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Old 14.08.2019, 12:31
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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I always assumed that nobody voluntarily gives up the comfort of their own home to go and live in a single room in a place full of old phobies, where you are told by nurse when to go to sleep, when to get up and what and when to eat.

People who do that don't have a choice. They have reached the point that they cannot look after themselves adequately.
There are all sorts of Altersheim options.

A friend is in a private 'Alters Residenz' where she has her own flat. She has a small kitchen, a nice living/dining room, a main bedroom and a very small office/extra room. The Altersheim has a restaurant, common areas such as a library, games or party rooms, a gym, etc. Transportation options are available.

At the first level of care, residents live pretty much independently, with some light oversight from the staff. Help is there in emergencies.

There are also Pflege- and Dementia care wings for residents who need more care. Often one starts with independent living and transitions to a Pflege wing as physical and mental needs change

From my many visits it looks like a rather nice option. Costs an absolute fortune, though.

But a far cry from the typical image of an Altersheim.

My friend chose this option as she lived alone, her family are no longer in Zürich. She had a fall one night, no one heard her call for help, it took her all day to crawl to the phone to call emergency services. A pretty terrifying experience that underscored just how vulnerable one can be living alone, even when generally in decent health. So she opted for the Alters Residenz, where part of the light oversight is twice daily door checks and emergency call buttons everywhere.
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  #22  
Old 14.08.2019, 12:43
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Re: Does your Krankenkasse help finance your stay in a retirement home?

Here's a link to the cost (broken down into components) in the City of Zurich's nursing homes.
https://www.stadt-zuerich.ch/gud/de/...l#gesamtkosten

The total costs are
  • those standard daily rates;
  • extras that are not included, and also not covered by the medical insurance, e.g. certain types of bandages, or a haircut;
  • actual nursing costs are covered by the medical insurance, but only up to a maximum ceiling;
  • some types of nursing which exceed those limits.

The old person pays this bill out of
  • his/her own pension (the AHV = mandatory social service pension.
  • a top-up benefit called Helplessness Compensation: anyone who is drawing an old-age pension from the government AHV (or for that matter a disability pension, called IV in German and AI in French) can apply for a so-called Helplessness Compensation ("Hilflosenentschädigung", abbreviated HLE) if they need direct or indirect help in basic daily functions such as dressing, washing, eating and mobility. Depending on the degree of frailty, the HLE can be "light", "medium" or "heavy", and each gives an extra flat-rate payment per month.
  • a pension according to the BVG (= mandatory pension plan, if they were employed)
  • any privately insured pensions schemes or lump-sum payouts,
  • the yields of their investments.

If those sources of income do not suffice, then it is expected that the person goes on to use up their savings to pay for the nursing home. This, however, only on until the person has depleted their saving down to certain "permissible" set amounts of assets, i.e. the bit they're allowed to keep and not have to spend it on their nursing home.

On reaching that point, the person can apply for so-called "Ergänzungsleistungen" (known as EL, = top-up benefits to the AHV or IV).

The calculation for the HLE is made only about the degree of help needed, and completely independently of their income and assets.
The calculation for the EL is purely means-tested.

If the patients' own means, plus the HLE, plus the EL are not enough, then the municipality ("Gemeinde") picks up the rest of the tab.

P.S. Please would someone who speaks French and Italian supply the vocab for these terms? Thank you.
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  #23  
Old 14.08.2019, 12:49
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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Well I don’t know anyone who did it by choice! I’d say it comes down to a situation where there is no other choice usually due to health reasons.
The paradox, in Switzerland, is that because the financing comes from so many different sources, and their rules are different for living "at home" or living "in a home", some people end up not being able to afford to live at home, given the level of care they need.

The absolute costs of their living in a home are often much higher than the costs would be of providing them nursing and care in their own homes, but the funding is provided only for the institutional variation. It's a crazy situation.
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Old 14.08.2019, 12:57
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Re: Does your Krankenkasse help finance your stay in a retirement home?

It's nice to hear they have different models of Altersheim here.

Perhaps it's harder to "stay in your own home" here than in the States? The vast majority of Swiss rent, so they still have pretty big housing costs as they age. In the States, every pensioner I know owns the house free and clear, so they only pay property taxes and maintenance. If you're able-bodied or even only a little hindered, that's far cheaper than any monthly rent in a nursing home or assisted living.

For me, not having children, I'll need to plan differently than someone who has a stack of kids and grandkids who can help keep me in my own home until I'm 99.

If Karl wants to leave something to the next generation(s) and Jim doesn't I see no problem with either - as long as those involved know what to expect down the line.

Edit to add - If a person in CH wants to stay home and only needs a little help, I believe Spitex is subsidized by the municipality (it is in my area, anyway). The Spitex people can help with personal care tasks, household tasks, and meals. A few hours of help a day is also less expensive than a home.
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Old 14.08.2019, 12:59
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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If the patients' own means, plus the HLE, plus the EL are not enough, then the municipality ("Gemeinde") picks up the rest of the tab.
If the Gemeinde has to pick up the rest of the tab, one should be aware that the Gemeinde might have a say in which Altersheim one goes to. Or not.

A friend-of-a-friend (so grain o' salt and all that) was in a private place when after some years the money ran out and she needed Gemeinde help. She had to move to the community Altersheim to receive that financial support.

Another friend-of-a-friend (grain o' salt again) was in the same situation. Her community contributed and allowed her to continue staying in the private place.

As with so much here, different practices in different places and cases. Just make sure you understand what your community typically does - even if you think now that you will never need the financial support.
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Old 14.08.2019, 13:18
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Re: Does your Krankenkasse help finance your stay in a retirement home?

This has been discussed in similar threads, but since we are on the subject:

Another option that might help you stay in your own home is Wohnen für Hilfe.

https://pszh.ch/soziales-und-beratun...rtnerschaften/

This is project where Pro Senectute and several universities have teamed up to solve two social problems: the shortage of affordable housing for students and seniors living alone in isolation.

The idea is that many seniors have flats or houses with extra space. In exchange for companionship and a bit of help around the house, students get a room in the senior's home. The 'rent' is one hour help per m2 private room per month. So if the student had a 15m2 bedroom exclusively for him or herself, the rent would be 15 hours of activity per month.

The senior and the student are free to define help as they both see fit. Perhaps a bit of gardening or cleaning help, or maybe some shopping or errand running, or even going to the opera together.

Above and beyond solving the housing/isolation problem, the goal is to try to build bridges between generations.
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Old 14.08.2019, 13:32
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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I always assumed that nobody voluntarily gives up the comfort of their own home to go and live in a single room in a place full of old phobies, where you are told by nurse when to go to sleep, when to get up and what and when to eat.

People who do that don't have a choice. They have reached the point that they cannot look after themselves adequately.
Actually, I know several people who have actually done so out of choice.

On the other hand, my grandfather lived at ome until he died at 103, and my wife's great uncle still lives at home having just celebrated his 104th!

Tom
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Old 14.08.2019, 13:45
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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This has been discussed in similar threads, but since we are on the subject:

Another option that might help you stay in your own home is Wohnen für Hilfe.

https://pszh.ch/soziales-und-beratun...rtnerschaften/

This is project where Pro Senectute and several universities have teamed up to solve two social problems: the shortage of affordable housing for students and seniors living alone in isolation.

The idea is that many seniors have flats or houses with extra space. In exchange for companionship and a bit of help around the house, students get a room in the senior's home. The 'rent' is one hour help per m2 private room per month. So if the student had a 15m2 bedroom exclusively for him or herself, the rent would be 15 hours of activity per month.

The senior and the student are free to define help as they both see fit. Perhaps a bit of gardening or cleaning help, or maybe some shopping or errand running, or even going to the opera together.

Above and beyond solving the housing/isolation problem, the goal is to try to build bridges between generations.
Yes, I have also read very positive reports of this scheme. Pro senectute helps the two parties to think through the contents of the deal and set up the contract. As far as I have heard, there are more students looking for an arrangement like this than seniors offering it.

It's a great idea for any senior who
  • lives within reasonable reach of a university or college, and
  • is fortunate enough to have a home large enough to offer a spare room.
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  #29  
Old 14.08.2019, 17:27
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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I am just looking forward a couple decades.. in the best case each of us will end up in an old folk's home here in good old Switzerland (if we choose to stay here), and I know they are ridiculously expensive, starting at 6K a month for no special care, and the sky is the limit. I know if you are a citizen your local village will cover your costs, but only after you've burned through your entire net worth first. Question: does anyone know if your private health insurance will cover at least some of the costs of long-term care? Or should I visit Dignitas at that stage so at least the kids inherit something.
They are not as expensive as 6000 CHF. Around 3500 CHF was a start price for a room,food in Zürich. The KK pays to a large extent any extra nursing.
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Old 14.08.2019, 19:03
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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Why go to a retirement home rather than live at home?

Tom
That's exactly what we thought with respect to my mom. She lived (alone) in a big house with a beautiful garden, lots of pets and memories etc. Then the falls started. Then her drivers license was revoked due to near-accidents. We hired help and a nurse to check on her regularly, but the place started falling apart.. she would put multiple bowls of cat food throughout the house which became a magnet for bugs. Dementia set in and she could no longer take her large regimen of pills on time, or she would forget completely. The house became a mess. She could no longer cook or shop or clean for herself and would just fry a slab of bacon, leave it on the counter and pick at it for days. Her large house and garden meant she was also isolated from other people which affected her mental health (all kids live far away). So the decision to move her to an assisted living home was unavoidable. Luckily, she had purchased long-term care insurance 20 years before - the place she lives in costs 5K per month for basic care (in Florida). I would certainly want to remain in my home as well, but I have witnessed how circumstances can change to make that option impossible.
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  #31  
Old 14.08.2019, 19:11
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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There are all sorts of Altersheim options.

A friend is in a private 'Alters Residenz' where she has her own flat. She has a small kitchen, a nice living/dining room, a main bedroom and a very small office/extra room. The Altersheim has a restaurant, common areas such as a library, games or party rooms, a gym, etc. Transportation options are available.

At the first level of care, residents live pretty much independently, with some light oversight from the staff. Help is there in emergencies.

There are also Pflege- and Dementia care wings for residents who need more care. Often one starts with independent living and transitions to a Pflege wing as physical and mental needs change

From my many visits it looks like a rather nice option. Costs an absolute fortune, though.

But a far cry from the typical image of an Altersheim.

My friend chose this option as she lived alone, her family are no longer in Zürich. She had a fall one night, no one heard her call for help, it took her all day to crawl to the phone to call emergency services. A pretty terrifying experience that underscored just how vulnerable one can be living alone, even when generally in decent health. So she opted for the Alters Residenz, where part of the light oversight is twice daily door checks and emergency call buttons everywhere.
Tell me what "the typical image of an Altersheim" is ?
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Old 14.08.2019, 19:17
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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They are not as expensive as 6000 CHF. Around 3500 CHF was a start price for a room,food in Zürich. The KK pays to a large extent any extra nursing.
I think you're mistaken, omtatsat. Or do you really know of an old-age nursing home that is cheaper than those run by the City of Zurich?

From the link to the City of Zurich’s municipal old-age nursing homes:

Care costs
60 x 14 days = 840
45 x 16 days = 720

Self-pay
30 x 21.60 = 648

Depending on whether the room is single or shared, with or without its own bathroom, the cost ranges from
Room and food 130 x 30 days = 3’900
up to
Room and food 200 x 30 days = 6’000

That’s
840 + 720 + 648 + 3’900 = 6’108
up to
840 + 720 + 648 + 6’000 = 8’208

before any of the additional charges are added.


Additional charges include, for example,
  • a fee for the staff member accompanying the patient to external appointments such as doctors or dentists, or to a hairdresser or lawyer
  • the haircut itself also charged to the patient,
  • a separate fee for the transport to and from such appointments,
  • telephone costs,
  • any extras consumed in the institution's restaurant,
  • errands such as getting shoes repaired,
  • any nursing or products deemed not to be covered by the medical insurance, which may include materials for bandaging, or a better type of product such as diapers, when only the basic one is covered.
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Old 14.08.2019, 19:25
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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I think you're mistaken, omtatsat. Or do you really know of an old-age nursing home that is cheaper than those run by the City of Zurich?

From the link to the City of Zurich’s municipal old-age nursing homes:

Care costs
60 x 14 days = 840
45 x 16 days = 720

Self-pay
30 x 21.60 = 648

Depending on whether the room is single or shared, with or without its own bathroom, the cost ranges from
Room and food 130 x 30 days = 3’900
up to
Room and food 200 x 30 days = 6’000

That’s
840 + 720 + 648 + 3’900 = 6’108
up to
840 + 720 + 648 + 6’000 = 8’208

before any of the additional charges are added.


Additional charges include, for example,
  • a fee for the staff member accompanying the patient to external appointments such as doctors or dentists, or to a hairdresser or lawyer
  • the haircut itself also charged to the patient,
  • a separate fee for the transport to and from such appointments,
  • telephone costs,
  • any extras consumed in the institution's restaurant,
  • errands such as getting shoes repaired,
  • any nursing or products deemed not to be covered by the medical insurance, which may include materials for bandaging, or a better type of product such as diapers, when only the basic one is covered.
Where I worked it was less than 4000CHF-but thats only for one room single occupancy with shower but without kitchen. Food costs are included in this price. These are the costs if one needs no help with anything. It was not a private home and not a State run home. It was a "Verein"
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  #34  
Old 14.08.2019, 19:37
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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Here's a link to the cost (broken down into components) in the City of Zurich's nursing homes.
https://www.stadt-zuerich.ch/gud/de/...l#gesamtkosten

The total costs are
  • those standard daily rates;
  • extras that are not included, and also not covered by the medical insurance, e.g. certain types of bandages, or a haircut;
  • actual nursing costs are covered by the medical insurance, but only up to a maximum ceiling;
  • some types of nursing which exceed those limits.

The old person pays this bill out of
  • his/her own pension (the AHV = mandatory social service pension.
  • a top-up benefit called Helplessness Compensation: anyone who is drawing an old-age pension from the government AHV (or for that matter a disability pension, called IV in German and AI in French) can apply for a so-called Helplessness Compensation ("Hilflosenentschädigung", abbreviated HLE) if they need direct or indirect help in basic daily functions such as dressing, washing, eating and mobility. Depending on the degree of frailty, the HLE can be "light", "medium" or "heavy", and each gives an extra flat-rate payment per month.
  • a pension according to the BVG (= mandatory pension plan, if they were employed)
  • any privately insured pensions schemes or lump-sum payouts,
  • the yields of their investments.

If those sources of income do not suffice, then it is expected that the person goes on to use up their savings to pay for the nursing home. This, however, only on until the person has depleted their saving down to certain "permissible" set amounts of assets, i.e. the bit they're allowed to keep and not have to spend it on their nursing home.

On reaching that point, the person can apply for so-called "Ergänzungsleistungen" (known as EL, = top-up benefits to the AHV or IV).

The calculation for the HLE is made only about the degree of help needed, and completely independently of their income and assets.
The calculation for the EL is purely means-tested.

If the patients' own means, plus the HLE, plus the EL are not enough, then the municipality ("Gemeinde") picks up the rest of the tab.

P.S. Please would someone who speaks French and Italian supply the vocab for these terms? Thank you.
Here you are referring to a Pflegezentren. Completely different to an Altersheim.https://www.stadt-zuerich.ch/gud/de/...en/kosten.html
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Old 14.08.2019, 19:57
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Re: Does your Krankenkasse help finance your stay in a retirement home?

Oh! Yes, I did mean old-age nursing home.
Thanks for the other link. I'll have look.
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Old 14.08.2019, 20:00
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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Oh! Yes, I did mean old-age nursing home.
Thanks for the other link. I'll have look.
Generally one does not say " old age " . Elderly is more appropriate.
And if the elderly persons money runs out then they come after the relatives to cover the costs
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Old 14.08.2019, 20:19
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Re: Does your Krankenkasse help finance your stay in a retirement home?

Oh, the nomenclature is probably also a cultural difference. Thanks.

Here's the equivalent sum done for the numbers from your link for the "Alterszentrum" (Centre for the Elderly), as opposed to the "Pflegeheim" (Nursing Home) from my link.
Yes, you are right, it is definitely cheaper in an Alterszentrum, but only as long as one is fit and needs neither care nor nursing. I suppose it is a gradual transition if one is not fortunate enough to shuffle off the mortal coil while still fit and active.

Care, depending on the intensity needed
if no nursing or care services are needed: zero
or
30 x 10 = 300
or
30 x 20 = 600
or
30 x 50 = 1’500
or
30 x 70 = 2’100

Self-pay
if no nursing or care services are needed: zero
or
30 x 12.10 = 363
or
30 x 21.60 = 648

Single apartment, single occupation
Room and food 30 x 117 = 3’510
up to
Room and food 30 x 137 = 4’110

That’s
0 + 0 + 3’510 = 3’510 for a fit old-age pensioner in the most modest old-age home, who needs neither care nor nursing,
up through the following levels as they become progressively frailer, or live in a slightly better room:
300 + 363 + 3’510 = 6’108
up to
2’100 + 648 + 4’100 = 8’208.

Plus additional charges, presumably as for the nursing homes.
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Old 14.08.2019, 20:29
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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if the elderly persons money runs out then they come after the relatives to cover the costs
No longer the case.

Tom
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Old 14.08.2019, 21:41
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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And if the elderly persons money runs out then they come after the relatives to cover the costs
I ran this by my kids. They were ok with it.
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Old 14.08.2019, 21:41
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Re: Does your Krankenkasse help finance your stay in a retirement home?

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No longer the case.

Tom
But it's what I read in the link.
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