This is a question that is asked of me and often causes controversy among the families that I serve. My goal is to find the best answer, and every situation is different. In the seven years that I have owned my senior living business, no two cases have been exactly alike. However, when a senior is still capable of making his/her own decisions, s/he almost always wants to remain in the home as long as possible. The only exceptions to the rule are if a senior is lonely and wants the socialization of being in a community, ot if medical issues no longer allow the senior to remain at home, or s/he can no longer afford the luxury of in-home care. Placement in a community is often the second choice to remaining in the home and normally arises when the senior is exhausting their funds. However, caution needs to be taken with this strategy, as many nursing homes are requiring a year or even two years of private pay before a person is admitted. This insures against the immediate filing of a Medicaid application, which can take up to a year for a resident’s reimbursement.
If you have a senior loved one who may need some help with his or her activities of daily living, I share below the ballpark figures for non-medical home care and long-term care community costs in the Cook, Will, Dupage, Lake. and Kane Counties in Illinois.
-The costs begin at $18.50 per hour. this is a quote from a licensed home care agency for companionship services. That means the caregiver is keeping the senior company. If the senior requires meal preparation, some help with activities of daily living (like standby assistance with a shower), light housekeeping and running errands, prices range from $20.25 – $22.50 and up. The more help the senior needs, the higher the price. Most agencies like to see a minimum of 4 hours per day. But some will do a lesser number of hours at a higher price. If your loved one requires a live-in aide, I have seen prices on the low end of $185 per day for companionship services. I have seen a variety of prices for seniors requiring more help from $200-$250 or more per day. Bear in mind, these prices on a monthly basis amount to $6,000 and above, which is akin to what a senior would be charged in a skilled nursing community. This means a nurse would be present on a 24-hour basis, and the price is inclusive of the person’s room and board.
Long-Term Care Costs
–Independent Living – $1,100-$3,500 for one bedroom. The senior can live on his/her own with some help with housekeeping. Normally, one full meal is provided.
–Assisted Living – $3,900-$6,000, normally for a studio or small one bedroom. The senior normally receives standby assistance with activities of daily living meaning bathing, dressing, toileting, transferring, walking, and eating with some hands-on care available.
–Skilled Nursing – $6,000-$9,000. The senior needs hands-on care with their activities of daily living and has a medical condition that requires the presence of a nurse on a 24-hour basis.
The answer to the question Home care or placement?, is one that will vary according to the needs of each senior. While I have heard some professionals within the elder care industry make the general comment that it is cheaper to stay at home, I have a real life story below that illustrates how the costs will vary on a case-by-case basis.
Real Life Story
Case 1
My clients were a 70 year old woman and her 90 year old mother. As avid gardeners they enjoyed living in their own home until the daughter’s medical conditions forced them to move to a condo. Her mother was beginning to have difficulty with meal preparation. Both wanted some help with light housekeeping and occasional running of errands. the price given to them by 2 non-medical home care agencies were $20.25 and $22.00 respectively. The would be charged for the use of the caregiver’s care if errands were run. As their condo. was scrupulously clean and they were both still quite independent, they only needed services for 4 hours, 2 times per week. For the cost of a little over $160 per week, why would you consider moving to a community?
Case 2
My client is a man in his early seventies who currently has a full-time caregiver. The cost of the caregiver is $7,500 per month. My client needs help wit meal preparation, standby assistance with a shower, dressing assistance, and medication reminders, and he prefers to have someone available at night if needed. His home is paid off. but, this individual does not have disposable income to maintain the $7,500 per month cost for a full-time caregiver. He doesn’t require one now. a part-time caregiver would be more appropriate. I also noticed during my interview that the caregiver was freely helping herself to the client’s food, which is another cost for consideration. This clients medical issues will require more help down the road. I was able to find placement in a Continuing Care Retirement Community (a community with independent, assisted, and nursing home living on one campus) that would start at $4,600 for assisted living. If he moved now, the community would keep him for life with his current financial picture. It is definitely worth the move.
Many situations will fall in between or outside of the two cases I have just discussed. You need to be cautious of charges that may not occur to you while you are exploring options and are under duress, like the cost of a caregiver’s food if you are going to provide it, mileage charges, or the additional costs incurred for taking Mom or Dad to the movies or out to lunch.
In any case, a spreadsheet will need to be prepared that compares your loved one’s current costs, plus in-home non-medical care, along with the anticipated costs of the future (such as in-home remodeling) vs. placement in a community. I help people analyze and foresee what the costs will be in both situations. Let me help you too!