Having the Senior Care Discussion

Staying Put at Home Tips for CaregivingWhen deciding whether to Age in Place or move out of your home, feelings can often be hurt. Maybe a parent isn’t ready to let go of the house that she has lived in for decades. Maybe one child doesn’t want to help pay for senior care, or another doesn’t want dad to come live with him. Whatever the case may be, coming up with a compromise can be an arduous give and take. For this post, Staying Put at Home considers how we can best deliberate on Aging in Place and senior care.

Prepare…

Just like with most activities, a little preparation beforehand can go a long way when it comes to figuring out a senior’s home and health care plans. Make it clear exactly what everyone’s responsibilities and expectations are. Establishing these roles before there is a problem will not only provide peace of mind, it will also make it easier for someone to get ready for a potentially demanding or expensive caregiver duty. A family planning meeting can also present a good opportunity to learn about the myriad costs of senior care and Aging in Place. Staying Put at Home has gone over the relative costs of these options, and even more options exist for more specialized care.

As the old saying goes, an ounce of prevention is worth a pound of cure. Crises and emergencies are almost always exacerbated when no preparation is made. AARP has a great guide for topics to discuss when discussing senior care options. A family planning meeting can also be one of the best decisions you make when it comes to senior finances. Should you have the opportunity, also try to discuss wills, trusts and durable powers of attorney.

…And Be Prepared to Make Changes

As another old saying goes, the best laid plans of mice and men go oft awry. Circumstances change, and what might have sounded like good plan two or three years ago might not be feasible today. However, this doesn’t mean that making preparations is arbitrary. A plan is still a great step, just remember that they aren’t necessarily ironclad.

Flexibility and accommodation might be difficult, but they are sometimes necessary when deciding the housing and care options for you or your senior loved one.

Get Help When You Need It

It is exhausting to make decisions regarding senior care. Good intentions might be lost in communication, or not everyone will see eye to eye. In cases like these, where it seems like there is no way forward, enlisting a professional geriatric care manager makes sense. This advisor will be able to outline your options and guide you toward the choice that makes the most sense. Their area of expertise can help clear up any misconceptions. For example, they’ll tell you that most long-term care is not covered by Medicare. Consulting with these trained specialists might save you a lot of headaches and heart breaks. Plus, consulting a care manager might help you save money in the long run.

What to Do When Everyone Lives in a Different Town

Children grow up and move to different towns and cities. When a parent eventually needs to decide on his or her senior care options, it can be strenuous to find out which responsibility each child will need to take on, especially if some aren’t nearby. We can’t reiterate enough the importance of having a family planning meeting, as these help the kids get on the same page. For example, if one child lives across the country, then they can still assist with caregiving by helping to fund a parent’s senior services. Having everyone in agreement before senior care is needed can help avoid any messy discord.

Be Honest and Realistic

At this critical juncture, clear and truthful communication is crucial. Make sure that everyone knows each other’s responsibilities and expectations. It is easy for people to overestimate how much time, money and energy they can provide, so giving a truthful, reasonable assessment for the amount of care that you can offer will help out down the line. Even a slight misunderstanding or miscommunication can have a resounding impact on both the caregiver and the person receiving assistance. Do your best to be upfront and realistic about your role when discussing caregiving.

We hope this advice has helped you consider how to broach senior care with your family. If you have any suggestions about caregiving conversations, then please share with the Staying Put at Home community in the comment section.

Aging in Place Essentials: Part 3 – How Can Aging in Place Save You Money?

Staying Put at Home Tips for CaregivingAging in Place can provide a much more affordable alternative to the high cost of independent living facilities, assisted living facilities and community care retirement centers. Our blog post this week explores how staying put in your own home will more likely save you money.

How Much Do Independent Living Facilities, Assisted Living Facilities and Community Care Retirement Centers Cost?

Independent living facilities is a general term for housing arrangements for seniors who do not need assistance with daily activities. These facilities come in the form of retirement communities, retirement homes, senior housing and senior apartments. Most of these facilities provide common areas for meals and socializing. Some independent living facilities also have medical and personal care services. However, you still remain independent, having your own housing and receiving less care than you would find at an assisted living facility. Services available at independent living facilities include laundry, meals, transportation and some social activities.

Assisted living facilities are long-term facilities for elderly or disabled people who are able to get around on their own but need help with some daily activities, such as medication assistance/management, bathing, dressing and transportation. Traditional options for assisted living facilities include:

  • Three meals a day served in a common dining room at prescribed times
  • Housekeeping services
  • Transportation
  • 24-hour security
  • Bathing/Dressing
  • Exercise and wellness programs
  • Laundry services
  • Social and recreational activities

Community care retirement centers (CCRCs) typically have three or four levels of care: independent living, assisted living and skilled nursing. These organizations offer you assistance as you need it. Perhaps you are healthy and do not need any support. Down the road, though, you might require a nurse. Community care retirement centers accommodate your needs as they change. Many even offer hospice care and end-of-life services. This housing allows seniors to remain at one residential location regardless of their health. CCRCs require you to pay an entrance fee. But beware, if a CCRC goes bankrupt, residents can lose part or all of their entrance fee. According to AARP, there are three types of contracts for CCRCs:

  • Life Care or Extended Contract: The most expensive option, but offers unlimited assisted living, medical treatment and skilled nursing care without additional charges.
  • Modified Contract: This option offers a number of services provided for a set length of time. Once that time has expired, other services can be purchased, but for higher monthly fees.
  • Fee-for-Service Contract: This option has a lower fee, but there are no long-term care benefits included in the contract. You will need to pay for long-term care benefits at their market rates when you need them.

The above mentioned most commonly available types of senior communities, however, might not be cost-effective. Whatever your rent is, your costs can quickly pile up, leaving you with a hefty bill:

  • Independent living facilities can cost between approximately $20,000 and $42,000 per year, depending on your locality and what services are included.1
  • In 2013, assisted living facilities had a median annual cost of $41,400.2 This was up 5% from the previous year.
  • Community care retirement centers have a national average entrance fee of approximately $250,000,3 and rent usually amounts to $3,000 to $5,000 per month.4 The cost of CCRCs also depends on your health, the kind of housing you have chosen and the number of residents in your facility.

Why Aging in Place Could Be The More Affordable Option

The cost of staying put in your current home, of course, depends on the condition of your home and your needs. Certain modifications may be necessary. In the long run, though, these purchases could save you money and keep you comfortable in your home. By not entering a senior care facility, you will hold on to thousands of dollars each year. Marty Bell, Executive Director of the National Aging in Place Council, estimates that annual cost for Aging in Place is $23,000.5 In a four-year analysis, the total costs for Aging in Place were thousands of dollars less than institutional care options.6 If you carefully invest in Aging in Place home improvements, you can come out ahead in the long run with Aging in Place, and also have the great joy of staying in your home as long as possible.

Cost Comparison table

There are many hypothetical premises, of course, behind the above calculations. For example:

  1. For simplification, it is assumed that the Aging in Place senior remains in good enough health to remain in his or her home.
  2. For simplification, it is assumed that there is no significant inflation in costs.

The above costs are the national averages for a single person. These numbers may be higher depending on your state. Costs for a couple will be 25 to 50% higher.

Financial Assistance

Certain grants and programs can also make Aging in Place more affordable:

  • Veterans are eligible for SAH, SHA and HISA grants through the VA that fund home remodeling projects.7 Your annual income and assets need to be below a certain threshold to qualify for these grants.
  • The Department of Agriculture offers Rural Repair and Rehabilitation grants to assist rural homeowners renovate for Aging in Place.8 These grants are designed for low-income homeowners. Those who qualify for these grants usually have less than 50% of the median annual income for the area.
  • Rebuilding Together is a national nonprofit aimed at seniors and veterans that offers financial assistance and volunteer labor for home modification projects.9 Rebuilding Together usually focuses on assisting low-income seniors.
  • Many states offer Home and Community Based Services (HCBS) waivers through Medicaid, which allow individuals to avoid nursing homes and hospitals, often by modifying their houses.10 To qualify for an HCBS, you need to be below a certain income. This number will vary depending on your state.

Many of these grants have eligibility requirements. If your assets ans annual income exceeds a certain level, then you may not be able to qualify for these grants.

Having financial security is a great benefit of Aging in Place. We hope that this blog post has clarified the often confusing question of how it compares to various senior living communities. Check back in at Staying Put at Home to see the rest of our series on Aging in Place:

Aging in Place Essentials

  1. Introduction
  2. Making Your Home Safer & More Comfortable
  3. How Can Aging in Place Save You Money?
  4. Maintaining & Modifying Your Home: Who Can Help?
  5. How To Make Your Bathroom Safer

1. Guide to Senior Housing Options | Return to Text
2. Nursing Home Costs Top $80,000 A Year | Return to Text
3. Continuing-Care Retirement Communities: Weighing the Risks | Return to Text
4. About Continuing Care Retirement Communities | Return to Text
5. As Senior Population Grows, Aging in Place Gains Popularity: Communities Conducting Outreach | Return to Text
6. Aging in Place Preserves Seniors’ Independence, Reduces Care Costs, Researchers Find | Return to Text
7. SAH, SHA & HISA Grants: Home Modification Help for Elderly and Disabled Veterans | Return to Text
8. Rural Housing: Housing Repair Loans and Grants | Return to Text
9. Rebuilding Together | Return to Text
10. Home & Community Based Services | Return to Text

Weighing Your In-Home Service Choices

Caregiving Staying Put at HomeStaying put at home is an achievable goal, but trying to do it entirely on your own can be a challenge. Friends and family members can be of immense help, yet complications such as distance, work and children may limit their ability to provide continual support. Loved ones may also be ill-equipped to handle serious or complex medical issues. So how can you get the assistance you need when you need it? By taking advantage of professional in-home services.

Skilled Medical Care

Are you recuperating from hip replacement surgery? Has your spouse suffered a stroke? Then you might want skilled medical care. As do other forms of in-home assistance, skilled medical care can go by different names, so be sure to confirm the type of services that an agency provides. Generally, though, a nurse, physician or therapist comes directly to your home to administer medications, dress wounds and perform other skilled medical tasks.

Personal or Home Health Care

You may never need surgery or suffer a stroke. However, chronic conditions can also impede physical and mental capabilities. Multiple sclerosis, Parkinson’s disease and Alzheimer’s disease are just a few of the conditions that might warrant personal or home health care. As the Alzheimer’s Association notes, agencies offering these services can assist with everyday health and hygiene needs such as grooming, bathing and toileting.

Homemaker or Home Care

Maybe you can look after yourself just fine, but you wouldn’t mind getting a little help around the house. If arthritis makes doing the dishes difficult, or poor vision prevents you from driving to and from the grocery store, you can hire a professional home care aide to assist with your household needs. Homemaker care services can even cook your meals so that you have more time to rest or enjoy your hobbies.

Companion Care

Speaking of hobbies… Do you wish you had a rummy partner? Or perhaps you would like an attendant to stay with your spouse while you go to the store? When the very presence of another person is the most important consideration, companion care might be the service you seek. As its name denotes, companion care allows recipients to spend time with attentive, nurturing professionals and provides families the chance to attend to other home and work obligations.

What are your in-home service experiences? Tell us about them in our comments section.

Does Your Spouse Need Caregiving Support?

Caregiving Staying Put at HomeHe’s been your partner for decades. She’s been your companion for years. Lately, though, you’ve noticed changes. Perhaps your husband forgets words and dates more often, or your wife seems more weary and withdrawn. Age can make many of us feel worn out after going to the store or forget where we left our keys, but some changes can signal a more serious problem. A time may come when your spouse needs you to be more than a partner; he or she might need a caregiver as well.

Drug Complications

Does your spouse take medications? Many seniors do, but with the use of prescription drugs comes the risk of abuse or adverse interactions. Early dementia could cause your husband or wife to forget medications or accidently overdose on them. So if your spouse appears lethargic or confused, it may be because of a drug interaction. To ensure safe medication usage, you may need to manage the dosing schedule and hold onto prescriptions to stop unintentional mistakes.

Home Concerns

Drug interactions can sometimes lead to unsafe situations. For instance, has your spouse ever forgotten to turn off the oven or stove? A bad drug interaction could make your husband or wife unsteady and cause a slip and fall accident as well. Also, take a look at the appearance of your house. Does it look as tidy as it normally would? Conditions such as dementia and depression can make it difficult for your spouse to remember or have the energy to do the dishes and dust the shelves.

Appearance Changes

A healthy diet can be difficult for seniors to maintain. With older age, taste diminishes and appetite can fade. The Department of Health and Human Services created a list of warning signs for spouses and other loved ones. Unexpected weight loss, which can happen if your spouse skips meals, might mean that he or she needs help. Poor hygiene is another sign. If your husband no longer bathes on a regular basis, or if your wife often forgets to change her clothes, it may be time to talk about your caregiving options.

Summary Points:

  • Older age might require some spouses to take on caregiving duties for their partners.
  • Noticing early physical and mental warning signs can prevent future accidents.
  • Weight loss and poor hygiene are two signs that your spouse might need help.