TAHLEQUAH DAILY PRESS — Most people don’t like to think about growing old and dying. If they do, they may imagine themselves passing slowly in their sleep, or surrounded by loved ones in their own beds, in the homes they’ve known and loved for years.

But that’s not often the case. Most people today spend their last days in a hospital or in a long-term care facility. And few plan for that eventuality. They may hope to pass their home and whatever savings they have along to their children, only to find their resources exhausted by the cost of care at the end of their lives.

“Most people, if they have a little money, it’s used up in a short time. The majority of people end up on state money, like Medicaid,” said Harold Nichols, ombudsman supervisor for Eastern Oklahoma Development Department’s Area Agency on Aging.

“There probably needs to be more encouragement of long-term planning. Maybe the government ought to offer more tax credits for long-term care insurance,” Nichols said.

In today’s economy, when millions of Americans do without basic health insurance, the additional cost of long-term care insurance is a pipe dream for many. And with baby boomers rapidly approaching the age when they will eventually need long-term care, the problem will not diminish in the foreseeable future.

Nursing home care can cost $5,000 to $6,000 per month – much more than most people have readily on hand. As Nichols said, whatever assets they have usually run out rapidly.

It’s possible to preserve the home and other assets, but this must be done well in advance of the time a person needs to enter a nursing home. Many people fail to do so, Nichols said.

This asset management must be performed five years before the person enters a nursing home.

“A lot of people call trying to figure it out at the last minute. They don’t want to lose the family home,” Nichols said.

While long-term care policies have been available for more than a decade, they aren’t used that frequently, according to his experience. And they don’t always deliver what the purchaser expected.

“Some people have bought long-term care policies and they’re not what they thought they were going to get,” Nichols said.

Some policies don’t cover assisted living, and some don’t allow the person to choose the facility where he’ll wind up.

Nichols thinks it’s time for more attention to be paid to this issue.

“In some countries, part of the payroll deduction that pays for Social Security and Medicare also pays for long-term care,” Nichols said.

Patty Colvin, administrator at Grace Living Center University Northwest, said few people who enter her facility have long-term care insurance.

“I was reading some documentation that about 5 percent of people overall have long-term care insurance,” she said.

That results in a very high dependence on Medicaid, or state, funding for nursing home care.

Some people pay privately when first entering a nursing home. “It depends on how long they’re here and how much money they have,” Colvin said. “They private pay until they become eligible for Medicaid.”

If the patient has a house they may not have to sell it until a year after entering the nursing home to be eligible for Medicaid. Sometimes a person is in a nursing home for a short time to recover from a stroke, injury, or other ailment and are able to return home, frequently with the assistance of home health providers.

Colvin said in many cases, residents enter Grace Living Center or other long-term care facilities because an illness or injury makes it necessary to do so. But many other people come in after it becomes impossible for family members to continue caring for them at home.

“They families have tried and have just exhausted all their resources,” she said. “When they start needing that 24-hour care, the families can’t do it.”

Family members frequently have children and grandchildren who need their attention also, and providing constant care for an older adult adds stress to their lives. In recent years, some day care facilities, such as Cherokee Nation Eldercare, have opened to allow family members a respite while they work or need to do things elsewhere. But in many cases, long-term care is the only solution.

Sometimes a spouse is no longer physically able to care for an ailing husband or wife, with all the lifting, bathing and other physical labor that entails. Frequently spouses spend much of the day with their spouses at nursing homes, going home only to rest a little at night and to sleep, Colvin said.

Another option many residents of Tahlequah – and those who have moved in from elsewhere for the city’s attractive environment for retirement – have taken advantage of is the Life Care program offered at Go Ye Village. About 300 residents inhabit the Christian retirement community along West Fourth Street, said David Williams, director of operations.

“What most people want to do is stay in their home as long as they can,” he said.

They want to enjoy their retirement, travel, be involved in the community.

“What they don’t plan is for the longevity of life,” Williams said.

Most people will need some form of care later in life, he said.

“The average individual assumes that Medicare is going to cover the cost of nursing home stays,” Williams said.

That isn’t the case. Medicare will cover nursing home care for a period of time — such as for someone recuperating from a stroke or a broken hip — but not for someone requiring nursing care for the rest of his or her life.

Between ages 55 and 65 is the best time to acquire long-term care insurance, or begin thinking about other options such as Go Ye Village, Williams said. Prospective residents move to the village when they are retired, still active, and want to downsize their homes and be relieved of the responsibility of caring for their property.

“The Go Ye Village Life Care program is designed for you while you’re still healthy and active, free to interact with others,” Williams said.

The village offers 20 floor plans, ranging from small efficiency or studio units to three-bedroom patio homes with garages. People pay a fee to enter the program. While they frequently must sell their homes to raise the fee, the monthly cost does not go up when they have to transfer to residential care (similar to assisted living) or to long-term care in the medical center.

“The average cost for a resident who needs to transfer temporarily into one of our nursing home units is about 60 percent less than in a standard nursing home,” Williams said.

Frequently one member of a couple transfers to one of the nursing units, and the other remains in the apartment. “They’re still under one roof, so to speak,” Williams said. “The beauty of it is, it’s just down the hall or across the street.”

Spouses and friends don’t have to drive across town to visit someone in the nursing unit, and it’s easy for the staff to get in touch with a spouse should an emergency arise.

The staff also gets to know the residents and their needs, and can help them make decisions about alternatives when they need a higher level of care.

But it’s not intended for people who need a nursing home environment immediately after becoming unable to care for themselves.

“The village is designed, and according to residential agreements, one of our qualifications is that they are able to maintain themselves in an independent living environment for at least six months,” Williams said.

Many of the people at Go Ye are longtime residents, including the first woman who moved in 32 years ago. “She’s still here, which is a testimony to the enhanced quality of life and longevity this type of program can offer,” Williams said.

He said some people believe you have to be wealthy to live at Go Ye, but that’s not the case. Many residents are retired ministers, missionaries and teachers, not professions known for high salaries. Some are from this area, while many others come from elsewhere.

“If you’re going to move here, you feel it’s the right fit for you,” Williams said.

Charlotte and John Kerth have lived at Go Ye for 5-1/2 years. They’re comfortable in their two-bedroom apartment in the main building, and realize the time will come when one or both have to move into one of the units providing more care.

“We priced out villages in different parts of the country, and they were just way out [financially]. We had friends here, we liked the atmosphere of this place. People really care about each other,” Charlotte said. “More advanced care is paid for when you pay your entrance fee, and you’re not burdened with thousands of dollars every year.”

“It’s the security of the village that’s the most important,” John added.

They have enjoyed attending activities at Northeastern State University, at the Tahlequah Public Library, and other events around town. They also have attended church outside the Go Ye complex. And they dine out whenever they want, although they praised the quality of food offered in the cafeteria. They always have the option of eating in their apartment, too.

The villageoffers residents trips to local and area events, and hosts health fairs and other activities in Richardson Hall.

“We have recreation here. I play a lot of pool and shuffleboard,” John said.

“You can be as involved as you want,” Charlotte said. “We’re forever being invited to something, so it’s really an individual choice as to how much we do.”