Numbers

Bundling can be hard to unbundle.

                  Difference between 90% Refundable and Amortize in five years should be about what a life insurance policy costs for the 90%.

                  Long-term care insurance, similarly.

                  Cost comparisons are hindered by different bundling for phone, housecleaning, and meal allowance.

 

Compare the differences

 


Rate the qualitative

 

What happens to your capital?

What happens to your income?