August 30

When Assisted Living Makes Sense

By Rick Banas of Gardant Management Solutions

Rick Banas, Vice President for Development and Positioning at Gardant Management Solutions

What makes the most sense for older adults who need some help to maintain their independence? Fending for themselves? Relying on family, neighbors or friends? Hiring a homemaker or home health aide? Moving to an assisted living community?

The questions came up during a lunch meeting last week with a financial planner.

Here are three reasons why assisted living can make sense:

1. Fending for themselves might end up being cheaper. Then again, it may not.

Older adults who are not eating properly or taking their medications in the right doses at the right time of day are more at risk of developing new or exasperating existing health issues. They may end up in a nursing home or visiting the doctor, emergency room or hospital more often. It can result in otherwise unnecessary expenses and have a negative impact on an individual’s quality of life.

When living alone, older adults can become less physically active and more socially isolated. As geriatric medicine physician Dr. David Fisher points out in his book “How to Keep Mom (And Yourself) Out of a Nursing Home,” one of his seven keys to keeping your independence is physical activity. As the good doctor notes, to keep moving, you have to keep moving.

Another key component of healthy aging, according to recent research, is social connectivity. Studies show that socializing can help ward off mental decline and reduce the risk of dementia.

The cost of nursing home care can hit the pocketbook hard. Nationally, the average monthly cost for a semi-private room in a nursing home was $7,441 (more than $89,000 annually), according to the most recent Genworth Cost of Care Survey, which was published in October of 2018. For a private room, the national average monthly cost was $8,365 (more than $100,000 a year).

Many older adults mistakenly assume that they can count on Medicare to pay for nursing home care. Traditional Medicare and most Medicare Advantage plans only provide very limited coverage for some short-term nursing home stays. The coverage only applies for short-term rehabilitation and only if the individual meets applicable Medicare criteria.

If an older adult does not have enough income to cover the cost of nursing home care, they will be required to dip into their assets. Medicaid is an option, but only when assets have been depleted to the point where an individual can qualify for Medicaid and only in a nursing home that accepts Medicaid. A Medicaid resident in a nursing home most likely will be sharing a room with at least one other person. 

2. Hiring a home health aide or a home maker can be more expensive than assisted living. The most recent Genworth Cost of Care Survey pegs the average cost of a home health aide nationally at $22 an hour and the average hourly rate for a homemaker at $21 an hour.

A relative in the Chicago area recently had a home health aide come to the house from 9 a.m. to 3 p.m. on Mondays through Fridays. The hourly rate was $25 an hour/$750 a week. The monthly cost just for the home health aide providing help 30 hours a week was $3,250 ($750 x 52 weeks a year = $39,000 divided by 12). This figure does not include any other living expenses such as rent, food and utilities.

Nationally, the average cost for assisted living according to the Genworth survey was $4,000. In the assisted living communities Gardant manages, the monthly fee covers the cost living in a private apartment with a private bathroom. Three meals a day plus snacks; and emergency alert system; and utilities, except for telephone, cable, and WiFi, are included. Staff is on-duty 24 hours a day/seven days a week. They are available to provide residents with the scheduled and unscheduled assistance they need. Staff also can be proactive if they should see changes in a resident’s appearance, demeanor or habits.

In addition, residents benefit from all of the opportunities that are available to socialize with family, friends and neighbors and to participate social, recreational, educational and wellness programs and activities.

3. Caregiving can have a major impact on a spouse and other family members. The stress and strain of caregiving can take its toll on a spouse who is serving as the caregiver. The stories are common about caregiving spouses experiencing health issues of their own that affect their ability to serve as caregiver. Many adult children struggle with having to balance the obligations, work, raising children and caring for an older adult parent.

Depending on income and assets, wartime veterans and spouses of wartime veterans may qualify for a special VA benefit called Aid and Attendance that can help cover the cost of long-term care, including home health care and assisted living.

Some Medicare Advantage plans are now starting to include some coverage for assisted living.

For older adults who do not have the financial resources to afford private pay assisted living, many of the communities Gardant operates in Illinois and Indiana are approved as Medicaid-waiver providers for assisted living. Click here to see a list of communities that Gardant manages.

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