What happens to I-bonds if rates plummet again

Discussion of the Bond portion of the Permanent Portfolio

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snedgar
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Re: What happens to I-bonds if rates plummet again

Post by snedgar »

Thanks, Barrett. That's my situation, exactly.

This all makes perfect sense to me. I'm all-in and have been for many years.

The challenge is that as I watch my seniors getting up in age, it is apparent that our investment plan needs to be simple enough to hand off with confidence. And to Vinny's point, although my wife understands in principle what we are doing, there is no way she could manage it on her own. In fact, she probably couldn't even unravel it.

So my current mission is to greatly simply our actual investment life while still maintaining the GB allocation.

I really like Sophie's input to consider just putting the iBond funds in the Treasury Money Market. I hadn't thought of that, but because we already have the TMM, that is definitely a good move.

Next up is to unwind our Perth Mint account. While it has worked exactly as advertised for quite a long time, I am not thrilled with how things worked out over covid. And, maybe more importantly, my wife would have a hard time with managing that, as well. Fortunately, Fidelity has an allocated storage option.
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Re: What happens to I-bonds if rates plummet again

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snedgar wrote: Mon Aug 07, 2023 12:49 pm
Thanks, Barrett. That's my situation, exactly.

This all makes perfect sense to me. I'm all-in and have been for many years.

The challenge is that as I watch my seniors getting up in age, it is apparent that our investment plan needs to be simple enough to hand off with confidence. And to Vinny's point, although my wife understands in principle what we are doing, there is no way she could manage it on her own. In fact, she probably couldn't even unravel it.

So my current mission is to greatly simply our actual investment life while still maintaining the GB allocation.

I really like Sophie's input to consider just putting the iBond funds in the Treasury Money Market. I hadn't thought of that, but because we already have the TMM, that is definitely a good move.

Next up is to unwind our Perth Mint account. While it has worked exactly as advertised for quite a long time, I am not thrilled with how things worked out over covid. And, maybe more importantly, my wife would have a hard time with managing that, as well. Fortunately, Fidelity has an allocated storage option.


I have a huge amount of money in VUSXX, Vanguard's Treasury Money Market Fund. I'm not liking at all that it holds only 70% Treasury bills with the balance being mainly Repurchase Agreements. Which is why I'm seeking to soon replace all of it with direct ownership of Treasuries, both nominal and TIPS.
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: What happens to I-bonds if rates plummet again

Post by ochotona »

I have some spending needs coming in 2026-2027, so I have been selling the I-Bonds with interest rates less than 4% and buying Treasuries maturing in 2026-2027 and locking in a bit more than 4%.
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Re: What happens to I-bonds if rates plummet again

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ochotona wrote: Tue Aug 08, 2023 5:01 pm
I have some spending needs coming in 2026-2027, so I have been selling the I-Bonds with interest rates less than 4% and buying Treasuries maturing in 2026-2027 and locking in a bit more than 4%.


Are those Treasuries tax-sheltered or not?
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: What happens to I-bonds if rates plummet again

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vnatale wrote: Tue Aug 08, 2023 7:57 pm
ochotona wrote: Tue Aug 08, 2023 5:01 pm I have some spending needs coming in 2026-2027, so I have been selling the I-Bonds with interest rates less than 4% and buying Treasuries maturing in 2026-2027 and locking in a bit more than 4%.
Are those Treasuries tax-sheltered or not?
No, they are exposed to taxes. It's a bit complicated. My personal situation requires that I double-down on Roth conversion between ages 65-70. I need after-tax money both to live on, and also to pay conversion taxes. During ages 65-70 I will have no salary, so it's the perfect time to convert, currently I'm 62. I'm running against the clock on Roth conversion because I'm not going to be married for very many years, maybe only until 70. It's quite sad. It has to do with my wife's health status.
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Re: What happens to I-bonds if rates plummet again

Post by yankees60 »

ochotona wrote: Wed Aug 09, 2023 11:33 am
vnatale wrote: Tue Aug 08, 2023 7:57 pm
ochotona wrote: Tue Aug 08, 2023 5:01 pm
I have some spending needs coming in 2026-2027, so I have been selling the I-Bonds with interest rates less than 4% and buying Treasuries maturing in 2026-2027 and locking in a bit more than 4%.


Are those Treasuries tax-sheltered or not?


No, they are exposed to taxes. It's a bit complicated. My personal situation requires that I double-down on Roth conversion between ages 65-70. I need after-tax money both to live on, and also to pay conversion taxes. During ages 65-70 I will have no salary, so it's the perfect time to convert, currently I'm 62. I'm running against the clock on Roth conversion because I'm not going to be married for very many years, maybe only until 70. It's quite sad. It has to do with my wife's health status.


I only asked because with the iBonds you only pay the taxes on them when they mature while with Treasuries you are paying taxes on them yearly.

But quite sorry to hear about your wife's health status.
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: What happens to I-bonds if rates plummet again

Post by sophie »

Still think the ladders are too complicated, Barrett - what you said about your wife not being able to handle it without you kinda says it all.

I can tell you that being a DPOA means you are managing TWO sets of finances and taxes, yours and the person you're caring for. I consider myself pretty investment savvy, but this has been almost overwhelming for me, especially adding in being responsible for my mother's medical care and living situation. She didn't give any thought to simplifying her finances, and even though she has less savings than I do her setup is a lot more complicated. I'm deeply thankful that my mother kept the bulk of her savings in Morgan Stanley with an assigned financial advisor who has been her close friend for many years. All I have to do is email or call him if I need to raise cash or whatever. Morgan's fees are roughly equivalent to hiring a financial advisor privately.

It's not all my mother's fault. The finances of Social Security, Medicare, pension, and retirement accounts are insanely complex. Who thought that was a good idea to foist on the elderly? You pretty much need a financial advisor for those reasons alone.

I've even been thinking that going the Medicare Advantage route might be best for simplification reasons. Yes out of pocket costs can be higher than with traditional Medigap coverage, but it's offset by savings on premiums and some stuff that Medicare doesn't cover, plus out of pocket costs are capped at a level that is quite tolerable if you're not prone to over-using medical care, don't have metabolic disease due to eating a species-appropriate diet, and have an appropriate level of retirement savings. That's probably a very small sliver of the US population but I bet it describes a lot of the older folks on this forum.
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Re: What happens to I-bonds if rates plummet again

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sophie wrote: Fri Aug 11, 2023 9:46 am Still think the ladders are too complicated, Barrett - what you said about your wife not being able to handle it without you kinda says it all.
Well, in general I think you are probably correct, but here are a few things specific to our case:

1) The ladders are not very long (tall?). My TIPS ladder only goes out to January of 2028 and our T-Bill ladders only go out a year with positions maturing roughly every three months.
2) I'm still of sound body and mind (most of the time).
3) There should be plenty of assets outside of the ladders to live on until the ladders mature.
4) I am teaching my wife about personal finance bit by bit. I now have her placing buy and (occasional) sell orders on the Fidelity website with a lot of over-the-shoulder coaching.
5) Our daughter is smart enough to figure this stuff out if she has to.
6) We hired a fee-only advisor last year who could be consulted if I pass.
7) Primary and secondary beneficiaries are named on all of our accounts. Wife is POD beneficiary on all of the I-Bonds in my name.
8) I am delaying SS until age 70 which will ensure a higher benefit for my wife should I pre-decease her.
9) My wife is not a total idiot, she just plays one in real life in certain areas where she counts on me.

But, yes, point taken and simplicity is always a good thing as we age (for us as well, not just for spouses). I even think that a PP spread out over several accounts & a couple of brokerages, and taking into account I-bonds, physical gold, etc. is way too complicated for most folks to figure out. So maybe it's a portfolio that is best held after accumulation and before mental decline which hardly makes it "permanent".

PS. I am not sure how that cool smily inserted itself into my post in place of the number 8, but I suspect it's dualstow's fault somehow!
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Re: What happens to I-bonds if rates plummet again

Post by sophie »

Sounds good Barrett!

Letting the ladders run down is a good escape hatch. And...sounds like you have a fee-only advisor already - ask if they'd be willing to handle financial management & transactions? If so, your wife could always arrange for that if needed when the time comes.

An aside - I've noted that Fidelity's auto-roll function is kinda iffy. About a quarter of the rollovers fail and the money remains in the core account - with no clear notification of this happening. Kind of annoying, as it means if you want to maintain the ladders you have to keep an eye on them.
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Re: What happens to I-bonds if rates plummet again

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sophie wrote: Wed Aug 16, 2023 10:21 am Sounds good Barrett!

Letting the ladders run down is a good escape hatch. And...sounds like you have a fee-only advisor already - ask if they'd be willing to handle financial management & transactions? If so, your wife could always arrange for that if needed when the time comes.

An aside - I've noted that Fidelity's auto-roll function is kinda iffy. About a quarter of the rollovers fail and the money remains in the core account - with no clear notification of this happening. Kind of annoying, as it means if you want to maintain the ladders you have to keep an eye on them.
The guy we have used is on the older side so I may be around longer than he is! But our situation is not very complex and it should be relatively easy to find another fee-only advisor if need be. But your suggestion to kind of scale up financial management with an advisor if needed is a good one.

I actually don't use the auto-roll feature with Fidelity. The buying of Treasuries every so often seems to satisfy my urge to be "hands on". I remember Desert posting about fiddling with fixed-income if one has to fiddle.
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Re: What happens to I-bonds if rates plummet again

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I guess when you're retired, buying T bills yourself could be a form of useful entertainment! I'm too busy right now though.

I had a long talk with my sister last night about another aunt in her 80s who (oddly enough) doesn't have dementia, but still needs a lot of help managing her finances & medical situation. We marveled at how the four of us siblings are now ALL spending considerable time and effort taking care of the elder generation. We were wondering just what's going to happen with us, because we doubt very much that the generation after us will do the same for us when our time comes. They're too busy having fun and letting their parents continue to take care of them even though the oldest ones are now graduated from college and in their 20s - NONE have a job.

And this morning was a long text conversation with a neighbor who is managing finances & medical care for her 90 year old mother....I've been helping her out quite extensively too. As a coop board member in charge of sales & sublets, I also get a lot of queries from shareholders about trust transfers, inheritance, planning for moving to a CCRC, etc. Everyone is struggling with these things.

Anyway, my sister is an accountant and certainly no stranger to financial matters, plus she's been privy to my efforts to manage my mother's finances, but she's overwhelmed by my aunt's far simpler finances and called me for help & advice. The aunt has a valuable property (lives on a a horse farm) with a reverse mortgage and minimal bank savings, and we are scheming about how to get her qualified for Medicaid and for the various senior local benefits she should have been getting all along. In short, it is a LOT of work to take over someone else's financial life and add it to your full plate, when you've also taken on managing other aspects of the elder person's life.

Everyone needs to do what they can to make life simpler for the person who will be managing your finances when you can't do it anymore. In the Good Old Days, it was only about bank savings accounts and a pension. Now, it's about multiple accounts of different flavors at different institutions with a wide variety of rules for DPOAs, complicated transactions with tax and fee consequences, and an extremely complex web of Medicare + private insurance + Medicaid + state/local senior benefits. I just don't see how most people can manage all that without professional help. I have a feeling there will be a major national crisis about this one of these days....unless it's already happening and it's just not on anyone's radar yet.
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Re: What happens to I-bonds if rates plummet again

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sophie wrote: Fri Aug 11, 2023 9:46 am Still think the ladders are too complicated
I've been thinking the opposite. Over here (UK) and our TIPS (index linked gilts) are pretty much at around 1% real yields across the yield curve https://www.yieldgimp.com/index-linked-gilt-yields

Target 2.3% real from that, 33% initial allocation and that spans a 19 year ladder. Another third in stocks and 3% dividends ... proportioned uplifts that 2.3% to 3.3%, a 30 year 3.33% SWR style objective. Spend the bonds, and stock dividends and after 19 years you're left with just the stock and gold, that were initially allocated a third each, so even at 0% real (price only) there's still two-thirds remaining for perhaps by then me needing care. Plus the house. Likely more than enough to see me out and without too much (financial management) burden on the kids, who as you say may very well be more inclined to be disinterested in providing direct care, farm me off to a care home.

It's a very similar situation in the UK, very many near free carers (family), that the state provides very little support to (around $80/week to the carer, $75 to the individual being cared for). But if put into a care home and the least expensive are around $80K/year. Our National Health Service and state pensions were originally based on much lighter loads, the 65 year old retirement age was a year past average life expectancy, so the state on average only funded a single year of pension payments, nowadays and even after increasing the retirement age a few years it can still be 30+ years of state pension years. The NHS was much lower tech back then also, nowadays some even get funded for the likes of boob jobs, too big/small - causing them distress. There's also a army of pen pushers (tablet tappers) that follow each carer/nurse around monitoring them for time and motion, record keeping ..etc. Whereas before nurses nursed and matron did all the commanding, with regimental style efficiencies.

The peak is perhaps the 2030/40's, 1950's/1960's baby boomers, beyond which perhaps the 'burdens' will lighten, a declining average age, the likes of me, that likely had to self fund care via savings and sale of home value.

You're fantastic Sophie, a godsend for your family, I've really struggled with just individuals. Family members decline have been more sequential rather than concurrent (dad, then aunt, now mum). Take care of yourself however, have at least some Sophie time and even a periodic Sophie week (vacation). As much as that might burden others, if you were to drop then they'd have to pick up and run with the ball anyway.
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Re: What happens to I-bonds if rates plummet again

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seajay wrote: Sun Aug 27, 2023 11:18 am
sophie wrote: Fri Aug 11, 2023 9:46 am Still think the ladders are too complicated
I've been thinking the opposite. Over here (UK) and our TIPS (index linked gilts) are pretty much at around 1% real yields across the yield curve https://www.yieldgimp.com/index-linked-gilt-yields

Target 2.3% real from that, 33% initial allocation and that spans a 19 year ladder. Another third in stocks and 3% dividends ... proportioned uplifts that 2.3% to 3.3%, a 30 year 3.33% SWR style objective. Spend the bonds, and stock dividends and after 19 years you're left with just the stock and gold, that were initially allocated a third each, so even at 0% real (price only) there's still two-thirds remaining for perhaps by then me needing care. Plus the house. Likely more than enough to see me out and without too much (financial management) burden on the kids, who as you say may very well be more inclined to be disinterested in providing direct care, farm me off to a care home.

It's a very similar situation in the UK, very many near free carers (family), that the state provides very little support to (around $80/week to the carer, $75 to the individual being cared for). But if put into a care home and the least expensive are around $80K/year. Our National Health Service and state pensions were originally based on much lighter loads, the 65 year old retirement age was a year past average life expectancy, so the state on average only funded a single year of pension payments, nowadays and even after increasing the retirement age a few years it can still be 30+ years of state pension years. The NHS was much lower tech back then also, nowadays some even get funded for the likes of boob jobs, too big/small - causing them distress. There's also a army of pen pushers (tablet tappers) that follow each carer/nurse around monitoring them for time and motion, record keeping ..etc. Whereas before nurses nursed and matron did all the commanding, with regimental style efficiencies.

The peak is perhaps the 2030/40's, 1950's/1960's baby boomers, beyond which perhaps the 'burdens' will lighten, a declining average age, the likes of me, that likely had to self fund care via savings and sale of home value.

You're fantastic Sophie, a godsend for your family, I've really struggled with just individuals. Family members decline have been more sequential rather than concurrent (dad, then aunt, now mum). Take care of yourself however, have at least some Sophie time and even a periodic Sophie week (vacation). As much as that might burden others, if you were to drop then they'd have to pick up and run with the ball anyway.
You might want to check your figures on this.

The thing that matters for pensions (and for health care for the elderly) as regards how costly it is for a given country (assuming everything else about the health care system is kept constant) is indeed life expectancy....but not life expectancy at birth.

You are correct that UK life expectancy at birth in 1947/48--when the NHS came into being--was around 66 years (although the sources I have show closer to 67 years). The issue is that the "life expectancy at birth" is lowered by those who die as babies, in the first year of their life, in childhood or adolescence, as working age adults, in late middle age, etc.

What really matters for the sustainability of pensions and retiree health care is life expectancy at retirement age, not life expectancy at birth. As per the UK's own Office of National Statistics (see https://www.ons.gov.uk/peoplepopulation ... 2015-09-09 ) life expectancy at age 65 at the time the NHS was created was around 11.5 years for men and just a tiny bit shy of 14 years for women. Even if you go back to 1908 (when the UK State Pension was first introduced) life expectancy at age 65 was roughly 10.9 or 11 years for men and maybe 12.1 or 12.2 years for women.

It is quite correct to state that life expectancy at age 65 has increased since those days....but it is nowhere near such an increase as would be the case if life expectancy at age 65 went from one year to its present 18.5 years or so for men and almost 22 years for women; had such been the situation life expectancy at age 65 would have expanded almost twentyfold (whereas in real life it actually didn't quite even double).
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Re: What happens to I-bonds if rates plummet again

Post by sophie »

Thank you Seajay that's very kind!! My sister and I were wondering who will take care of us in our old age. The next generation just doesn't have that same sense of responsibility and dedication to family that was imbued into us when we were growing up.

My point about the ladders wasn't about yield, but rather the complexity of managing them. In theory, there are semi-automated tools that places like Fidelity might offer, but I've found that the auto rollovers fail a large proportion of the time. And, when you're already struggling to keep your head above water due to managing things like the cadre of aides, doctors, medications, therapists etc that an elderly parent needs, handling these little financial tasks is a very unwelcome addition to an already overfull plate. Honestly, once you hit age 80 and/or start to develop significant medical problems and start needing family help, your financial setup needs to be no more complicated than a single stock/bond fund plus a money market fund. Anything more than that and you'd better have a financial advisor in place to handle it.

Taking time off....yeah, wish I could do more of that. I hadn't been considering assisted living for my mother before, because I know she'll react very badly among other issues, but....it is THE only way to get help when you don't have local family support. I do have a great family, but everyone is busy taking care of multiple sick elders and all of my sibs live far away.
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Re: What happens to I-bonds if rates plummet again

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sophie wrote: Wed Aug 30, 2023 12:37 pmTaking time off....yeah, wish I could do more of that. I hadn't been considering assisted living for my mother before, because I know she'll react very badly among other issues, but....it is THE only way to get help when you don't have local family support. I do have a great family, but everyone is busy taking care of multiple sick elders and all of my sibs live far away.
Mum is now in a nursing home, didn't like it at first, but has become more tolerant/accepting of it, on the pretence that its "only a temporary" thing. She's at a stage where she'll nod off and upon awakening again continues her dreams as though reality. So she'll have been around the shops, or had lunch with friends or have taken her dogs (that passed many years ago) around the fields. Or have been waiting in a waiting-room with all these other people for hours and still not having been seen ...etc. In truth she'd better cared for by the staff than what I alone could achieve 24/7.

Predominately owned/run by Sri Lankans/Indians - who seem very good at care. In contrast prior African carers were seemingly more harsh/less caring IME.

Even just trying a number of places, perhaps for a week at a time, is both a introduction for them and a break for you, where you'll likely also gain insight into what each place is actually like that you don't get to see from a brief tour. So if/when a more permanent move does become appropriate at least you know which might be the better placement.

In regards to the total rejection of even just some days or a week long stay, I lied and suggested that it was for medical assessment purpose and work towards improving her mobility/mind, referring to the home as a hospital and the staff as doctors/nurses. In some cases she liked the place and activities/others. Visits were the most difficult, saying goodbye - see you tomorrow ... more often resulted in her also wanting to grab her things/coat to leave with me. Now I tend to just say I'm popping into the loo, or want to speak to a doctor in the office - and just disappear. I'm also trying to leave a day or two between visits as daily has you little to say whilst two or three days between and she's more happier to see me and we have a more enjoyable visit. With daily visits the conversations were more moaning/uncomfortable/awkward.
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Re: What happens to I-bonds if rates plummet again

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seajay wrote: Mon Sep 04, 2023 1:16 pm
sophie wrote: Wed Aug 30, 2023 12:37 pmTaking time off....yeah, wish I could do more of that. I hadn't been considering assisted living for my mother before, because I know she'll react very badly among other issues, but....it is THE only way to get help when you don't have local family support. I do have a great family, but everyone is busy taking care of multiple sick elders and all of my sibs live far away.
Mum is now in a nursing home, didn't like it at first, but has become more tolerant/accepting of it, on the pretence that its "only a temporary" thing. She's at a stage where she'll nod off and upon awakening again continues her dreams as though reality. So she'll have been around the shops, or had lunch with friends or have taken her dogs (that passed many years ago) around the fields. Or have been waiting in a waiting-room with all these other people for hours and still not having been seen ...etc. In truth she'd better cared for by the staff than what I alone could achieve 24/7.

Predominately owned/run by Sri Lankans/Indians - who seem very good at care. In contrast prior African carers were seemingly more harsh/less caring IME.

Even just trying a number of places, perhaps for a week at a time, is both a introduction for them and a break for you, where you'll likely also gain insight into what each place is actually like that you don't get to see from a brief tour. So if/when a more permanent move does become appropriate at least you know which might be the better placement.

In regards to the total rejection of even just some days or a week long stay, I lied and suggested that it was for medical assessment purpose and work towards improving her mobility/mind, referring to the home as a hospital and the staff as doctors/nurses. In some cases she liked the place and activities/others. Visits were the most difficult, saying goodbye - see you tomorrow ... more often resulted in her also wanting to grab her things/coat to leave with me. Now I tend to just say I'm popping into the loo, or want to speak to a doctor in the office - and just disappear. I'm also trying to leave a day or two between visits as daily has you little to say whilst two or three days between and she's more happier to see me and we have a more enjoyable visit. With daily visits the conversations were more moaning/uncomfortable/awkward.

seajay, thanks very much for telling us about your experience. I'm hopefully a ways from dealing with this kind of thing, but it's helpful to begin thinking about it.
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Re: What happens to I-bonds if rates plummet again

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Xan wrote: Mon Sep 04, 2023 2:50 pmseajay, thanks very much for telling us about your experience. I'm hopefully a ways from dealing with this kind of thing, but it's helpful to begin thinking about it.
Like Sophie, I foresee that when my time may come that siblings would just farm me off into a care/nursing home and originally with first hand sight of such I was inclined towards a smoke/drink myself into avoidance of that posture. Now however I'm more inclined towards a 'not so bad' posture and financially prepare for the possibility. Where mum is the care is good, they do daily activities and have some fun/banter in their own way between themselves etc. Typical/average 4 years residency time, multiplied by a high yearly cost but where other factors help to reduce that cost down, such as your pension(s), additional state/health support elements ...etc. where often some capital set aside and/or own home/house value may for many be more than 'enough'. A more significant risk is that of younger age entry, many years, perhaps a decade+ of care/nursing situation, and/or higher nursing requirements ... where the skies the limit and the only protection is having way more than enough wealth than what might more usually be required for a more 'usual' retirement/twilight.

As-is the yearly cost is around $85K. Mum's pension is around $20K, and she's also entitled to a further $7K attendance allowance and $15K nursing allowance (National Health Service, similar I believe to US Medicare). If you can't self fund the Local Authority steps in, but then they define where you get to stay - and obviously go with the least expensive choice, a bit of a lottery, some in the same care home as mum for instance are authority funded, others are elsewhere and in places that you wouldn't even place a dog (a risk for those that are authority funded that sit alongside mum is that they might at any time be moved to somewhere else - presumably as and when such lower cost places become free). That's all inclusive, other than nails/hair ...etc. couple of hundred $/month type additional costs. For us, that $40K additional amounts to find above pensions/allowances is relatively trivial (house and savings combined value of $2M or so). Her current care/nursing needs are relatively light/inexpensive, with progression of her vascular dementia however and more intensive nursing obviously could see the costs spike sharply, but, bluntly, are inclined to be a relatively shorter term cost. For some perspective the average (median) UK wage is around $38K gross, $28K net, compared to around $55K gross I believe in the US, so proportionately scale the above figures by a 1.45 multiple.

The alternative of having living or daily visiting carers wasn't viable for us. Mum simply locked them out, or their actual attendance was too sporadic/unreliable, as was it problematic having different individuals turning up who were mostly minimum wage and not adequately trained for dealing with dementia. Social/life was also more confined, prior regular friends for instance tending to tail off into just periodic courtesy brief visits. I was taking her out for activities most days, but that was hard for me and still pretty isolatory, 24/365 decimation for the single siblings own well-being. Not really healthy for either of us.

A risk for me is that as a baby-boomer there's likely to be very high demand at the time I may need such care, where a highest bidder gets the placement situation could see costs sharply higher, but likely still OK. Before the 'unknown' and seemingly large costs were frightening, knowledge/familiarity however (along with likely having 'enough') has greatly alleviated such fears.
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Re: What happens to I-bonds if rates plummet again

Post by sophie »

Thanks for those insights, Seajay! I will say that the finances of placing a dementia patient in the UK are FAR nicer than what we've got here, which is a big fat goose egg from the government, and prices that will make your eyes bug out.

I researched care facilities in my area, because I finally hit the end of my rope with my mom. She's now got chronic pain to deal with in addition to the psychiatric issues, and it's just got to be too much. On top of that, the live-in aide who has been with us for 1.5 years has decided to go back to Georgia (the country, not the state). It's likely a permanent move. Her mother has developed dementia and she wants to go back and care for her.

So what I found was super interesting. First, most places will not take the 70+% of Alzheimer's patients with behavior problems (a category which includes my mother). Actually I would guess it's more like 90%. In other words, they want to cherry pick the easiest patients and refuse the rest. They may advertise their "memory care" and dementia facilities, but it's just a joke. I found this was true of virtually all the small facilities, and the ones not run by large organizations.

The large-organization ones will indeed take people like my mom, as long as they aren't physically aggressive to the point where staff & patients are endangered. Fair enough. The two I looked at were Brightview and Sunrise (for those in the US, those are big chains with lots of facilities sprinkled everywhere). Of the two, I much preferred Sunrise. They try to keep dementia patients in assisted living as long as possible, and consider memory care as a last resort. Since quality of life is much, much better in assisted living, that was a big draw for me.

My other criteria was whether the facility will allow residents to continue cannabis products. These are very effective for many of the problems that Alzheimer's patients have, although this is based on word of mouth and anecdotal evidence only because there are almost no studies. That's true of Alzheimer behavioral care in general though. My mother has been on CBD oil for a couple years now. I don't know what we'd have done without it. Sunrise is the only facility that doesn't ban it outright. One facility wouldn't even allow Epidiolex, which is CBD oil in an FDA-approved pill.

Now for the costs part....$85K a year, yeah, maybe you'll find that in South Dakota or something, but certainly not in the New York metro area. The facility I picked out for my mom costs around $11,000 a month, or $132K a year. In comparison to the $15K my mother is currently paying out for home care plus home costs, though, it's a bargain. Now you know why I said anyone in the US who wants to be treated humanely after getting their dementia had better have $2 million in assets & income (over a 15 year course).

Interested to see how my mother does in the AL facility, once I make it happen. They will keep her active and engaged, and will be able to stay on top of her medical and psychiatric issues a lot more easily than I can with her at home. I'm sure the adjustment will be incredibly difficult, but she may end up being happy there....hope so. I'm prepared for this to fail, as she does not take direction easily and has been almost fanatically insistent on staying in her house. We'll see.
boglerdude
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Re: What happens to I-bonds if rates plummet again

Post by boglerdude »

^ thanks for update. Looks like ill be forced into Canada's MAID
https://old.reddit.com/r/Futurology/com ... troversial

Lived with grandma during her last 10 years. what TV narratives dont tell you is its not simply "memory loss" like you cant remember where you left the keys. They are always confused - and its your fault - and you are going to hear about it all day every day. Gave me TMJ.

Hit that treadmill and eat as little as you can folks.
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sophie
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Re: What happens to I-bonds if rates plummet again

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Boglerdude, can I quote you on that??? I'm writing an op-ed to submit to the NY Times about this. I've had it. No more Ms. Nice Guy. I've got other places to send it if the NY Times refuses.

I had come to that same realization. One of my statements in the op-ed piece is that the term "memory disorder clinic" is simply evidence that the medical establishment doesn't get it, because that's probably the least of the problems that you deal with in a dementia patient. It's just that those other problems, like psychotic delusions/suspicions and anxiety/blowups over every little thing, are completely ignored. NIH/NIA has zero interest in that, same for the FDA. There are no approved drugs for any of those things, and that's a direct consequence of that lack of interest.

There was a famous neurological patient known as H.M., who recently passed away (there's now a wikipedia page on him). He suffered a catastrophic memory loss after bilateral temporal lobe resections for epilepsy in the 1950s, which started the whole field of studying the role of the hippocampus in memory. If you compare his subsequent capabilities and course with dementia, you'll immediately see the difference: he was quite functional, finding ways to adapt to his memory loss, and lived a long and fairly happy life afterwards. If dementia were all about memory problems, the patients would be no worse off than H.M. I'm at a loss to understand why medical professionals who specialize in dementia don't get it.

BTW assisted living plan is on hold. I figured out why my mom was in chronic pain. It was a side effect of Risperdone (back muscle spasms). She's now switched to Abilify and Cogentin. Pain is gone, mood is better. Guess who had to figure that out: me, and me alone. So now I have to make sure she's on a stable medical regimen before I can think about AL again.
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Re: What happens to I-bonds if rates plummet again

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Our Sophie is back. ^-^
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Re: What happens to I-bonds if rates plummet again

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boglerdude wrote: Sun Sep 17, 2023 5:04 am ^ thanks for update. Looks like ill be forced into Canada's MAID
https://old.reddit.com/r/Futurology/com ... troversial

Lived with grandma during her last 10 years. what TV narratives dont tell you is its not simply "memory loss" like you cant remember where you left the keys. They are always confused - and its your fault - and you are going to hear about it all day every day. Gave me TMJ.

Hit that treadmill and eat as little as you can folks.
Mum's the same. Daily repeats of the same talk item over and over and over again. With frequent swings in emotions, very depressed, angry, scared, assertive, less often happy. When you yourself are OK you can take the insults and blame on the chin ... "its mums way of expressing her emotions". When you've been up all day, and been kept awake all night ... for several nights on the trot, you absorb it more and become depressed yourself. Assistance is more often lacking, mostly pen pushers that come with a tablet, tap in some notes, and disappear. Seems like a world of where no one really wants to do any real work, only the minimum wagers who have to, everyone else wants to be a tablet tapper.

Little things can kick off a entire days talk, a simple advertisement that drops through the letterbox or something on the TV (she periodically becomes angry that the TV News presenter whose looking out at her ... doesn't listen or reply to her). Fears that that cat in that tree is stuck - when its nothing other than a branch of the tree. Or extreme fears as someone is watching her, stared through the window at her, when nothing of the kind actually occurred.

Over here, partners/family who give up work to provide care are aided by a state payment of around $80/week, provided they have no other sources of income above a relatively low amount - is 'a means tested' benefit). The cared for individual can claim $70/week - which isn't means tested. For those with little/no savings that additionally compounds their problems of coping with dementia with financial worries. Yet if the state instead has to care for the individual the costs are thousands/week - but where policies have been directed to make sure they milk every penny out of the individual/family before then (sell the house, use all of savings etc.). A young man crashes their bike, is left in a comma for months, and that's all covered free of charge (to the individual).Dementia ... and you're self funding (outside of a limited/small period of time). Fundamentally discriminatory and more generally (old) age discrimination.

Very much over hear in the UK seems to be a case of education has evolved into being a gravy train, high uni fees, high student accommodation fees - will take near anyone for a placement/course - just to milk the money, and where graduates just seem so lacking, not like uni grads of old. Same for care, predominately a money milk operation, where actual support and good quality care is increasingly rare. Whilst there's a army of individuals across the country who often have given up well paid work to in effect work as 24/7 carers for a pittance, way way below minimum wage levels, not even really bare subsistence levels.

The state doesn't have the money is the usual dismissal, but in other areas can bloat the debt by a trillion at the drop of a hat in order to fund other ventures. Fair enough, blatant age and dementia discrimination has to be accepted, but they could at least spend some on upping the assistance for those that are a carer of a family member with dementia. There's way too many different departments, each sending tablet tappers that more often amounts to just a burden for the carer rather than a aid. Too little in actual real help/assistance. In past times we had Matrons in hospitals, who were the Lady of the Manor, knew their wards, new the staff and patients, got things properly done. Nowadays its those with the tablets that define the gameplay, and from across different departments where any questioning seems to be responded with a not-my-job dismissal. Its similar out in the community, yes there are still district nurses, who once were like hospital matrons, but no longer seem to have the same authority or respect by other departments.
sophie wrote: Sun Sep 17, 2023 10:11 am BTW assisted living plan is on hold. I figured out why my mom was in chronic pain. It was a side effect of Risperdone (back muscle spasms). She's now switched to Abilify and Cogentin. Pain is gone, mood is better. Guess who had to figure that out: me, and me alone. So now I have to make sure she's on a stable medical regimen before I can think about AL again.
You're a true angel Sophie, makes me feel somewhat ashamed and stupid. Your medical awareness is far superior to mine. With mum now in care my prior exhaustion and depression has massively reduced, and I appreciate the nursing homes skills in identifying such issues that more likely I would simply miss. Not the ideal nursing home that I would prefer, but way better than the worst, and moves aren't really viable, and better than what I alone can/could provide. I opine it to be one of the best I'm likely to find such that a search for a 'more ideal' is inclined to result in any move resulting in a greater negative side risk than a upward improvement. I knew little/nowt about such homes before it became necessary, your becoming familiar before such a necessity is a considerable bonus. I got lucky rather than through design.
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