The sordid reality of retirement villages: Residents are being milked for profit
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I run a weekly route with MealsOnWheels and deliver food/perform wellness checks to many people whom are homebound. There are much worse fates for seniors than a community home with social programs and meal service.
I think it is everyone’s duty to buy long-term care insurance (perhaps the government should provide this, as we will all need it). I also believe you must provide for the retirement you expect.
My company offers one that claims to be reliable (owned by an insurance company that's been around for over 100 years, albeit not in the LTC space).
The one thing I didn't like about them: They don't adjust for inflation. So if you sign up for a $100K plan, you'll get $100K - which will worth a lot less by the time I need it.
this is called Social Security
Rapid population decline is a separate issue that makes this problem seem much worse. In other words, if elderly care works in a steady state population then it’s a symptom here not a cause.
Bloquons tout!
Instead changing demographics means retirement benefits may need to alter their payout formulas, but more prosperity means more money for retirees in absolute terms even if they keep receiving the same percentage of GDP. IE X% of per capita GDP in 2025 is way higher than X% of per capita GDP in 1975 adjusted for inflation easily offsetting increased lifespan. The same is nearly guaranteed in another 50 years.
By maximizing the float you can maximize risk-free returns
One of my Grandfathers just stopped taking medication and going to the docs. And died quite peacefully within a couple years of retiring. Death and decay is just natural and quick. While my other grandfather has been kept alive 30-35 years post retirement popping a tray full of pills everyday, having gone through dozens of surgeries and has had hopeless quality of life post retirement.
The med-industrial complex is a run-away train that is detached for any moral system. It can't even produce any morality anymore. Because its not efficient or rational to do so :)
But this is separate from the question of retirement as such, or the question of aging. Your grandfather, I presume, only refused to take medication and medical treatment, which falls under "extraordinary care", and this is morally licit. Had he refused food or offed himself intentionally (or with "assistance"), that would have been a different matter.
We could just as well ask:
Are you volunteering yourself and your children for 30 years hooked up to tubes with partially effective pain medication?
No one spends 30 years hooked to tubes. Ask better questions, or at least dial back on the hyperbole if you'd like a reasonable discussion.
If possible I would volunteer you and your family to stop getting medical care when all of you get old.
Fair?
We've always lived past our 40s. We just stopped having a bunch of people die in childhood (or birthing children).
https://www.bbc.com/future/article/20181002-how-long-did-anc...
"If one’s thirties were a decrepit old age, ancient writers and politicians don’t seem to have got the message. In the early 7th Century BC, the Greek poet Hesiod wrote that a man should marry “when you are not much less than 30, and not much more”. Meanwhile, ancient Rome’s ‘cursus honorum’ – the sequence of political offices that an ambitious young man would undertake – didn’t even allow a young man to stand for his first office, that of quaestor, until the age of 30 (under Emperor Augustus, this was later lowered to 25; Augustus himself died at 75). To be consul, you had to be 43 – eight years older than the US’s minimum age limit of 35 to hold a presidency."
"As a result, much of what we think we know about ancient Rome’s statistical life expectancy comes from life expectancies in comparable societies. Those tell us that as many as one-third of infants died before the age of one, and half of children before age 10. After that age your chances got significantly better. If you made it to 60, you’d probably live to be 70."
Neanderthal elders probably took on lighter-duty tasks as they aged just like today's elders do.
Children and other family squabble over the assets even before they pass. You'll see neighbors talking senile/demented seniors into giving away their stuff, or selling it for a silly low price (like a truck for a dollar, or my one neighbor asking my other neighbor for a free fishing boat). Then there's the scam calls...
Give it not too much longer, and someone somewhere will make it so debts will be inherited, and then we can all be milked even harder.
In reading the article, it doesn't seem to me that anyone is being taken advantage of any more than all of us are when we walk into a shopping mall, open amazon.com, or buy a home.
It was pretty clear to me they think the entire system is set up so that anyone with needs is milked to extract the maximum possible amount of money.
Elder care is hard, and expensive. Friends have worked in various levels of it at various times, from food services on up. There is clearly some good for people to be around a community and there are real needs that require constant attention for some. But there is a drive to do more with less which almost always seems to end up with stories of people not being attended to as quickly as you might hope.
Memory care is particularly difficult, on the family and on the businesses. It is just so all consuming and from the outside it can be hard to know if adequate care is being taken. Of course I do know someone who's mom put her dad into memory care, then moved and basically started a new life with a boyfriend while still married so she had access to the money.
My parent's solution is to day they don't want to draw things out. But I think that is easy to say from a position of health and barring any significant diagnosis there is more of a slow slide to infirmity than a clear juncture to make such a choice. We'll see, my family is close and I expect we will provide care in person. But also life is complicated and that is a ways off.
A rational society would be regulating those corporations to ensure they act in the public best interest at least some of the time. We're seeing the result of what happens when we are 50 years behind on that. And the current administration is generally rolling back regulations all over.
Think of the money at stake and it will become obvious that our current situation isn't mere happenstance. The chaos is a deliberate smoke screen -- perhaps not exactly planned by the current administration, but orchestrated by the oligarchs behind the scenes.
These days every few months there's a new "accident" reported in these places. They have been destaffed to dangerous levels. Apparently last months' issue was that the administration was wrong. A room that had an elderly person was registered as empty, but had an old lady inside. She starved to death because she was unable to leave the room and "didn't call for help" (probably didn't call loud enough).
That last 20-30 years have seen increasing privatization of services paid for with public funds, in everything from infrastructure, healthcare, eldercare and schools. Of course they maximize profits (maximizing residents, students, patients) and minimize costs (staff, care).
It's the same problem, not a different one.
In public industry the name of the game is to maximize subsidy for minimal actual work done. Lots of people, but nothing happens.
If you were alive in the 80s you would have seen this in action. People who "work" ... but not much at all. Many people, but zero activity. I'm told it was much worse in the 60s.
It could of course pan out like you describe, but the only guarantee for it is if humans are inherently lazy, and while I agree some are I don't believe this to be a general fact. Just look at teachers or nurses for example. They're certainly not doing it for the pay, and a lot of them are absolutely going above and beyond.
Is your claim that not funneling profits to private holding companies and instead hiring extra nurses with that money would not lead to better care? Or what is the comparative claim?
Yes, I was alive in the 80s, and I'm not sure what you're referring to.
It's an incredibly difficult problem with no perfect solution.
Wrong! Because while their house is worth $3M, it will be fully leveraged to pay for the cost of their deathcare. Mom and dad will die broke in a retirement home, and your inheritance will be paying for their funeral out of your own pocket.
"Sell Your Life Insurance Policy. Turn your life insurance policy into an immediate cash payout" next to a picture of seniors vacationing on a yacht. Then they bring out Tom Selleck who looks in the camera and says "Would I lie to you? You can trust me!"
* People complaining that the cafe wasn't as good as they liked.
* The fact that old people have signed up for a retirement village.
* The fact that some of them get confused and need help.
What's the evidence base here?
I think running a care home isn't a great way to make a huge profit.
What I think is more frustrating is that they aren't upfront about the costs; although I think many of the residents wouldn't live there if they were upfront about the costs, even though they can afford it.
Otherwise, it seems like some very basic reform about explaining costs is needed, and some reform to prevent episodes like the lady laying on the floor for 45 minutes.
> when he dies, the company will buy back his share from his next of kin for less than he originally paid.
As a paramedic, this galls me. As much as it galled me that many of these times, the "care team" (mostly LPNs) would call 911, for anything larger than a bandaid, or simple care tasks. Why? "Because of our policy/liability insurance", generally.
The worst part? Often the big sign out front. "Round the clock nursing care!" - and a bill to match.
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You know how you are asked to agree to cookies even though you agreed recently on the same site? It's probably because they added a partner to the 1000 previous ones.
The notice is likely EU (+ UK) specific for GDPR compliance, if you're elsewhere.
> so it's not like they could store data even if they wanted to. I don't need to know about their attempts that are going to fail anyway
They're also using fingerprinting:
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If you're using something like Tor browser that does its best to hide those characteristics then you may be fine.
Not that I'm defending this, it's all terrible. But how many of us reading this article about to stump up for a paid subscription for Unherd? I'd wager next to none.
50 cents flat to read the whole article, without being harassed by aggressive ads or tracked by 900 different companies? I'd be more than willing.
Why micropayments will never be a thing in journalism:
https://www.cjr.org/opinion/micropayments-subscription-pay-b...
How do you know that the next month worth of articles from the publisher you are subscribed to is worth the fee before seeing it?
There is a such a thing as building trust in a brand, this is not a barrier to micropayments.
Asking up front has the issue that you then have to think about money every time you open an article - a lot of friction
People understand you gotta pay to go to the gym. News, on the other hand, you can get for free (give or take ads and tracking).
The gym question is "am I gonna use this?" The news question is "do I need this?" or "is this sufficiently better than the alternatives to justify the cost?"
Edit: and to touch on the "per-article" aspect, odds are that people might spend let's say ~$2/month with a publisher through article reads, but not $5/month for a subscription.
I'd say I read an average of 10 articles per day (with various definitions of "read"). I can't see myself actually spending $5 a day.
At that point I'd be better off getting a few news site subscriptions, but I also highly dislike the idea of committing to a single news source, and committing to a few isn't much of an improvement.
Of course, you could introduce a "tip after you read" mechanism, which I assume would generate probably about 50c per article, and probably motivate various "remember to tip" mechanisms that (I suspect) the same people who say they'd pay/tip would hate with a passion.
No one’s successfully done this because when they do they want to individually price articles and consumers like you for some reason want to attach a per-word-price for each article.
Implement a legitimate system and people will use it. Implement a system with work arounds and people will use the work arounds.
But different articles are worth different amounts of money. You can't really escape that fact. If a news org has spent three months doing a deep dive into political corruption and created a blockbuster report on it, in what world can it be justified for that to be the same price as someone recapping last night's episode of Survivor? This is all covered in the article I linked to.
> Implement a legitimate system
By whose definition of legitimate is the question, I guess. I think it's very easy to stand on the outside and say "duh, just do it the right way!".
It's not like things haven't been tried.
- Blendle: https://en.wikipedia.org/wiki/Blendle
- Scroll: https://en.wikipedia.org/wiki/Scroll_(web_service)
- Google Contributor: https://en.wikipedia.org/wiki/Google_Contributor
- Axate: https://www.axate.com
- Coil (to an extent): https://coil.com/
All these people tried to solve this problem and weren't able to.
This sounds like no true Scotsman.
I guess it's tautological that nobody's tried the right model because nobody's been successful.
Ancestor comment https://news.ycombinator.com/item?id=45302115 already starts with the context of not wanting to subscribe to a random site, so I don't know how we don't end back up exactly there to have a non-leaky system with micropayments on top?
It worked well, I loaded it with about $3 and used it a few times.
Clearly not something publishers are fans of though as it's far easier to carefully select 987 partners to sell your data to.
They say stuff like they whitelist, or donate (it certainly brings lots os social praise) but if you have ever been on the other side, you know that virtually nobody does this.
The overhead, as a consumer, of managing any of this as actual subscriptions, transactions, or membership to some (likely multiple) sort of ecosystem would be substantial, even beyond just the money aspect.
Want to read that NYT article? Fine, pay the 30 cents and read it. Want to read all the NYT articles? Subscribe for $20 a week.
If Youtube wasn't owned by an advert company you could have the same -- creators could have a "pay 50c to watch this 30 minute video without adverts". I believe (haven't had youtube adverts for years) that the ad rates for western viewers are under 1 cent per view, with 1 advert every 5 minutes, so a 30 minute video would be 6 adverts or 5 cents. Youtube even has the funding built in via the "tip" mechanism.
You are getting older and can't take care of yourself. You worked hard your entire life so you have non-zero assets.
Your options are: Sign away everything you have and more to a company in the hope that they will take care of you according to the contract. Or die in your own filth or from tripping and falling in the tub.
Medicare doesn't take care of you until you are destitute, so your only option is to pay whatever a company is asking.
These companies charge $20k a month, but pay their actual laborers peanuts, like we are talking hourly wages that are barely competitive with good construction jobs despite requiring training and spending all day literally wiping down human shit. You will be lucky to have one employee taking care of 30 of you.
All that money is just fed back to shareholders. And building real-estate in the priciest parts of built up cities. Grandma literally can't leave the facility because she's got the dementia and the kids are all in another state so why even build the facility in the middle of a city with skyrocketing housing costs and real-estate prices? Because your clients will pay anything, and that will leave you with a great high value asset that a facility out in a cheaper area would not.
It's just a neat little system for ensuring all those savings and retirement accounts built up by the boomers will not be inherited, and instead will be captured by very very wealthy people.
What possible mechanism could there even be for downward pressure on prices in this system? What are you going to do, NOT need help in your old age?
their buy-back prices dont let them reap the windfall from the wild growth of housing prices? or that they're complaining about too many "old people" in a retirement home? they need to pay 5 quid for a beer?
Surely, some of these people blocked development and did everything they could to boost their personal net worth at the expense of younger generations. Other people did the reverse. Most people just went with the flow and didn't bother to vote either way.
Residents face service charges averaging £524 a month, on top of ground rents that can exceed £500 a year.
£500 a year would be implausibly low. I suspect a few missing nils or a thousands indicator.
I gather this is about retirement villages in the UK; are retirement villages new there?
No job? No life? Stay here eating, sleeping and fucking around until some opportunity comes up.
These living communities are meant to house you, until you die, for a price. You have saved up money to pay for that service until you die. Why would they leave money on the table? Why would they spend any extra on someone who's "going to die anyway". Someone who is barely ambulatory; who has few outside connections.
It's the horrible result of end stage capitalism, but it's hardly unexpected.
Because if they don't, the customer will go to the competition who does.
The reality is that once that elderly person has moved to the retirement facility, they're pretty much a locked in customer. The firm (sadly) can pretty much do with them as they please within the extent of the law.
You are NOT going to be changing houses and care homes very regularly past a certain age.
The animal that you pilot, will simply not have the capability to power through the change, remember every item, keep on top of documents, bills and more. You will not necessarily have friends and family to help you through this.
Going to court is unpleasant, since it will mean you are going to spend the rest of your life fighting. You may count on the fact that some portion of people will be fighters, and willing to sue, but thats statistic is of little comfort if you are the one fighting.
Wringing the elderly for profit would not happen under any other economic system because Capitalism is the only economic system which puts profit as the central motivation.
My understanding is the profit is purely a capitalistic idea. Feel free to prove me wrong.
The above is a bunch of non-sequitur nonsense.
The article is about how senior living facilities do everything they can to reduce cost/liabilities and to maximize profit. Did you actually read it or are you just posting contrary comments?
I responded to the article that under capitalism, of course these firms are going to maximize profits. Even when doing something that most of us would consider a humane responsibility like elder care.
You asked me why do I limit profit seeking in this manner to capitalism, seemingly not knowing that profit is a Capitalistic idea. And then you non sequitur into whether elders are taken care of under all economic systems and what motivates that.
THE POINT BEING MADE is that regardless of what the outcome of the situation is, elders being taken care of, elders not being taken care of, houses being painted red vs blue, etc, it is unsurprising that firms are seeking maximize profit. The question to be ask it is why they would not seek profit, under capitalism.
The last time Capitalism went unchecked and tried to eat itself was the Great Depression. That was ended by controlling Capitalism with strong regulations, high taxes on the rich, and pervasive union membership of workers. And the Social Security system and Medicare were also a part of that deal.
When people talk of "end stage Capitalism" all they are saying is that they lack the will and the power to use the tools we already know work to solve these problems.
> a yell cuts through the noise; an older lady has fallen by the serving hatch and is unable to stand unassisted. “Would you give me a hand, sweetheart?”, she calmly asks, “Don’t touch her!” the bar manager snaps as I bend towards her. “You’re not allowed to touch her!” The woman blinks up at me, confused. “We have to call the care team — otherwise she could sue.” And so, for the next 45 minutes, she lies there
That's nothing to do with profit. Nonprofit and government-run facilities are just as strict about following legally dictated rules to illogical and counterproductive results as for-profit facilities are.
I'm actually impressed that the author found so little to complain about.
On the supposed topic of profiteering, the article is frustratingly light on analysis. It's presented like it's going to be an exposé, but then he gets distracted by his own discovery of the horrors of aging:
> it’s hard to feel sentimental when I recall my own experiences: shepherding confused residents to the toilet; placing cones beside rogue deposits in the restaurant; mopping up suspicious puddles (custard, John Smiths, or other); nudging care teams about overstuffed stoma bags; and politely reminding people of where exactly they live
> It strikes me that no matter the service charge, or the quality of the restaurant — which John chides as “more like a backstreet cafe” — or whether privately owned or council-housed, you may still end up defecating onto your shoe in the middle of a bistro. No amount of ground rent can protect your dignity when there is an intrinsic lack of it in ageing
> “How’s Harry?” I ask. “Dead.” “Helen?” “Dead.” “Lucy?” “In care.” “Pirate Paul?” (he wore an eye-patch and a cap with an anchor on it.) “Dead, I found him.” “Mary One?” “Alive.” “Mary Two?” “Nope.” “Bombay Jan?” “In the bar.” “Little John?” “Had a fall”.
It might have been a better article if he had spared us his personal feelings about aging -- his most interested readers have nothing to learn from him on that topic -- and dedicated those inches to the economics. All he manages to tell us is that people are paying quite a bit, which means nothing in isolation. Are there examples of how it can be done for less?
It also glosses over some details that seem important for analyzing cost and comparing to alternatives, like what level of assistance is provided, though I'm American and this is perhaps not an issue for British readers. (The existence of "care teams" that attend to falls and stoma bags shows that "independent living" means something different in this context than in an American one.)
Speaking as someone with an aging parent who will likely need some kind of daily assistance in the 5-10 years if not sooner, the picture painted by the article doesn't sound like a bad way for my mom to spend her remaining years. I'm not seeing the "sordid reality" the headline promises.