Long-Term Care Basics - Home Care

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Apr 2021

Here’s the headline: $119,238. That’s how much a nursing home costs the average resident for an average stay of 14 months. And that’s just the last phase of care. Before entering a nursing home, most seniors previously receive care at home — and potentially in a less intensive assisted living facility. All of these arrangements are part of the long-term care continuum. Americans turning 65 today have a 70% chance of needing some form of long-term care during their lifetime: That’s why you need a basic understanding of how the system works while you still have time to plan and save for your future.

Many Paths, One Destination

Figuring out what your long-term care journey will look like and how much it will cost is guesswork. You may not stay in a nursing home at all. You may or may not have health conditions that require skilled nursing care. Based on your personal medical history, your doctor may offer some advice on conditions you may develop as you age, and the family history of close relatives can also offer some clues.

Long-term care ranges from having a minimally trained helper come in for a few hours of light housekeeping each week to receiving 24/7 custodial care in a dementia/Alzheimer’s unit. Each potential arrangement comes with its own regimen and associated costs.

Where you live has an enormous impact on price as well: The median cost of a private room in a nursing home is almost $362,000 a year in Alaska — more than three times the national median of $102,200 — while in Oklahoma, it drops to $67,000. Here are some options you might have for receiving long-term care at home.

In-Home Caregivers

For most seniors, staying in their own home — or in the home of an adult child or relative — is their first choice. A homemaker is a person who comes in to do light housekeeping and run errands but is not medically trained and remains “hands off” with the client. An assistant who provides some direct care to the patient, like mobility and toileting, is a home health aide. The median national wage for homemakers is $22.50 an hour, whereas it’s $23 an hour for a home health aide.

For those who need professional medical support on a limited basis but are otherwise able to move about, make their own meals and tidy the house, in-home skilled nursing provided by an RN, LPN or other trained healthcare worker is also available at a median national cost of $87 per visit.

Having a live-in helper is popular with those who have space in their home. Costs vary widely depending on where you live, what hours and duties are required, whether the helper needs medical training and whether you hire them through an agency, community program or private agreement.

Community-Based Programs

Especially for a family caring for an older relative, having a safe place he or she can go during the day can be a good option. Adult Day Health Care (ADHC) programs vary by the facility but can include transportation, medical management and meals. The median rate nationally is $75 a day, and some programs offer half-day sessions at a lower cost.

Senior Housing Options

Independent living and senior housing facilities provide additional on-site services for residents, sometimes at an additional cost. Individual apartments are often equipped with grab bars, call buttons and other amenities and safety features geared toward an aging population. They might also offer a visiting nurse service, on-site social activities or transportation to local stores and other destinations.

Many seniors (and younger people with certain conditions) sustain semi-independent living for many years, if not their entire lives. However, once there is a need for greater assistance with medication management and activities of daily living, a residential care program may be needed — these options are discussed in part two.

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