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As people age, their needs will also change. Some may want to downsize and move somewhere where they can partake in a wide variety of activities, while others may need more help with tasks ranging from cooking and cleaning to bathing and dressing. At some point, you’ll face these issues yourself. But first, you’ll most likely need to help aging parents or loved ones consider the options that are available.
There are a number of in-home care options, and many of them are more affordable than care facilities, especially if a low level of care is needed. Options typically include:
- Nursing registries: Nursing registries match trained nurses with individuals after an illness or accident. These nurses treat medical conditions and assist with physical therapy. Note that registries only oversee the matching process, and do not supervise training or job performance.
- Home health agencies (HHAs): HHAs train and supervise their own nurses. These agencies are usually state-licensed and have Medicare certification, meaning they meet minimum federal standards and accept Medicare. HHAs may also be able to provide you with personal care aides, who may not have medical training, but can provide cleaning, cooking, and bathing/dressing services.
- Local government agencies: Government agencies, like the Department of Social Services, Department of Human Services, or the Area Agency on Aging can also help you source in-home care personnel.
Care facilities are another option for your aging loved ones, and may be a more suitable option for those adults with growing or worsening needs. Options typically include:
- Retirement communities: Residents have greater levels of independence in retirement communities and can order services such as house cleaning or property management. Social activities and interactions are common as residents are all in similar life stages.
- Centers for care: These community centers provide daytime care only. This is a common option for caregivers who work full-time but can care for the older adult in the evenings.
- Nursing home centers: Nursing homes are state-licensed facilities that provide a variety of care, from short-term temporary care following an accident or injury to long-term care if individuals can no longer care for themselves. Care can include skilled nursing care, therapy, and custodial services.
- Rehabilitation centers: Like nursing homes, rehabilitation centers are state-licensed facilities that provide a variety of care services for people who are recovering from an accident or illness. They tend to be affiliated with hospitals and often have more professional therapies available than nursing homes. Medicare limits reimbursement to a lifetime total of 100 days stay in rehabilitation centers.
- Assisted living facilities: Often confused with nursing homes, assisted living facilities are available for people for whom independent living is not appropriate due to disabilities but who do not need the 24-hour medical care provided by a nursing home. These facilities provide supervision or assistance with activities of daily living, such as personal hygiene and grooming, food preparation and feeding, and using the bathroom. They also facilitate the coordination of services by outside healthcare providers and monitor residents' activities to help ensure their health, safety, and well-being.
Paying for elder care
When deciding to pursue in-home care or care facilities, you’ll want to closely familiarize yourself with individual facilities and their costs. Below are some national median figures, although you will want to research local costs to get a clearer picture.
|Type of Care||National Median||Increase over 2015||Five-year Annual Growth Rate|
|In-home Care (custodial care)||$20/hour||2.56%||2.13%|
|Home Health Aide||$20/hour||1.25%||1.28%|
|Adult Day Healthcare||$68/day||-1.25%||2.53%|
|Assisted Living Facility||$3,628/month||.78%||2.53%|
|Nursing Home (Semi-Private Room)||$225/day||2.27%||3.12%|
|Nursing Home (Private Room)||$253/day||1.25%||3.51%|
Source: Genworth 2016 Cost of Care Survey 1
Be sure to ask questions about various options and hidden costs. A semi-private room, rather than a private room, for instance, can save you some money. But also try to balance cost with the quality of care needed, understanding that the less expensive options may offer less in the way in basic services and staff skill. You’ll want to make a long-term plan and make sure that there are enough resources to cover a long stay at the facility. Out-of-state options, perhaps where other family members reside, may provide cost savings.
Learn more about the following when making a plan to pay for care:
- Medicare: Medicare Part A covers medically necessary and skilled part-time care. This care is provided by a Medicare-certified Home Health Agency (HHA) nurse and is supervised by a physician. Rehabilitation centers are included in Medicare Part A coverage. In certain circumstances, Medicare Part B can cover in-home healthcare.
- Long-term care insurance: Policies differ, but long-term care insurance generally covers both in-home and nursing home care and kicks in once the insured can no longer take care of certain tasks, such as bathing, for themselves. This benefit is usually expressed as a daily dollar amount with a maximum benefit amount. Only care as defined in each policy is covered and there may be different waiting periods for various levels of care.
- Medicaid: Medicaid provides assistance to individuals who cannot afford long-term nursing home care. Eligibility requirements differ from state to state, but generally an individual must spend their available resources before becoming eligible. If you anticipate needing Medicaid, it’s helpful to plan more than five years in advance if possible, as government officials may pore over your records going back that far.
Being the caregiver
Another option, and one that is gaining popularity in recent years, is to provide care for an older adult at home.
Family caregivers typically provide a range of care, depending on what the older adult needs and what the caregiver can provide. These services may include personal care such as bathing, dressing, and feeding and everyday tasks, such as providing transportation and managing medications.
While usually fulfilling, there are also negative side effects to becoming a caregiver. You may suffer from poorer health, lower productivity at work, and lost employer-paid health benefits, Social Security, and pension income if you leave your job. While your main goal is to provide care for your loved one, it’s equally important to monitor your own health while caregiving.
Remember to reach out to family members and friends and seek support, as many of your peers are probably experiencing similar feelings. There are also community groups you can join for support and motivation. Some may even be covered under your insurance.
Contact your local Area Agency on Aging (AAA) for more information.
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