Assisted living vs in home care is a tough choice
When your parent or spouse needs assistance in their daily life, many families end up at a crossroads.
We share what you need to know about the 3 essential factors to consider: how much help they need, the key differences between assisted living vs home care, and the financial situation.
Knowing the facts helps you make the best choice for (or with) your older adult.
1. Figure out how much help they need
Before making any decisions, it’s necessary to find out how much help your older adult needs and compare that with how much help is already available. Previously, we’ve talked about understanding their needs in 8 key areas of life and being realistic about how much help family will provide.
First, make a list of everything your older adult needs help with on a daily, weekly, and monthly basis. Being able to see the whole picture helps you choose the correct level of care.
Next, be realistic about how much help you, family, or friends and neighbors will provide. It’s important to think about this in terms of long-term, ongoing help – a few weeks or months isn’t going to be enough.
After comparing those two lists, you’ll have a better sense for the tasks your older adult will need additional help with – anything that isn’t already covered.
In some cases, looking at this list makes it obvious that in home care will work best. In other cases, assisted living might be the clear choice.
2. Understand key differences between in home care and assisted living
Before you can choose between in home care and assisted living, it’s important to understand how they work. Here are the basics and key pros and cons for each.
In home care: pros and cons
In home care is when a caregiver is hired to come into the home to help seniors with activities of daily living. This enables your older adult to continue living safely at home.
The specific help provided depends on the older adult’s needs and could include meal preparation, getting around the house, transportation, bathing, dressing, using the toilet, etc.
- Senior gets one-on-one care tailored to their needs and preferences
- Senior can stay in their home or a relative’s home as they age
- Costs can be lower depending on hours of care needed and caregiver skill level
- Family gets to choose the caregiver
- Senior gets to know one caregiver, rather than being cared for by many different people
- Flexibility in care arrangements: different types of care could be combined to lower costs, increase social interaction, or provide medical-type care – family help, adult day programs, privately-hired caregivers, agency caregivers, and home health care
- High costs if 24/7 care is needed
- Ongoing family involvement is needed for hiring and managing caregivers as well as planning backup care options
- Potential for social isolation, which can contribute to depression, cognitive decline, or health problems
- Home may need modifications for safety or wheelchair accessibility
- Housekeeping and home maintenance need to be done and groceries and personal care and household supplies need to be bought
Assisted living: pros and cons
An assisted living community is a place where many seniors live, in rooms or small apartments. Most communities offer a wide range of care options, from seniors who are mostly independent to those who need a high level of care.
Services like meals, transportation, group activities, and housekeeping are typically included in the monthly fee.
- More affordable way to get 24/7 supervision and care
- Family can focus more on the relationship rather than on care needs
- Senior has plenty of opportunities for social interaction with other residents
- Family doesn’t need to worry about hiring, scheduling, or managing caregivers
- Level of care can be ramped up as needed because staff is already in place
- One-on-one care won’t be as personal or consistent as it is at home, frequent changes in staff is common
- Quality of care can vary depending on the staff
- If significant one-on-one care is needed, hiring (and paying out-of-pocket for) a private aide may become necessary
- Seniors could get kicked out of the community for a variety of reasons with little advanced notice
- Senior may not enjoy being in a group living environment
Now that you know more about assisted living and in home care, the choice between them is probably becoming clearer. The next critical item to consider is the cost of care.
3. Understand the financial situation
Before you can make a choice about assisted living or in home care, you need to know how each choice would work with your older adult’s budget.
Figuring out assisted living and in home care costs isn’t easy and is specific to each person’s needs, location, and how much family help they have. This takes some work, but it’s worth the effort because it helps you plan for the future and avoid unpleasant scenarios like your older adult suddenly running out of money.
The best thing to do is to call around to get actual pricing information from assisted living communities you’d consider and in home care providers you might use. That way, you’ll know how much it would cost to get the level of care your older adult needs in the city they live in.
A faster, but less accurate approach is to use averages from an online long term care cost estimating tool. According to Genworth, the 2016 national average monthly cost for in home care was $3861 (for 44 hours of care per week). The 2016 national average monthly cost for assisted living was $3628.
There will be a lot of factors to consider because you’re basically doing financial planning for the next 5 to 10 years of your older adult’s life. If analyzing and comparing costs becomes overwhelming, ask a trusted relative or friend for help. Or, consult a reputable financial adviser or accountant.
Here’s an overview of the key costs you’ll need to take into account.
Monthly in home care costs
- Hours of care needed x caregiver hourly rate
- Groceries and meal preparation
- Personal care supplies
- Household supplies
- Housekeeping and laundry
- Rent or mortgage and property taxes
- Home and yard maintenance
- Utilities, water, and garbage
Assisted living costs
Assisted living fees vary by community so don’t assume that most services will be covered by the base monthly rate.
That’s why it’s important to ask for a list of ALL potential fees on top of the monthly rate. Your older adult may be using these additional services now or in the future.
- Monthly base rate
- Additional fees for the necessary level of care
- Housekeeping and laundry
- Personal care supplies
- Meals, in-room dining, or snacks
- Overnight visitors (like you)
After adding up the costs, you’ll have a good idea of which option fits better in your older adult’s budget, assisted living or in home care.
Choosing between assisted living and in home care involves so many factors, both personal and financial. Making the decision can feel overwhelming. Remember that you don’t have to make an all or nothing choice.
If you’re really unsure, start with home care. Give it time to see if it’s working – there’s an adjustment period while you get the arrangements in place and get the caregiver and family help up to speed.
If home care ends up not working out or if the cost is too high to sustain, then you’ll know that assisted living is the way to go.
You might also like:
— When Should a Senior Move to Assisted Living? Get Advice from a Social Worker
— 3 Reasons to Stop Feeling Guilty About Putting Mom in Assisted Living
— 7 Things You Must Do When Hiring an In-Home Caregiver
By DailyCaring Editorial Team
Image: Thorne Crest Senior Living Community
A version of this article was originally published on Sixty and Me
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