Assisted Living or Home Care? How to Help an Elderly Loved One Make the Right Choice
by Susan Pasternak – Make It Better Magazine, July 11, 2017
For Jeff Pryor, keeping his 93-year-old mother, Adele Pryor, in her own home after his father passed was a priority.
“It’s a very personal decision,” Pryor says. “My example was my father, who took care of my mother for 20 years after she had a stroke. I’ve tried to live up to that example and we have an opportunity to do that with care in her home.”
As baby boomers age and require more help with daily life, many will face the choice between staying in their homes with some sort of support, or moving to an assisted living facility. Making that decision is deeply personal, and should take into account personality, location of family, and finances.
When the last of the baby boomers reaches age 65 in 2029, that generation will represent more than 20 percent of the total U.S. population. Add to that the fact that 70 percent of Americans require some kind of long-term care after they turn 65 and this country will see a huge spike in demand for senior living facilities and services in the coming decades, according to a Genworth Financial study.
While there’s a range of living and support situations for aging seniors, many people initially consider the benefits and challenges of in-home assistance versus moving to an independent or assisted living facility, depending on how much care is needed. The benefits of staying in one’s own home are obvious; a move can cause emotional upheaval for those used to a lifetime of independence and the comforts of home. And experts point out that even in an assisted living facility, residents might end up requiring one-on-one care.
“We have plenty of clients who live in assisted living facilities,” says Sam Cross, administrator at Broad Street Home Care, which leverages its on-staff nurses and professional network to bring high-quality care to seniors. Broad Street nurses and other support staff members work with Pryor and his family to provide the best caregivers for his aging mother. “Really the two elements to consider are: where do you want to live and what services do you need?”
The goal of assisted living is to maximize independence for residents, while offering on-demand assistance with tasks such as meal preparation, housecleaning and laundry, the dispensing of medications, and bathing and dressing, if needed. Assisted living residences are ideal for people who are finding it a challenge to live independently, but do not require more intensive care found in a higher-level nursing facility. However, situations often arise that require higher level medical care, which is when the resident would likely need to hire supplemental help, or move to the assisted living facility’s skilled nursing section.
Assisted living facilities also offer social and emotional support, an intangible benefit for seniors who don’t want to feel isolated. These facilities often offer organized activities and outings. Meal times offer opportunities to engage with other residents, as do enrichment programs that are often scheduled throughout the week.
“Just being around people is important,” says Nancy Siegel, a care manager at Senior Living Experts, which offers personalized service to evaluate care needs, budget and geographical preference.
Ideally, a move to assisted living is initiated proactively, and not as a reaction to a change in health or the passing of a spouse, and started in good health, when the senior can make thoughtful and informed decisions.
“We urge people not to wait until there’s a crisis to start thinking about this,” says Maribeth Bersani, chief operating officer at Argentum, an advocacy organization representing for-profit senior living facilities. “Take tours and meet the residents. Go to an open house if there’s a new community opening up. There is some of that gut instinct involved. It’s a little bit like love: you’ll know it when you see it.”
An important factor to consider is price. In-home aid typically costs between $20 and $27 per hour, experts say. The cost for assisted living varies depending on many factors such as quality of the residence, the staff to resident ratio, types of meal plans, and other factors, with the national median falling around $3,000 per month, according to various studies. In a growing number of states, some assisted-living services are covered under Medicaid, but most people pay out-of-pocket or through a long-term-care insurance policy.
Whether looking for an in-home aide or an assisted living facility, experts caution to ask the right questions and to understand that higher prices do often translate to higher quality and more services. Seniors weighing the financial implications of either hiring in-home might consider hiring an aide for just a few hours a day to help with meal preparation and light housekeeping. However, quality caregivers looking for full-time work will then look elsewhere, or try to piece together multiple jobs, which isn’t ideal for what can be physically and emotionally tiring work.
“If consistency in a caregiver is important, you have to be prepared to meet a certain threshold of hours,” Cross says.
In addition to assisted living and in-home care, proactive seniors are also exploring another option: CRCCs, or Continuing Care Retirement Communities, which provide independent living options for on-the-go seniors but also offer services providing a greater level of assistance if the need arises. For example, should a spouse fall ill or become memory-impaired, they are able to move to an assisted living or nursing care building, while the partner is able to live independently, all on the same campus.