How to Choose and Pay For Senior Care

If you’re starting to consider senior care options for a loved one, you know the choices can be overwhelming. Choosing the right living situation depends on factors such as meeting your loved one’s needs and respecting their physical and mental health. This includes everything from cognitive ability and physical health to social aptitude and desire for independence.

There’s a lot to consider when choosing the next step in living arrangements for a loved one, including what you and your family members can afford. Finances are often a major contributing factor to the decisions that are made.

By 2030, older adults are expected to comprise 20% of the U.S. population. The good news is you don’t need to navigate the living and financial options for senior care alone. This guide will help you make these decisions by detailing the various care options available and provide insight into the financial side of senior care, so you can successfully support your loved ones' transition into their senior years.

You have many choices when it comes to senior care options. The cost of senior care depends on various factors, including insurance, the level of care, how much supervision an individual needs and geographical location.

According to Dr. Deirdre Thornlow, an associate professor at Duke University School of Nursing, determining the level of care for aging adults depends highly on their ability to complete instrumental activities of daily living (IADLs) such as bathing, grooming, eating and maintaining finances. Prices shown are for informative purposes only. Your costs will be dependent on personalized determining factors.

In-home care enables older people to stay in their home while receiving the care and medical attention they may need. In-home care can include anything from daily assistance with activities such as bathing and eating to care for disease and illnesses. Examples of in-home care options include:

• Personal Care Aides: PCAs help seniors with daily activities and provide long-term care.
• Home Health Aides: HHAs are similar to PCAs, except they have additional training and licensing that enables them to recognize symptoms in their patients that require immediate attention.
• Seniors Helping Seniors: This model enables seniors to stay in their homes by providing companionship and care from other seniors.
• Aging in Place: Sometimes, the ability to remain home requires nothing more than home modifications. Organizations like the National Institute on Aging provide resources for home modifications that can keep seniors in their homes longer.

In-home senior care can be ideal for nearly anyone who can afford it. However, it might not be the best choice of long-term care for every individual. Questions to ask yourself to determine if in-home care is right for you and what level of care you’d need include:

• What illnesses do my spouse or I have?
• How independent do I want to be?
• How many years of in-home care will I require?
• Do I need help remembering to take my medications? Cooking for myself? Bathing?
• Am I comfortable with a health care professional coming into my home to take care of me?

In-home senior care costs vary greatly based on the care you’re receiving, but there are some average costs you can keep in mind.

• Hourly: $16–28/hour.
• Daily care: $200–350 per day.
• Overnight care: $120–$200 for every 10- to 12-hour shift.

A nursing home provides 24-hour supervision and multiple levels of care. Services can include housing and housekeeping, medical services and personal care. Examples of nursing home care include:

• Short-term care: For seniors who need short-term care after a medical incident, they can be in a nursing home for several days or weeks.
• Long-term care: Care for ongoing physical or mental conditions.
• Rehabilitation services: Assistance recovering from physical injury.
• Alzheimer’s disease and dementia facilities: Many facilities offer special programs for those experiencing memory loss, including Alzheimer’s disease and dementia.

Nursing homes are an ideal situation for seniors who need 24-hour supervision and require continual medical, physical or mental care that would be taxing on a family member. A nursing home might be ideal for your loved one if:

• They’ve been hospitalized multiple times for cognitive issues like confusion and memory loss or falls and injuries.
• In-home care is not an option because of cost, privacy or independent reasons.
• They’re suffering from an illness that requires continual medical attention.
• It’s unsafe to leave your loved one alone for any amount of time.

Nursing home costs vary by state and services required. As of 2018, state by state nursing home daily rates were between $153–$963.

Senior co-ops are communities that seniors can buy into and become a part of. The community takes care of things like maintenance, chores and home expenses while organizing different social activities.

Senior co-ops provide independent seniors a way to live conveniently and have a say in their community. These co-ops are for seniors who are mentally and physically healthy but don’t want to deal with the typical chores that come with homeownership. It’s also ideal for seniors looking to maintain an active and social lifestyle.

Since you’re buying into a community, you’ll be in charge of the share costs of becoming a member of a senior co-op. These costs can range anywhere from 20%–40% of your living unit’s value. The average unit values are anywhere from $100,000 to $250,000.

Retirement communities are age-restricted communities that offer housing for individuals that are usually healthy enough to care for themselves. Retirement communities can offer services like transportation, meals, community activities and socialization activities. Living options in these communities typically include:

• Public housing, which is typically for low- to moderate-income individuals.
• Assisted living for older people who need daily aid but do not need medical services.
• Continuing care communities, which provide different housing and care options into which older individuals can transition.

If your loved one can take care of themselves but can't remain in their current home, a retirement community may be the right choice. Retirement communities are a good solution for seniors looking to maintain their independence but seeking the convenience of having some daily services taken care of, such as meals and transportation.

The cost of retirement communities significantly varies since there are so many options available. Assisted living can cost anywhere from $1,500 to $6,000 a month, while community care facilities could range from $1,000 to $5,000. Seniors may also be able to find affordable housing at more reasonable prices.

Assisted living provides housing and support for aging adults who need assistance with regular and instrumental daily living activities such as bathing, tidying up, taking medication and preparing meals. “These properties are not required to have a registered nurse on duty,” says Dr. Thornlow. “But they may offer licensed practical nursing (LPN) care and memory care units to cater to those with dementia or other cognitive limitations.”

This type of living is necessary for older people who cannot live safely on their own and who may be suffering from cognitive issues that cause them to forget to take medications or not allow them to take care of themselves properly. For individuals who may be unable to bathe or adequately feed themselves or are living with an illness or disease, assisted living can be a viable living option.

Assisted living costs can range from $1,500 to $6,500 a month, depending on the location and services offered. Most facilities offer the ability to pay for additional levels of care and services as needed.

Designed for seniors who need supervision and assistance throughout the day, adult day care is exactly like it sounds. Services provided can include the following:

• Counseling
• Education
• Evening care
• Exercise
• Health screening
• Meals
• Medical care
• Physical therapy
• Recreation
• Respite care
• Socialization
• Supervision
• Transportation
• Medication management

Adult day care provides relief for families who have loved ones that require supervision during the day but do not need to be in a full-time care environment. For seniors looking to maintain their independence and social lifestyle, adult day care offers that opportunity. Seniors considering adult day care should be in good health mentally and physically and not require daily medical care.

Costs will vary depending on location and services offered but are usually between $25 to $100 a day.

Hospice is end-of-life care for those with terminal illnesses or nearing their final days. Hospice care can be offered at nearly any location, including a home, nursing facility, assisted living facility or hospital. The goal of hospice care is to help the patient be as comfortable as possible in their final days.

Hospice is end-of-life care for those with terminal illnesses or nearing their final days. Hospice care can be offered at nearly any location, including a home, nursing facility, assisted living facility or hospital. Hospice care's goal is to help patients be as comfortable as possible in their final days.

Depending on the level of hospice care, location and length, care can cost anywhere from $150 a day to $500 a day.

Understanding your senior care options is crucial in choosing the best situation for yourself or a loved one. Still, it's vital you also appreciate the options for paying for these services. There are just as many ways to pay for senior care as there are options for senior living.

While there are many ways to pay for senior care, the costs can add up quickly. Fidelity Investments estimates that an average senior couple will spend $295,000 for health care expenses during their retirement. Fortunately, various senior care financial assistance programs are designed to help ease the burden of paying for senior care.

Medicare & Medicaid: By far, the most common financial assistance programs for senior care is Medicare and Medicaid. If you qualify for both, a majority of your health care costs will be paid. Medicare is aimed to assist individuals no matter their income, while Medicaid is designed for low-income seniors.

Area Agency on Aging (AAA): A network of more than 620 non-profit organizations nationwide that provide a variety of services to older people, including nutrition, caregiver support, care management, insurance counseling and transportation, to name a few. AAAs serve specific counties.

Senior Health Insurance Assistance Program (SHIP): This program offers specialists that can help seniors understand their health insurance benefits and different plans and coverage that may be available to them. SHIP will help you find a specialist in your area with which to work.

State Assistive Technology Programs: Funded by the Assistive Technology Act, all 50 U.S. states are provided with the resources and funding to help the elderly access necessary assistive technology. Every state is different, but nearly every one consists of the following components: device and equipment loan programs, recycling and exchange programs and low-interest loans and grants.

Veterans Aid and Attendance: Certain veterans qualify for several financial relief programs offered through the VA. These programs include long-term care at home or in a nursing facility, assisted-living centers and adult day care centers. The VA also offers several different pension options to help pay for long-term care.

Older Americans who have underlying medical conditions are at higher risk of contracting COVID-19. When choosing senior care for a loved one, it’s essential to thoroughly vet your options to understand the coronavirus's potential risk and how the facility is handling cases that may break out in their building. When speaking with potential care providers, keep an eye on the following and ask these crucial questions.

• How the facility maintains cleanliness of the facility and patients.
• Whether the facility is practicing social distancing and requiring protective gear such as masks.
• How many staff interact with a patient at a time. The more people who interact with each other, the more likely someone is to contract COVID-19.
• Determine if the facility has had any COVID-19 cases and the steps they took to control the virus's spread.
• Try and get a general sense of the risk of your loved one contracting COVID-19. Seniors living in nursing homes and assisted-living facilities are more likely to contract the coronavirus because of residents' close proximity to each other.

Essential questions to ask:

• Has anyone in the facility tested positive for COVID-19?
• What are you doing to prevent infection?
• How often are you conducting health screenings?
• What is your communication plan for keeping patients and families up-to-date on the coronavirus status in your facility?
• If a patient gets sick, or there is an outbreak in your facility, what type of medical care can your facility provide?
• What is your emergency operations plan?
• What are your visitation rules?
• What should I do if my loved one tests positive for COVID-19?
• What support do you offer for patients who have dementia or Alzheimer’s disease?

When it comes to senior care, there are many resources available to help. According to Dr. Thornlow, it’s never too early to start planning for care. “Usually, around retirement age, people are ready to discuss options and begin planning for the next phase of their lives. Include your parents in these discussions to preserve their autonomy.” When you do start planning, you can use these additional resources to assist in the process.

Administration for Community Living
Created by the U.S. Department of Health and Human Services, the ACL combines the efforts of the Administration on Aging (AoA), the Administration on Intellectual Development Disabilities (AIDD) and the HHS Office on Disability to help increase access to community support and resources for aging adults.

Alzheimers.gov
Unbiased and comprehensive information regarding Alzheimer's disease.

Americans With Disabilities Act National Network
Resources and information on the regulations granting universal access to the disabled.

Consumer Finance Protection Bureau
Guides and resources for managing the finances of an aging loved one.

Elder Justice
Resources to help respond and prevent the abuse of older people.

FDA Tips for Seniors
Tips and resources for seniors on safe medication use.

Health Insurance Portability and Accountability Act
Information regarding medical information privacy laws and how to ensure you can access your loved ones’ medical records as they age.

Nursing Home Compare
A detailed list of the past performance of every Medicare and Medicaid certified nursing home in the country.

Supplemental Social Security Income
Information on benefits paid for aging adults with disabilities who have limited income and resources.

U.S. Department of Veteran Affairs
The official website for the Veteran Affairs department providing resources and guides for aging veterans.