Realizing that a parent or loved one needs long-term care can be a tough pill to swallow. It can be hard to watch as a once healthy and active person can no longer manage simple tasks on his or her own. It can be even tougher to have the long-term care conversation with your loved one. After all, who wants to be told that she is no longer capable of caring for herself?
Fortunately, there are several levels of care. So if Mom is diagnosed with Alzheimer’s disease or Dad develops Parkinson’s disease, that doesn’t mean she or he needs to be in a nursing home right away.
What it does mean, though, is that you and your loved ones need to be aware of the options and the cost of those options so you can create a care plan that fits your loved ones’ needs and budget.
Care at home
Nearly three-quarters of adults surveyed by Nationwide Retirement Institute said they would prefer to receive long-term care in their own home. Although people often rely on family caregivers, there are also professional home care providers.
Homemaker services provide assistance with household tasks such as meal preparation, transportation, and cleaning. The median monthly cost of homemaker services is $4,290, according to insurance company Genworth’s 2019 Cost of Care Survey.
Home health aide services offer hands-on help with activities such dressing and bathing as well as assistance with house household tasks. The median monthly cost of a home health aide is $4,385, according to Genworth. If your loved one needs medical assistance, you will need to hire a licensed professional such as a nurse to provide care. The median cost per visit is $87.50, according to Genworth.
You can find home care agencies and providers near you through A Place for Mom, Care.com and Caring.com. Be aware that home care might not be the best option for your loved ones if their home isn’t set up to accommodate their needs. For example, a second-story bedroom might not be accessible in the later stages of a physically or mentally debilitating disease. So it’s important to weigh the risks and downsides when considering care at home.
Adult day care
This community-based service can be ideal for someone who doesn’t need a high level of care. It also can be an affordable alternative to home care.
As the name suggests, adult day care provides services for older adults in a group setting. Services can include meals, transportation, personal care, and social and therapeutic activities. The median monthly cost is $1,625, according to Genworth. You can find adult day care services in your area by searching the National Adult Day Services Association’s database.
Residential care homes
These facilities – also called adult family homes – provide care in a home-like setting to a small group of adults. Services include meals and assistance with activities such as dressing, bathing and going to the bathroom. However, residential care homes typically don’t offer medical care, according to A Place for Mom. Rooms can be shared or private. And the cost of a residential care home typically is lower than the cost of an assisted living facility. You can find a care home near you through A Place for Mom.
Assisted living facility
If your loved one needs round-the-clock assistance with bathing, dressing, eating, going to the bathroom and other activities of daily living, an assisted living facility might be ideal. These facilities typically offer social activities, exercise programs and even outings for residents. And units in these facilities can range from shared rooms to one- and two-bedroom apartments.
Staff can help with medication reminders, and some facilities have nurses on staff. However, these facilities do not provide medical care. The median monthly cost of an assisted living facility is $4,051, according to Genworth. You can find one near you at A Place for Mom and Caring.com.
Memory care facility
If your loved one has dementia, a memory care facility can provide the additional level of care he or she needs. These facilities provide assistance with activities of daily living as assisted living facilities do, However, they are secure to prevent residents from wandering out of the building and tend to have floor plans that prevent residents from getting lost within the building. Memory care facilities also might have nurses on staff or contract with medical professionals to provide care on-site.
The cost of memory care facilities can be on par or higher than assisted living facilities. And some assisted living facilities have memory care units within them. You can find one near you through A Place for Mom and Caring.com.
Skilled nursing facility
These facilities can provide short-term care to people who need medical assistance and rehabilitation after a hospital stay and long-term care to people who can’t function independently and need 24-hour medical care. Licensed nurses and certified nursing assistants are on staff to provide care. Facilities also may have physical, occupational and speech therapists.
They tend to feel and look more like a hospital (whereas, assisted living facilities and memory care facilities tend to be homier). The median monthly cost of a semi-private room is $7,513, while a private room is $8,517, according to Genworth. Medicare.gov has a guide to choosing a nursing home, and you can use its nursing home compare tool to find Medicare and Medicaid-certified facilities.
Continuing care community
Your loved one’s need for care likely will change over time. So you and your loved one can solve that problem by opting for a continuing care retirement community that would allow your loved one to age in place. These communities offer independent living, assisted living and nursing care in one location to make the transition easy as the need for care changes.
However, continuing care communities tend to be the most expensive care option. They tend to require a hefty initial payment ranging from $200,000 to $1 million, according to AgingCare. Then monthly fees can range from $1,500 to $5,000 and will increase as care needs increase.
Medicare typically does not pay for long-term care (just short-term rehabilitation). Medicaid will pay for care at home and in nursing homes, but your loved one must have limited income and assets to be eligible for this joint state and federal health care program.
For the most part, your loved one will need to pay for long-term care on his or her own. A long-term care insurance policy or life insurance policy with long-term care benefits can help offset the cost of care. Other options to pay for care can include annuities and a reverse mortgage. Learn more about the ways to pay for long-term care here: How to Pay for Long-Term Care