Learn the pros and cons of in-home senior care vs. assisted living to determine which would be the correct fit for you or your family.
THERE COMES A TIME IN most seniors’ lives when medical conditions, loneliness or an inability to care for oneself force families to decide about where a loved one should be living. Often a decision needs to be made between staying at home with the assistance of a caregiver or moving to an Independent or Assisted Living community. Each decision is an intensely personal one, and families must consider many factors when trying to make the right decision.
What Is Senior Home Care?
Senior home care is provided to a senior in his or her own home. Typically, services include assistance with activities of daily living, such as bathing, dressing, toileting and household tasks such as cooking, cleaning and running errands. Many families hire an agency that sends a caregiver to the home for several hours each day or a few times a week, depending on the senior’s needs. A live-in caregiver is another option that some families choose. Most insurance plans do not cover these services and can be quite expensive.
What is Independent Living?
Independent Living Communities are designed for older adults who are still active and independent but want to take advantage of community living and the amenities that come with it. Communities usually include many opportunities, including social, educational and recreational activities. Independent living offers residents convenient amenities that allow them to fully enjoy retirement. Some of the more common amenities include exercise facilities, a library, housekeeping and dining services, to name a few.
Living in a communities give you the chance to do the things you want during your retirement years without the worry of taking care of a home. Residents of Independent living communities have more time and opportunities to meet new people and try new things.
What Is Assisted Living?
Assisted living is a great option for people who can get around independently but need assistance in some aspects of their activities of daily living (ADLs). These communities offer services such as medication management and light personal care within a supervised setting. Assisted Living Communities focus on group and individual activities and efforts by staff to prevent residents from feeling isolated. Services provided by these facilities may include:
• Medication management
• Transportation arrangement
• Social activities
• Assistance with activities of daily living (bathing, toileting, etc.)
• Health services
• 24-hour security
• Wellness program
• Community involvement
Every community is different, and all offer varying levels of assistance. It is important to thoroughly assess you or your loved one’s needs before deciding on which facility is the most appropriate fit for you or your family member.
Assisted Living vs. Home Care-Which Option Is Right?
It’s not that one option is always better than another. It all depends on the situation, and each family will have to consider its own needs.
Both senior home care and assisted living have their pros and cons. In deciding which is the best option, you’ll need to consider carefully your loved one’s needs and preferences and weigh those against your financial resources, and safety concerns. There is no one-size-fits-all answer to this question.
Staying at home, which many think would always be preferable, must be evaluated on a person-by-person basis, based on both physical as well as social elements. These factors include, but are not limited to:
• Safety and supervision.
• Access to care.
• Ability to manage bathing, dressing, medications and food access and preparation.
• Connections to other people and basic socialization.
A key component of whether or not home care is a better option than assisted living is safety. If a senior is planning to remain in the home, I would recommend having a professional Home Safety Evaluation to identify potential hazardous throughout the residence to decrease the risk of falls.
The Importance of Socialization
There’s a potential for isolation and loneliness when staying at home. A person, or their family, will still have responsibilities, such as cooking, shopping and maintaining the home, which can entail paying bills, doing yard work and so on. Also, care is not always available at the exact time of need. The family must make plans for “call outs” of caregivers at the last minute.
In an assisted living community care is available 24/7. That hands-on, 24-hour access to care and support is one major advantage an assisted living community typically has over home care. In home care, you don’t have access to that 360-degree view of care and socializing. There are not many programs viable outside of one-on-one activities in the home setting.
The Health Effect of Socialization
Socialization is a major factor in deciding where to live and shouldn’t necessarily be overshadowed by other factors. If you’re around like-minded people and you’re socializing with others in a book club or a golf club or whatever your interest is, that plays a role in living a healthier, longer life with fewer ailments. There’s substantial research from the National Institute of Health that shows that socialization is important for health. It can be very hard to create adequate socialization opportunities at home.
Contact with others can also provide improved medical care. The care team in an assisted living community can take a coordinated approach and collaborate to come up with the best comprehensive plan. Coordination of care in an assisted living community includes dietary concerns and working with your physician, a psychologist, social workers, music therapists and others. All of those services are rarely available in a home care setting.
Paying for Assisted Living & Home Care
Figuring out how to pay for senior care can be a major issue for many families. Retirement savings, the sale of the family home, private health insurance, veteran’s benefits and long-term care insurance are all potential sources of funding to pay for this type of care. The calculus involved is highly situational and varies greatly from one senior to the next.
It’s important to note that there can be a significant financial difference between staying at home and moving into an assisted living facility. A 2018 survey conducted by Genworth Financial found that the median monthly cost for an assisted living community is $4,000 – totaling $48,000 annually. By comparison, long-term care by a home health aide tops $4,195 monthly or more than $50,300 annually. Skilled nursing in a private room will set you back $8,365 per month, adding up to more than $100,000 per year. Prices can vary a lot depending on where in the country the community is located and which services a senior is using.
Hiring Private Care
Hiring a private home care aide or live-in care can also get expensive. Although millions of family members provide unpaid care to older relatives around the country every day, when we’re talking about professional caregivers, fees can range widely. Hourly rates tend to fall between $15 and $25 per hour or $150 to $300/day. This will depend on how the care contract is structured, the state you live in and what kind of services are being provided. Bottom line: Home-care options can be just as expensive or more so than moving to an assisted living facility. This will depend on a range of factors, and it’s important to do your due diligence to determine what you’ll have the financial reserves to pay for.
In addition to important decisions about where a loved one will receive the best care, it’s important to consider the costs associated with that care and to understand what insurance – most likely Medicare – will and will not cover. Medicare does not cover the cost of or help to pay for assisted living arrangements. This means that people generally must pay either out-of-pocket or with the help of long-term care insurance. However, Medicare will only pay for home care services after a decline in function of the senior and it will only cover short term services.
How Long Can Home Care Last?
As needs change, a senior’s ability to continue living at home may change too. For many people that means there will come a time when they must move into an assisted living or nursing home setting. Knowing when is the right time to move can be a tricky question that’s different for everyone.
Assisted living should be considered when the safety of an older person becomes a factor. Some examples are:
- being susceptible to a fall
- taking the wrong medications
- experiencing weight loss from unhealthy eating
- the inability to cook safely
- developing cognitive deficits
then it might be time to start thinking about moving into an assisted living community.
Mental health issues, such as feelings of isolation, loneliness and depression, may also prompt a move. Loneliness has the same impact on mortality as smoking 15 cigarettes per day. A 2018 survey from the health insurer Cigna noted that roughly half of all Americans feel lonely. However, 88% of those who have daily in-person interactions say their overall health and mental health are good or excellent.
In other cases, when a senior develops multiple chronic medical conditions that require frequent doctor’s appointments to manage, it may be time to move into assisted living to make care more accessible. The simple logistics of having access to health care on site can decrease many trips to doctor’s offices.
Assisted Living Guilt
Moving a loved one into assisted living can be a difficult decision and challenging transition. Many adult children feel guilty about moving a parent into assisted living. However the majority later come back and report it was the best thing for their parent. Adult children often have more trouble with the transition than the parent. Assisted living can bring a new lease on life with an active setting, new friends and new hobbies. Services in assisted living are available 24/7, therefore, you have peace of mind that someone is always there to assist.
In all things related to senior care, it is important to plan early and do your due diligence. This will decrease feelings of guilt and stress. Moving into assisted living is a new chapter in someone’s life. Being prepared ahead of time offers an opportunity to get excited about it instead of dreading it.
Knowing that their own wishes have been heard and honored as much as possible will also make a world of difference in how a senior feels about a move to a new home – if and when the time comes.