As many as 77% of adults 50 and older want to age in place in their homes… yet 70% will eventually require some assistance to do so.
Consider the following scenarios. Mom has been having increased difficulty with her mobility with increasing knee pain. She has sustained a few falls resulting in ER visits. She is no longer able to effectively take care of the home and her laundry and trash have piled up in an unsustainable manner. Her loving family lives out of state. Dad has been forgetting to take his medications. He has left on the stove or oven a few times without realizing until the fire alarm alerted him. Since then, he has been primarily snacking instead of fixing well-rounded nutritious meals. He has experienced weight loss and increased frailty as a result. These are just a couple examples of scenarios in which the important decision arises—- Should family consider home care services, moving to an independent living facility, or assisted living facility?
HOME CARE
Hired caregivers (either private or from a home care agency) are able to provide hourly care to assist with activities of daily living such as bathing, dressing, toileting and instrumental activities of daily living including housekeeping, meal preparation, pet care, grocery shopping, etc. These services can range to a few hours per week to 24 hour care. This can assist your aging loved one in safely remaining at home. Caregivers can also provided companionship and assistance with community integration at times (transporting your loved one to community events). Costs are typically between $20-$30 per hour. Long term care insurance may cover some or all of the costs of hired caregivers. There are many considerations regarding finding the right caregiver or caregiving agency for your loved one. And keep in mind that many times, there is a trial-and-error aspect to finding the right fit.
If there is a skilled need for home health care and the older adult is deemed “homebound,” the elder’s doctor can conduct a face-to-face visit and order home health services. This can include a nurse, social worker, occupational therapist, physical therapist, speech language pathologist, and bath aide to assist with showering. These services vary, but often provide visits 1-2x per week per discipline. This is a temporary service that will discontinue when goals are met or progress ceases with therapy. Hospice or palliative care are also services which may provide home visits to monitor your aging loved one at home. These services can be ongoing as long as the senior continues to qualify.
INDEPENDENT LIVING FACILITY
Independent Living Facilities are 55+ age residential communities that offer amenities such as meals, transportation, housekeeping for people who are independent with their daily care, medication management and mobility. That is the idea, anyway. There has been a shift in the past decade regarding more and more older adults who require some level of care moving into independent living facilities. Often there are options for private caregivers (such as home care agencies) who can help independent living residents who require some amount of care, however this is not included and would be paid privately to the caregiver or caregiving company. There are also some facilities that have contracted therapy agencies that can address the overall independence and safety of independent living residents through physical, occupational and speech therapy. It’s important to be discerning in understanding the different amenities offered in order to make the right choice of Independent Living Facilities. There are often amenities including activities, games, social events, community transportation with field trips and outings. Independent Living Facilities are excellent for active seniors who seek connections and friendships with others rather than feeling isolated in their homes, and may have some limitations which made keeping up with a home difficult. Additionally, there are safety features including “medical alert” buttons and call cords available to residents in the event they require assistance (such as a fall). Nation-wide, independent living facilities vary widely in the monthly rent— from $1800 to over $6000. The median cost is $3100. This including rent, food, and all amenities of the facility (not caregiving services).
ASSISTED LIVING FACILITY
Assisted Living Facilities have grown in their popularity over the past 30 years as an alternative to nursing home for older adults who require care. People can have assistance with daily care (bathing, dressing, grooming, toileting, assistance with incontinence products), meals, housekeeping and community transportation while not needing to move into an institutionalized medical facility. Although they do have medical staff on site— usually a nurse supervisor, medical techs and personal care aides— they are primarily residential communities with caregivers who can assist with ADLs and mobility as needed to their residents. They often have many perks including activity departments with daily games, social activities, entertainment, church services and outdoors spaces. Many also offer contracted therapy services including occupational, physical and speech therapy. These services can be utilizing to help the residents remain as independent and safe as possible in order to be able to remain at this level of care. Assisted Living Facilities vary widely from area to area, however $5,500 is the medium nationwide cost per month. The cost typically covers everything.
OTHER LONG TERM CARE ARRANGEMENTS
Depending on the needs of the senior, there are other options aside from remaining at home with caregivers, independent living or assisted living. Additional settings to consider include memory care facilities. These facilities are for elderly people living with dementia who require increased care and safety precautions (such as locked units and trained staff). There are also adult day care settings which can be a great resource for some families— especially for elderly parents who live with adult children who work during the day. There are also continuing care retirement communities (CCRCs) which have a continuum of care from independent living, assisted living, skilled nursing and some memory care as well in order to keep seniors in the same community as their needs advance. There are also group living arrangements with variable services and amenities offered. And lastly, PACE programs (Programs for the All-Inclusive Care for Elderly) can be wonderful for families— providing services including a comprehensive medical team addressing the needs of the elderly person and adult day services with community transportation to the PACE center. They provide all services covered by Medicaid and Medicare including dentistry, primary care doctor, therapy services, social services, medications, meals, home visits and more. Where there’s a need, there’s a solution. There are other options not mentioned above, as well, as many long-term care models are continuing to expand to meet the needs of the aging population.
MAKING THE RIGHT CHOICE
At Peace of Mind Aging Consulting, we specialize in providing expert assistance to assess the unique needs of older adults and develop personalized plans to ensure their independence and safety, whether they choose to remain at home or transition to a new living situation. Our team of experienced professionals is dedicated to offering guidance and support every step of the way. Contact us today to learn how we can help your loved one enjoy a secure and fulfilling life as they age.
