ERE or Semi-ERE past Age 65

[J_]

@ EGO wrote: "On the other hand, they have a nice, comfortable place to live for the rest of their lives"

I do not look out to such a place. My mindset is geared to an adventurous life. As long as I stay healthy as I am still now (with the aid of the applied knowledge (by me) of Nutritionfacts.org) I do think that living a curious adventurous life and sharing such a life with a changing bunch of people is what I want. 24 years ago I draw a plan how to live to an age of 100 years. It had always a component of changing places and a boat. Of course the plan has changed but not its broad scope.

Yes, serendipity can happen in positive ways (as until now) but also in negative ways. Much earlier in my life I have learned to live with very basic means, and was happy too. I can always go back to such a life and feel the same. For adverse accidents with regard to my health there are enough safety nets here in the European countries I live in. And yes, I can die every moment.

cross reaction @Chenda, sorry to hear about the sudden deterioration of the health of your parents. At the same moment I read your message a trauma helicopter landed besides our place to save the life of a neighbour (88). It left a hour later, without him. Our neighbour died. A fortnight ago we spoke with him outside, walking with sticks. Such happenings helps to see life in all its fragility.

[7Wannabe5]

@Frita:

I agree, and the first step should be lowering the barriers to choice of hospice care. It's not discussed much, but in many situations, hospice care is basically a form of assisted suicide. because the palliative drugs do contribute to shortening lifespan. Dementia remains the thorniest problem, because although I would certainly want to be assisted to suicide before dementia sets in, the onset may influence decision-making ability. I was recently talking to a friend about this issue, and how we admired the practice of Maude in "Harold and Maude." My friend said that I remind him a good deal of Maude, so he could see me just picking a death date and sticking to it, but we both agreed that her choice of 80th birthday might be a bit on the young side these-a-days, because many are still pretty lively.

I think maybe we should each come up with a personalized set of 5 life quality and competency measures that if no longer in place or likely to be put back in place would warrant timely exit. For instance, if/when I can no longer consistently beat the average participant doing Wordle puzzle, that might be a sign of incipient dementia. So, for example:

1) Wordle puzzle fail. 1 month limit and may need to somehow automate exit.
2) Can no longer bake my own cookies and/or clean up broken glass mess from pickle jar when I drop it and it breaks on the floor. 1 year limit.
3) 5 years celibate and counting. Aide smiling while he wipes my ass does not count as sexual encounter. Grouchy old guy falling asleep while fondling me might count.
4) 3 years failure to plant/harvest anything resembling a garden. Reasonably complex terrarium might count.
5) Nothing on the new, new shelf at the library interests me. 1 year limit.


OTOH, I've increasingly come to believe that the sort of rigid rugged independence that sez "I don't want any help from my kids" is sort of bull-shit if you take a multi-generational perspective. For simple example, how would you feel about sitting down with your 12 year old grandchild and explaining to him how he has zero responsibility for caring for your child/his parent as they age? I think the problems that may accrue are really more complex in terms of anybody needing/demanding what some particular other may not be able/willing/wanting to provide in any social context/relationship. For example, it's entirely possible that a human could have three children, loving social circle members, one of whom excels at cutting through bureaucratic red tape, another whom excels at making money/paying bills, and another whom excels at offering warm bedside presence. Like maybe it goes from Family/Charity -> Welfare State -> Complex System of Caring Others Congruent with Personal Philosophy at Level Turquoise.

[loutfard]

My native Belgium currently is relatively easy for people in old age:
- excellent public/universal health care and end of life care
- close to as good as it gets publicly organised care for the elderly
- somewhat decent pensions

All of this is being paid for by the world's highest income taxes and social security contributions in the world. The rather intense government intervention does make building a resilient individual old age policy substantially more difficult.

It's a double edged sword. As long as it works, it's fairly robust. Failure could be fairly spectacular though.

If I may speculate, at least the fairly relaxed euthanasia regulation is unlikely to go in the short to medium term. I realise it's been a very long time since I've heard that described as "assisted suicide". A big no-no over here as a description for euthanasia. Hardly anyone would use that except perhaps extremely conservative religious fanatics.

[guitarplayer]

I realise it's been a very long time since I've heard that described as "assisted suicide". A big no-no [...]

Think @Frita had used a different figure of speech 'self-selected termination' (which by the way sounded pretty intj'y ) and the assisted suicide bit was to do with allegorical interpretation of palliative care.

Coincidentally, just at Christmas I found myself bringing up life choices of the Hardins (of tragedy of the commons).

@J_ has it - reminds me of that essay about a British doctor-turned-sailor, @theanimal shared the other day.

[7Wannabe5]

How about "graceful death choice?"

The primary underlying value of ERE, as I understand it, is reducing expenses towards reducing your share of CO2 burn and natural resource depletion. ERE is also inherent of many other values and preferences which I don't share with Jacob. That is why I said (above) do not look to me as an example for ERE.

I'm going to step-back a bit on this quote of myself from above (and then I am going to shut-up for a bit .) I believe that I am an imperfectly achieved example of a more unusual model that still falls within the general framework of "ERE" (the book.) My lifestyle has been pretty low-rent Renaissance soul, although with different categories preferenced than Jacob. My spending level has been towards eco-sustainable (even when I wasn't making that calculation.) "ERE" the book allows for low earning/low-spending option. In "ERE" the book, Jacob makes clear that his preference for "not losing" towards calm life may not be universal, and is likely not in alignment with all temperaments. One way in which my particular model is imperfectly achieved might be full realization of my own unique Apocalyptic Scenario Survival Skillz Set, which might be less in alignment with being able to outrun/out-fight any predator like Jacob, and more in alignment (if I attempt to fully "realize" it) with foraging for herbs with which to poison the "predator" while pretending like I am harmless. Although, it does seem like I should do some more research and training in creative weaponry. As in, what would McGyver do if he was an older woman who can't do a pull-up or run super-fast? I actually have had the experience of being assaulted by a human who was much larger and stronger than me, so I could try to reflect rationally upon that experience beyond the preventative practices I have already put into place.

I wanted to make this point, because I think the general applicability of "ERE" is one of its strengths, so I wanted to make it clear that my "case" is not a fail of the generalizability of the program. What I meant to communicate was that I am not a good example of "ERE" for somebody who is an INTJ or otherwise more like Jacob in personality type/preferences/physiology, ergo, most other members of this forum.

[ffj]

For those who incorporate high quality end of life care to cover worst case scenario into your FIRE plan, what does that look like? I’m assuming ye old 4% rule is irrelevant. What sort of multipliers or stash sizes are we talking here? What’s the math for this? How did you decide you were done earning?

Around here in my neck of the woods 5-7K/month is what is required to fund full-time care. Ideally, investments should cover the yearly costs without touching the principle which would allow care to continue until death. So you are looking at a couple mil invested if you were to pay straight out-of-pocket.

Now of course there are always work-arounds with the largest pay-off maintaining your health as long as you can. Making yourself knowledgeable about government subsidies such as Medicare/Medicaid, maximizing your choices while not leaving money on the table. Then it is a matter of staying in your home with minimal care until it is not feasible. Family members can be a huge asset at this stage. Hopefully at some point you've acquired LTC insurance to fund your eventual stay elsewhere. And you have secured your investments with a trusted money manager (or family member) that can make decisions for you in your best interests while incapacitated.

It's a lot of work (literally) and planning to avoid being at the mercy of the State. Nobody is sent out on an ice float but with some of these places for the destitute you may wish you had. Hopefully assisted suicide (life-affirming care?) will be available for all of those that qualify soon too as the DIY'er tends to not do a good job of it for all involved. It really should be a choice at some point in some people's lives in a professional manner to lend some dignity back to the suffering person.

@7
Nobody here should care whether they are an "ideal" ERE person or whatever fucking color or Wheaton level to which they think they belong. I really hope nobody out there is reluctant to lend their voice to any conversation because they feel they don't belong. Jacob would be talking to himself if purity tests were required.

[suomalainen]

I am neither ERE/semi-ERE nor past the age of 65, but I have begun thinking of this topic, in some part due to my parents' advancing age, and so I offer some thoughts from observing them:

1) My parents are frugal. They have a 7-figure kitty, but they live off of social security alone and have for about a decade. Perhaps the existence of such an income stream alleviates the pressure on accumulating one's own private stash and/or allows one to "bucket" it for long term care expenses.

2) My own "past age 65" is beyond the 5-10 year fog that @bsog discusses in a post mentioned above. Will social security be solvent enough to cover my expenses in my 70s? Too far out to tell. Likewise with my health status, my social network status, my stash status, etc. I make what reasonable plans I can to be positioned properly 5 - 10 years out, and I trust my 5-to-10-years-out self to repeat the process, hopefully from a good spot with a hat-tip to my 5-to-10-years-ago self.

3) My dad (former physicist, so he's a math/statistics guy) told me once in response to my question about the costs of long term care that the average usage of long term care is something on the order of 2 years. So while $10 grand / month is a lot of money, it's very unlikely to last for a long time. It may be that he's willing to "self-insure" this risk on the basis of their stash and his comfort with the statistics or it may be that he has or will purchase long term care insurance or some such product (if such a thing exists, I know not) at some point in time. I have not raised the issue again, having comforted myself in knowing that he has put sufficient thought into such exigencies.

4) Can bad shit unexpectedly happen, such that your ability to adapt is reduced to zero overnight? Absolutely, yes. Not much you can do about that, but in that 5 - 10 year planning, plans can be made to deal with that (health care directives, powers of attorney, a will, life insurance, private long term disability insurance, etc.).

Put it all together, and the answer for my 45-year-old self is: don't worry about it. If I'm still not demented at age 60, I can start to make plans based on where I am (and the world is) at. If I am demented at 60, I hope that I made appropriate plans at 55, and so on. The plans I have in place now are: I have health insurance and I try to stay active and eat nutritiously to avoid / reduce the risk of lifestyle diseases; I have purchased as much long-term disability insurance from my employer as I can; I trust my wife to make decisions on my behalf and to pull the plug if need be; I try to save some money; I have life insurance and a will. Based on where I am at and my view of where the world is at, I'm as covered as I reasonably can be. Re-evaluate at the next open enrollment if something changes.

[Scott 2]

@ffj - We decided not to buy LTC insurance. From what I understand, coming out ahead is tough. It's basically an annuity, with very complex rules.


@candide - The desire for a legacy makes things a lot more difficult. LTC expenses are life changing money.

While I can make plans for increasing tiers of wealth, they start to look very wasteful. Is that really how I go out? Burning $6k/month to convalesce???

I don't think I've seen enough aging to know the answer. I imagine it depends heavily on state of the world and my path of decline.

It does feel a little cowardly. Hoarding wealth, to hedge my final few % of risk, while so many suffer. I could see eventually shifting my mindset.

It does seem with children, you have the most leverage while they are young. Though - giving well is tricky.

[ffj]

@Suo

I would be careful relying on averages. These cases are anecdotal but I know of three people that have spent or will spend much more than two years in long term care. A friend on mines wife spent close to 10 years in LTC battling Parkinsons and dementia before passing away. A client of my wife almost outlived her substantial investments and finally died at 93 ( my wife said she was really close to exhausting her remaining money ) and an acquaintance just entered the system at 70 and there is no reason for him to die anytime soon and he has no money saved. So far he keeps getting shuffled from one facility to another.

I'm older than you and my wife works in this field so my perspective is a bit more jaded so take that for what it is worth.

@Scott

My mother-in-law has a policy which is a good thing as she will more than likely need it in the future. For her, it costs around $2000/year but at 77 years of age it's a bargain. Right now her kids are determined to keep her at home which is a blessing.

[Western Red Cedar]

@ffj - for some reason I had never considered covering LTC strictly through investment income. Makes a lot of sense. Of course, who knows what the going rate for LTC/nursing homes will be in 20-30 years. Do you have concerns that your plan would only provide for one member of your household? What if you and your wife both need LTC at the same time?

Part of the challenge for me in thinking about this is the amount of "what ifs" that pop up - and the fact that contingency planning can quickly increase the necessary portfolio to support those possibilities.

[jennypenny]

Yeah, I want to know the median length of time spent in LTC. I bet it's an inverted bell curve.


@Chenda {{hugs}} I'll keep your family in my prayers.

[7Wannabe5]

Interesting statistic. The rate of dementia goes up dramatically with age to 33% of the population over the age of 85. So, the need for long-term care, which is over 50% due to dementia as opposed to other conditions, has gone up in direct proportion to the decrease in deaths by heart disease. So, all other things being equal, 85 is probably the best bet for Maude style birthday self-chosen graceful death, and taking up smoking, drinking, and bacon-eating at 70 might be great way to avoid long-term care expenses.

[Jin+Guice]

I thought about this more and I think for me, ending up in a LTC facility would be a personal failure. I think it's a mistake to rely only on monetary capital and not social or other forms of capital. I also think that having no financial plan or wishing this part of life and our modern solution to it away is also a mistake.

Paying strangers to take care of you at the end of your life is a relatively knew and non-ideal phenomenon.

I agree with Mrs. Ego that buying and moving into an LTC facility is likely a bad choice. More specifically it's likely a good choice for your end of life care and likely a bad choice for you until your demise.


Otherwise I agree with what @Henry said. We're unlikely to know what is happening with death or the end of life until it is happening. Not an excuse or reason for no plan, but also a reason that extremely detailed early planning or massive over-saving is unlikely to pay off.

[Scott 2]

@ffj - But what does that $2000/year buy? What are the coverage rules? How long has she been paying? Can the premiums rise year over year? Will the insurer use regulatory capture to renege on premium promises?

https://www.investmentnews.com/industry ... cies-79415

No need to answer, only making a point on the complexity.

From what I've read, policies prior to 2008 could be a good deal. It's also possible after paying in for many years, the LTC plan is a significant asset. Telling that from a short description is impossible.

For me personally - I'd rather peel off as much LTC adjacent risk as possible. Longevity risk - delayed social security. Healthcare risk - the medicare suite. Then looking at the LTC specific risk, decide if it's worth insuring, and how.

When we talk about buy-in to an LTC facility, that is what happens. The up front lump same payment effectively creates an annuity. I wouldn't be surprised to learn the facility has an insurer involved, managing the risk pool.

For me personally - I'd rather not delegate that choice to an LTC company. I see them as another middle-man, with limited value to offer. I'd much rather self-insure, planning to make the annuity purchase as appropriate.

The risk pooling still happens, at purchase time. I'm now betting with the entity I lump sum into. This is why @ego's friend finds such benefit to buying early. It's just like starting the LTC policy when you are young. The cumulative odds are lower, so you get priced into a better risk pool.

The thing that sucks about an annuity, is you could be one of the losers. Pay the $300k buy in and die 6 months later. This risk can be sliced and diced in any variety of ways. But it's never free.


@Suo - The first time I thought deeply about this, was leaving my job at 39. I wanted to understand the paths closed. Age 65+ strategy also features heavily in retirement books. Like you, as my parents reach traditional retirement milestones, it comes up again. While it's a small risk, the severity is high. So I give it some thought. Maybe 2-3 days cumulative planning to date.

[take2]

The thing that sucks about an annuity, is you could be one of the losers. Pay the $300k buy in and die 6 months later. This risk can be sliced and diced in any variety of ways. But it's never free.

To be fair I’m not sure this matters all that much unless you’re equally concerned about leaving an estate (which I don’t think you are?)

[candide]

When we talk about buy-in to an LTC facility, that is what happens. The up front lump same payment effectively creates an annuity. I wouldn't be surprised to learn the facility has an insurer involved, managing the risk pool.

For me personally - I'd rather not delegate that choice to an LTC company. I see them as another middle-man, with limited value to offer. I'd much rather self-insure, planning to make the annuity purchase as appropriate.

Your reasoning is probably correct for your circumstance, but for people entering LTC right now with the boomer wave, I would argue that the higher priority is hedging against LTC price increases, which I imagine will trounce inflation each year at least until 99% of boomers are dead. Buy-in might be the best way to do that.

[ffj]

@WRC

You have to be careful with the what-ifs for sure. But we know for certain we will all die, and some of us will become greatly diminished before that happens. Seems kind of silly to roll the dice on that one hoping for the best, especially when you can witness losing hands all around you. And especially this crowd, the kind of people that obsess over every detail in relation to their freedom. It's sort of like climbing Mt. Everest, when you reach the top it's best to be mindful that you are only halfway done on your adventure.

What if both myself and wife had to go at the same time? I have a pension so the focus is on her. Not to disclose too much of my financial situation but we're good and the longer we live healthily the better off we become so no worries. Keep in mind we are in our fifties so we have had time to accumulate resources needed and we started early. The larger point though is that if you are married there are two of you. That matters.

@Scott

I don't know the fine details of the policy but you are absolutely correct to parse over whether it is worth the cost. My mother-in-law has a chronic condition that only gets worse with age so it was a no-brainer on my father-in-laws part to secure the policy before he passed away. But it's sort of like the age-old question of whether to rent or buy a home: it depends.

@jp

Seems like something one could research easily? Is Google your friend on this one? Maybe, maybe not.

[Ego]

Your reasoning is probably correct for your circumstance, but for people entering LTC right now with the boomer wave, I would argue that the higher priority is hedging against LTC price increases, which I imagine will trounce inflation each year at least until 99% of boomers are dead. Buy-in might be the best way to do that.

It is really difficult to anticipate what the Boomer wave will do to the industry. Right now, most of the very good CCRCs are non-profits with religious affiliations. When screening potential residents, they can eliminate all but the applicants with the deepest pockets, avoiding those most costly to the organization who are likely to run out of funds long before dying. Life extending interventions, which are getting better every day, may be the monkey-wrench in this plan.

The for-profits have been building apartment-style active living facilities in anticipation of the Boomer wave. Their prices are more attractive and they are less selective. Right now their model works because costs are low with relatively young, relatively healthy residents. They are siphoning the profit from the system by selling average apartments at exorbitant prices with the promise of lifetime care. The Boomers will eventually graduate from active-living apartments to more expensive care at the adjacent hospital-like facilities. This will free up space for those who follow, but the costs of taking care of all those Boomers in their last days will skyrocket. As the costs go up, I suspect we will see a wave of underfunded facilities blaming unanticipated longevity for their bankruptcies.

Throughout their life, Boomers have repeated this process over and over again. Underfunding institutions that reach a crisis state, then voting for bailouts as the solutions. But this time things will be different. With half the Boomers dead or incapacitated, they will not be able to use their massive generational advantage to vote themselves a bailout.

Who knows, maybe the prospect of talking mom or grandma back from the bankrupt facility will prompt Millennials and Zs to bailout.

Regardless, this makes it very challenging for those of us who will follow the Boomers to anticipate what will happen.

[suomalainen]

I thought about this more and I think for me, ending up in a LTC facility would be a personal failure. I think it's a mistake to rely only on monetary capital and not social or other forms of capital. I also think that having no financial plan or wishing this part of life and our modern solution to it away is also a mistake.

Paying strangers to take care of you at the end of your life is a relatively knew and non-ideal phenomenon.

I think you're only looking at this from the "patient" perspective. The thing about using social capital to support you in your old age is that you are not bearing the cost - your social network is: friends, family. By some's perspective, it is a burden that they do not want to foist on their loved ones, so they internalize the cost by accumulating money to pay professionals to bear that burden. In other words, there is no "ideal" way to care for a decrepit old person. This is why my dad has made long term care plans. I also do not plan on burdening anyone with wiping my ass unless they're getting paid for it.

Edit - also relatively new: being able to choose not to die from the first (or second, or third) thing that tries to kill you. Without modern medicine, both of my parents would already be dead from heart failures of one stripe or another. See, e.g., @7's point about dementia.

[jennypenny]

@jp

Seems like something one could research easily? Is Google your friend on this one? Maybe, maybe not.

median = 5 months

So not an inverted bell curve. Majority of stays are shorter than 6 months according to the NIH. A few unlucky patients are driving the average way up. I'd only buy the insurance if I had a dreadful family history with confirmation of risk through DNA testing.*


To Seppia's point in the FIRE thread about money being a tool ... we are currently renovating our one-story house to accommodate my mostly-immobile MIL (ADA compliant bath, ramps, etc). There are four houses in our small cabal of EREish people attempting to mitigate aging in place together, and all three two-story houses will also get stair lifts. It's a multigenerational effort that we feel will make it easier to care for people at home and share the burden of care when needed. We are including deep adaptation strategies as part of this process as well. The 'kids' also seem less intimidated by our aging and more interested in participating in the plan since we're including general adaptation strategies and trying as hard as we can to avoid needing any help from them.

We'd rather invest in our future selves who might need the same accommodations as MIL someday instead of buying insurance or saving all of our money until the bitter end. I'd much rather put the money towards at-home care options than pay for care/insurance. FYI two of the four households don't have kids, so having offspring is not a requirement to make this kind of arrangement work.


*Most term life insurance plans allow you to take 50% of your benefit in the last six months of life if you have a terminal condition. That seems like a much cheaper way to insure for typical end-of-life LTC with more upside (albeit for someone else) if you don't need it.