Care/Cost: Home vs Nursing Home etc

Caregiving Old Guy is all about providing what’s necessary at home, via this website, so he admits to not exploring other options much.

In an article ostensibly about COVID-19’s impact on nursing homes, journalist M. Jagannathan also discusses corporate issues,  Medicare / Medicaid funding for patients,  some innovations in elder housing and care options.  It describes the big picture, a complicated one, and was informative for the Old Guy.

Home just seems like the most personal, safest and perhaps cheapest option (with better music playlists) while the Old Guy can still get  things done.  He gets help from family or paid caregivers picking up some slack, even has contingency plans, but it’s nice to know what’s available.

Our community seems to provide four basic care and housing options for a person with care needs:  home, with family member care, sometimes with paid caregivers; an “adult family home,” usually a small group with a caregiver on site 24/7; “assisted living,” sometimes apartment-like living with shared dining and activity areas and multiple staff members, and nursing homes, sometimes with specialized dementia or “memory” units.

How much do these cost?  One “referral” website that is very informative and seems reputable, “A Place for Mom,” states that assisted living was about $4,000/month, and that nursing homes cost about $7000/month, in 2019.  The  website has another article about “board and care” homes (called adult family homes around here), saying the cost is anywhere from $1500 to $4000/month.

Guesstimate for 24/7 home caregivers:  24 hr x 7 days x 4 weeks = 672 hrs/month.  If an agency caregiver is ~ $35/hr, that’s ~$24,000/ month.  So any “savings” comes from family care hours (one might write “love,” or “duty”, but it’s complex, ain’t it?)

Of course, adapting a home can also be pricey in its own way: installing ramps, safety bars, modifying bathrooms, accommodating wheelchairs, etc.  So the decision about what’s best is not easy and really depends on the family.

The only things that seem certain are that the need for care increases with time, and planning seems to help.  So good luck to us all!

Addendum:  thanks to folks who responded since the posting earlier today.  Old Guy is pretty naive, and  didn’t know that most of the time quotes in assisted living are for room & meals, but “care” might be an extra charge.  One person’s parents doubled their baseline fees as care needs grew, up to ~$15,000/month.

Another person did find that even in a corporate national chain nursing home, her mom had wonderful loving care, but the costs did increase.  Another person’s father used up all his assets for adult family home care, then local Medicaid became available for the costs.  For those setting up the care, it’s still a crazy hodgepodge of options, but there are some no charge referral and navigation services.