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The 64,000 Dollar Question, Give or Take a Few Grand

Approximately 40 million Americans today are caring for an elderly loved one. Are you one of them? The demands of caring for an elderly loved one along with your own family can be physically and psychologically challenging. If you are employed, the additional responsibility of becoming a family caregiver might not be feasible for your schedule. In addition, the role reversal experienced between the “adult-child caregiver” and the elderly parent can lead to resentment and stress. If you must relinquish caregiving responsibility, the question ultimately becomes, “Should I place my loved one in a long-term care community or hire someone to help care for him/her at home?

This question is continually 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 nine years that I have offered my senior living services, no two cases have ever 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 exemptions to the rule are if a senior is lonely and wants the social benefits of being in a community or medical issues no longer allow the senior to remain in the 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 his/her funds. However, caution needs to be taken with this strategy as many nursing homes require 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 entail months for a long-term care community to receive reimbursement (from the state) for a resident’s care.

If you have a senior loved one who may need some help with the activities of daily living in the future, ballpark figures (based upon national averages) for non-medical home care and long-term care community costs are listed below to assist in making your decision:

Licensed Non-medical Home Care
The national average for this type of care is $20.00 per hour. A private caregiver will assist a senior in his/her home with activities of daily living (bathing, dressing, transferring, toileting, walking), meal preparation, light housekeeping and running errands. The more help the senior needs, the higher the price. Most agencies like to see a minimum of 4 hours of service per day. But some will provide a lesser number of hours at a higher price. If your loved one requires a live-in aide, prices may average $220 – $250 or more per day, depending upon where the senior lives. Bear in mind, those prices yield a monthly basis average of $6,600 and above, which is akin to what a senior would be charged in a skilled nursing facility. That 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
Assisted Living: $3,900 – $6,000, normally for a studio or small one bedroom. The senior normally receives standby assistance with the activities of daily living, meaning bathing, dressing, toileting, transferring, walking, and eating, with some hands-on care available.

Skilled Nursing: $4,200-$27,130. The senior needs hands-on care with the 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 questions, Home 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 actually cheaper to stay at home, I have some figures below to share with you that illustrate how the costs will vary on a case-to-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 had enjoyed living in their own home until the daughter’s medical conditions forced them to move to a condo. Her mother was also 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. They would be charged mileage for the use of the caregiver’s car if errands were run. As their condo was scrupulously clean and they were still quite independent, they only needed services for 4 hours, 2 times per week at the outset. For the cost of a little over $160.00 per week, why would they consider moving to a senior community?

Case 2
My client was a man in his early 70’s who at the time had a full-time caregiver. The cost of the full-time caregiver was $7,500 per month. My client needed help with meal preparation, standby assistance with a shower, dressing assistance, and medication reminders. He preferred to have someone available at night, if needed. His home was paid off. But, my client didn’t have disposable income to maintain the $7,500 per month cost for a full-time caregiver. I noticed during my interview that the caregiver was freely helping herself to the client’s food, which was another cost for consideration. This person’s medical issues would require more care 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 immediately, the community would keep him for life with his current financial picture. It was definitely worth the move.

Many situations will fall in between or outside of the two cases I have just discussed. You need be mindful of charges that may not readily occur to you when under duress, like the cost of the caregiver’s food if you are going to feed him or her, the 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 anticipated costs of the future (such as in-home remodeling) vs. placement in a community. I help people analyze what the costs will be in both scenarios.

You may want to keep handy this checklist. It will help you to make some tough decisions.

To begin your cost comparison of in-home care vs. long-term care community placement for your elderly loved one, please have the figures in the checklist prepared in advance, so if a crisis hits, you are ready.

For all of your senior living needs, contact Andrea Donovan Senior Living Advisors. Call us at (708) 415-2934 or email us at Please visit our website. Please watch my video to learn how the process works.