When evaluating long-term care options most people eliminate the possibility of home care because of the potential cost. With rates ranging for $17 to $25 an hour, it’s easy to understand why people would lean toward more traditional forms of long-term care like nursing homes and assisted living facilities.
Adding to the perception that home care is too expensive is the lack of funding sources available. Most people assume that insurance eventually picks up the cost for facility-based care while care provided at home is completely out of pocket. The fact is that most types of long-term care have some out-of-pocket cost. That said even home care can be subsidized through local government and not-for-profit agencies.
A Case Study
In the process of planning for long-term care, many of my clients are surprised to learn that they can receive care at home for less than what you would pay a nursing home or assisted living for long-term care. It just a matter of taking at the same expense (long-term care) and applying it a little differently.
Jane Smith is a recently widowed 75 year old woman who needs daily help at home. Mrs. Smith has severe arthritis in her shoulders which limits her ability to take care of herself and Chronic COPD which limits her endurance. Otherwise Mrs. Smith can walk safely around the house and show no signs of confusion or Dementia.
After the recent death of her husband, Jane finds that she needs assistance with everyday tasks like dressing, bathing, cooking and other household chores. Those are things her husband used to do for her but after his passing her children don’t have time to help as much as they would like.
Mrs. Smith would like nothing more than to age in place at home but has recently been asked by her children to consider assisted living because of the care she needs. If she just had a little help to get through her day, she could live happily and healthy at home. The problem is that her family doesn’t have the time to consistently provide the care she needs when she needs it.
It easy to see why the family is concerned. Mrs. Smith does need help and without the proper assistance her health could decline to the point where she has an accident or needs to go to the hospital. The family is correct in looking for ways to get their mother the care she needs. But does she need assisted living? Her health condition suggests that targeted home care service could help her stay at home.
According to the Assisted Living Federation of America the average monthly cost for Assisted Living is $3,000. That is within Mrs. Smith income range and could afford her a comfortable stay at her local assisted living.
For the sake of this article we must understand that Mrs. Smith’s long term care expense is inevitable. Whether she decides to stay at home or go to an assisted living she will have to spend some of her monthly income on long-term care services. Now it’s just a matter of spending it in a way that provides her with the care she needs in a place she is comfortable with.
Elder Centered Approach
By using an Elder Centered approach we can apply home care services to Mrs. Smith’s specific needs thereby using her resources more efficiently. Here is a quick review of Mrs. Smith’s needs. Her arthritis makes it difficult for her to get dressed and cleaned up in the morning. Her Chronic COPD and shortness of breath prevent her from having the endurance to complete housekeeping and cooking chores. Because her mobility or mental capacities are not impaired she doesn’t need 24 hour assistance.
What Mrs. Smith needs is a home health care aide to come in the morning and help her start her day. A home health aide could come to her house help her get up and get dressed. Afterward the aide could complete the housework and prepare meals for Mrs. Smith that she can easily heat up later. That is just four hours of service a day. At $20 an hour that cost is $2400 a month. That is $600 dollars less than she would pay in the assisted living while getting the opportunity to stay in her family home. In addition the care she would get in her home would be one-on-one care.
This illustration isn’t meant to espouse the virtues of home care but rather to show that options exist when developing a long-term care plan. That is why it is important to investigate your long-term care options now and not get fast-tracked into a nursing facility simply because you are uninformed.
Contact Elder Advocacy Group if you have any questions about long-term care costs and how to develop an elder centered plan for you or someone your care for.