Emigrating From the U.S. May Be the Only Way To Afford Eldercare


A nursing home for my mother in Germany would cost less than half of what she pays in Sacramento.

Later this year, my partner and I plan to marry and move to Cologne, Germany, where he lives, and we agreed to bring my mother with us. So, last September, I visited the Residenz am Dom, a senior care facility in Cologne, and met with Marie-Luise Wrage, a social worker who counsels family members of potential residents.

When it came time to discuss costs, Wrage appeared slightly flustered, concerned that the amounts would be off-putting. First, she explained to me that the German healthcare system uniformly classifies stages of disability and that costs are strictly regulated based on a patient’s needs. The monthly fees for my mother to be housed, fed and cared for at the Residenz, she finally revealed, would come to about $3,200—at which point I revealed that my mother pays more than twice that in Sacramento.

We laughed, but joking aside, agreed: Growing old—or falling ill—in the United States is not for the poor.

The national median cost in the United States for a one-bedroom unit in an assisted living community is now $4,000 per month or $48,000 per year. Alzheimer’s or dementia care increases that cost by an additional $1,200 per month. Seniors must also often plan for out-of-pocket expenses, in some cases up to $2,000 in copays, coinsurance and prescription drugs, as well as amenities not provided by care facilities, such as toiletries and nonprescription medicines.

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