General Medical issues thread

[Quickstatus]

I walked down a dark passageway

Sounded to me (initially) as a dramatic start to a novel

Guilty as charged. Very poor planning with regards to mum and dad. We did not think this moment would come.

In fairness to you, I don't think a lot of people have planned for this either. Effectively and rough round numbers to be self funding in Australia for a nursing home placement can require $1M in savings. So a lot of people if they ever considered it would think what the heck , I'll spend all my assets before I need a NH

 

[prozac]

I walked down a dark passageway without turning on the lights. Crashed to the floor when I tangled with some shopping. Bruised and bloodied I snuck back to the bedroom after wiping off a lot of the blood.
Have decided not to do that ever again as I landed on my re-constructed shoulder and bottom.
Flying home was a bit uncomfortable. I was lucky.

You've had a bottom reconstruction?
That's a new one even for me.

 

[love_the_life]

You've had a bottom reconstruction?
That's a new one even for me.

Apparently derriere augmentation is quite the thing.

Regarding nursing homes, my mother only ended up paying for about 4 weeks of care. She had some respite through DVA, then a try before you buy 2 weeks free. I paid for the it and then was reimbursed from the estate as she had gone in quickly from hospital and didn't have the Centrelink paperwork etc. That was a nightmare as she had money and shares stashed all over the place and no one knew exactly where. Kept finding accounts with $30K etc. Anyway from memory it was about $700 per week at that time. She was adamant she didn't want to sell the house (which as it was she passed away before it needed to be sold).

 

[Quickstatus]

She had some respite through DVA, then a try before you buy 2 weeks free.

In aged care, people get 63 days per year respite which is free

That was a nightmare as she had money and shares stashed all over the place

Same here. Accounts kept popping up like whack a mole

it was about $700 per week at that time

I don't know about DVA but for those self funding, the initial payments can appear to be high. Especially when they have to pay the means test fee . The means test fee is different depending on individual means. It can be up to $35K capped per year, then add on the daily fee of 85% of OAP to see what theytake out of bank account.

The means test fee is also not spread out over 12months - they charge you up to $400 per day toward the annual capped means test fee (for those who have to pay it). It can be anywhere between zero and $400 depending on the amount of means test fee liable - this is worked out again by Services Australia. So whatever the means test fee is for the individual person, the annual cap is reached after about 90 days in a year. After that no further payments are made until the next year when it starts again. The means test fee also has a lifetime cap of up to $85K (again actual number determined by Setvices Australia). This means that after about 2.5years there is no more means test fee and , the only outgoing is the 85% of the OAP.

 

[Pushka]

These fees going to aged care might be somewhat more palatable if the services provided matched the cost. Thankfully mum couldn't see much of what was an issue but we could.

 

[Quickstatus]

the services provided matched the cost.

The problem I think is that the cost of providing the services for many facilities is less than the income generated.

As of November 2025, the facility can retain 2% per year of the RAD for up to 5 years so only 90% is refundable.
Changes to NH fee structure only affect new entrants.

Also as on November 2025 there will be a hoteling supplement of up to $22.50 per day. Services Australia will determine through the same means tests the amount paid by new entrants.
Then depending on liability to pay for the hoteling contribution, the govt has introduced a new payment called non clinical care component also means tested for those who have to pay the full hoteling supplement. The daily cap for this is $105.30. With a lifetime cap of $135K or 4 years whichever is reached first.

It can be good to be poor

 

[mrsterryn]

As of November 2025, the facility can retain 2% per year of the RAD for up to 5 years so only 90% is refundable.
Changes to NH fee structure only affect new entrants.

I realise that the 2% is 'new" again however back in 2014 mum had that as well. Though her bond and the house weren't considered an asset at least initially. Though sold the house whilst mum was in care.
Not sure the caps were in at that time.

 

[tgh]

It can be good to be poor

Indeed, as the goal posts have shifted ; folks who currently consider themselves "comfortable", will find they are likely to live out
their lives at the same social and economic level as someone who has been unemployed their whole life.

Skinning the rich is a badge of honour for the idealistic socialist.

Finding a way to avoid mass market aged care processing is a serious challenge, ; money helps but there is more to the task.

 

[Pushka]

The problem I think is that the cost of providing the services for many facilities is less than the income generated.

As of November 2025, the facility can retain 2% per year of the RAD for up to 5 years so only 90% is refundable.
Changes to NH fee structure only affect new entrants.

Also as on November 2025 there will be a hoteling supplement of up to $22.50 per day. Services Australia will determine through the same means tests the amount paid by new entrants.
Then depending on liability to pay for the hoteling contribution, the govt has introduced a new payment called non clinical care component also means tested for those who have to pay the full hoteling supplement. The daily cap for this is $105.30. With a lifetime cap of $135K or 4 years whichever is reached first.

It can be good to be poor

I’m sure that’s true. Which means the model is broken and the elderly not only stump up their life savings but get less than adequate - or worse - service.

 

[JohnK]

Further, while the marital home is exempt for the purposes of nursing home contributions if a protected person continues to live in it (eg spouse), the moment the spouse does not live in it or the house is sold/transferred (eg into a trust or ownership by another person or entity), it is my understanding that Services Australia will recalculate your dad's contribution EVEN if he is already a nursing home resident.

The value of the marital home that is used to calculate the nursing home contribution is currently indexed at $210,000 per spouse (as per July 2025) - this is called the home exemption cap. Again if no protected person is living in the home.

You and your daughter are not protected persons - unless you are on an Australian income support and have been living in the house for at least 5 years

Interesting.

So if mum transferred house to kids but still lived in house we'd have to still pay $210,000 a year for dads Nursing home costs? Wow. House is only worth just over 1 million so basically gone after 4-5 years care.

Dad is a mess. He's basically given up and with onset of dementia/alzheimers he has lost a grip on reality. I'm not qualified but I don't think mum will need nursing home. Yes, yes I know. She is much stronger than dad and is active in the garden, housework, going out etc where as dad gave up 4-5 years at same age mum is now.

Think we leave things as they are and get wills done for mum and dad (not sure dad is in a state of signing anything including power of attorney) and leave their house to my daughter as my brother and I have decided we don't need house.

What @prozac mentioned makes sense. Set up some sort of trust so that daughter does not lose everything even if she ends up with gold digger. Need to be careful of legal costs as both my brother and I have limited cash funds.

I have read what @Hvr has posted. Great stuff. Lots of work to do but Im stuck in Brisbane.

 

[VPS]

In fairness to you, I don't think a lot of people have planned for this either. Effectively and rough round numbers to be self funding in Australia for a nursing home placement can require $1M in savings. So a lot of people if they ever considered it would think what the heck , I'll spend all my assets before I need a NH

I find this incredibly frustrating. People will get old and need help and it’s much better to do it when you’re all able to make the decisions and not stressed about it. I have a number of people that say I didn’t think my parents would ever die and that they would live forever. Sorry people you do need to be practical and I know it’s hard but it saves a lot of angst later on.

 

[tgh]

A number of friends are now living increasingly simple lives as rampant inflation soaks up their savings and pensions, these
same folks have lived more than comfortable lives while the music was playing….
In general it seems folks don't really plan out very far and do not grasp the math of aged survival.

What do the seriously wealthy do in lieu of the aged care black hole ?

 

[mrsterryn]

A number of friends are now living increasingly simple lives as rampant inflation soaks up their savings and pensions, these
same folks have lived more than comfortable lives while the music was playing….
In general it seems folks don't really plan out very far and do not grasp the math of aged survival.

What do the seriously wealthy do in lieu of the aged care black hole ?

They are in care ? Or they just don't have much at all ?

My view re the bonds for nursing home is I pay for the roof over my head . So if needed my home will be sold to pay the bond. Just a bit different if one of us has to go into care and the other still at home

 

[drron]

A number of friends are now living increasingly simple lives as rampant inflation soaks up their savings and pensions, these
same folks have lived more than comfortable lives while the music was playing….
In general it seems folks don't really plan out very far and do not grasp the math of aged survival.

What do the seriously wealthy do in lieu of the aged care black hole ?

Cruise.
Have met several Americans who have done just that. Cruising on Silversea was less expensive than aged care.

 

[prozac]

Cruise.
Have met several Americans who have done just that. Cruising on Silversea was less expensive than aged care.

You read these stories. Better catering too.

 

[MARTINE]

Better catering too.

Posher gastro

 

[Quickstatus]

So if mum transferred house to kids but still lived in house we'd have to still pay $210,000 a year for dads Nursing home costs? Wow. House is only worth just over 1 million so basically gone after 4-5 years care.

Not sure how you got to $210K per year payment. But it is not true

The value of the house up to that amount (indexed) per person seeking NH care is used in the means test calculation for the :

Means test fee - from $0 to $85k lifetime cap
Hoteling supplement - from $0 to $22.50 per day
Non clinical care component - from $0 to $105k lifetime cap (only if paying the maximum hoteling supplement)

You should always talk to a lawyer or accountant when selling large assets if on an aged pension. Look up "deprivation of assets Centrelink". And remember that once the home is sold the proceeds are no longer exempt and are considered non exempt assets for the purposes of calculating the OAP etc

The idea basically a person's assets should firstly go toward their care first rather than be given to someone else

 

[Quickstatus]

Cruising on Silversea was less expensive than aged care.

How does that work if someone needs 24/7 care or even assistance with daily activities - showering, dressing etc. . Presumably cruising only works if a person is independent with their daily activities

 

[Pushka]

Interesting.

So if mum transferred house to kids but still lived in house we'd have to still pay $210,000 a year for dads Nursing home costs? Wow. House is only worth just over 1 million so basically gone after 4-5 years care.

Dad is a mess. He's basically given up and with onset of dementia/alzheimers he has lost a grip on reality. I'm not qualified but I don't think mum will need nursing home. Yes, yes I know. She is much stronger than dad and is active in the garden, housework, going out etc where as dad gave up 4-5 years at same age mum is now.

Think we leave things as they are and get wills done for mum and dad (not sure dad is in a state of signing anything including power of attorney) and leave their house to my daughter as my brother and I have decided we don't need house.

What @prozac mentioned makes sense. Set up some sort of trust so that daughter does not lose everything even if she ends up with gold digger. Need to be careful of legal costs as both my brother and I have limited cash funds.

I have read what @Hvr has posted. Great stuff. Lots of work to do but Im stuck in Brisbane.

The real costs won't kick in with the trust until after you've died.

 

[tgh]

cruise...

fine, and what happens when you need hospitalisation , the elephant in the room for the cruising aged.
Who wants to cope with being dumped in a third world hospital unable to fly ?
Does the generic American air retrieval insurance cover posh gastro ?

Everyone needs a home but aged care offers a 2* level hotel room (and likely 1* catering or worse) and doesn't seem like a home to me…more like a prison...