Family Update
We're heading up to Pittsburgh for a week, our annual trip to see Grammy and Pop. The kids want to bowl and catch a Pirates game. It's always a good reminder for them of what it feels like to walk around a real city. Chris isn't a fan of that part. Honestly, neither am I.
The lanai extension is finally done. It was supposed to take three months. It took eleven. I have come to believe that contractors exist in their own relationship with time, one that has very little to do with the calendar the rest of us use. And here's the thing: they all do it, so none of them feel particularly bad about it. You have no real leverage. They have your money. You have a hole in your house.
We've been watching some USA World Cup soccer. I want to be into it. I really do. But I just can't quite get there. I suspect that if I understood the rules and strategies better, it would be more interesting. For now, I'll keep trying. As my son Alex put it: "Dad, this game is basically just people kicking a ball around." He's not wrong.
If I’m honest, this is the hardest conversation I have in this business. Harder than market downturns, harder than tax questions, harder than anything about money itself. It’s the conversation about long-term care, about a parent, a spouse, or even yourself someday needing more help than home can provide.
I want to share some numbers with you, not to make this clinical, but because, in my experience, fear grows the most in the dark. A lot of the dread I see in this conversation comes from picturing something worse than what’s actually true. So here’s what’s actually true.
Assisted living isn’t what people picture. The national median cost is around $6,200 per month, or about $74,000 per year. That’s real money, but it’s a manageable, predictable expense. Many families can get by for a couple of years without the wheels coming off the plan. And if you haven't toured an assisted living facility recently, many are surprisingly nice places with social activities and good care.
Nursing home care is the expensive tier, but it isn’t the terrifying unknown that people imagine. A semi-private room runs about $115,000 a year, a private room around $128,000. This is the level where planning matters most, and where Medicaid exists specifically to help.
Most people picture the moment Medicaid kicks in as something out of a Dickens novel. The staff wheels you quietly down a long hallway, past the nice wing with the piano and the fresh flowers, through a set of doors that creak, and into a dimly lit room where a single bulb flickers overhead, and someone slides a bowl of gruel under the door twice a day.
That is not what happens.
In reality, it's usually the same building, the same staff, the same room. Nobody comes to collect your good pillow. You don't have to sleep on the floor. If you self-paid your way into a facility and later qualify for Medicaid, most places don't make you move at all. You've already established residency. They simply continue caring for you and send the bill to a different address.
The hardest part usually isn’t the money. It’s the conversation itself, and the guilt that comes with it. Getting a parent or spouse to agree to the move is often harder than anything on a spreadsheet. Nobody wants to leave a home they’ve lived in for decades, and that’s completely understandable. It should be honored, not dismissed. But something I’ve seen over and over is that once someone actually moves in, they often wish they’d done it sooner.
Regular meals, people to talk to, staff checking in, and activities to look forward to. Home is often dangerous, and often the families trying hardest to keep a loved one home are also the ones quietly running themselves into the ground trying to provide care they were never equipped to give.
It’s also usually a shorter season than people fear. The average stay in assisted living is about two years. The average nursing home stay is roughly a year to a year and a half. This isn’t a life sentence. It’s a chapter, and a shorter one than most people brace themselves for.
Here’s what I want you to take from this. The scenario you’re most afraid of, running out of money in a nursing home, has a real safety net built for exactly that situation. And the more common scenario, assisted living, is more affordable and often more life-giving than people expect. It's still not fun to talk about, that's for sure.
Be Blessed,
Dave