The three C’s
OK, you’re back from spending time with your parents or other loved ones and you now realize they’re not as independent as they used to be. The decision is whether to get someone to come into their home (more frequently) or having them move into a location that provides more supervision and care such as assisted living. Let’s take a look at these two options:
Care. Most home care is non-medical care provided by trained caregivers. However, some home care can only be delivered by licensed, health care professionals. Caregivers can be hired through an agency, registry, or privately, and because every state has authority to license and regulate its home care agency system, there are often variations in licensure requirements and regulations from state to state.
Costs. According to the 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs, the national average rate for non-medical care runs $21 per hour. Rates are different from one metropolitan area to another and rates are higher for medical or nurse assistance at home.
Caution. Caregivers can be hired from an agency or they can be hired as a private or independent caregiver. Be careful if you are considering hiring a private or independent caregiver, since the individual becomes your employee and you become the employer. On the other hand, if you hire an agency, they may be a little higher in cost but will screen caregivers and do thorough background checks, assume full liability for all care provided, supervise caregivers, cover auto insurance, take responsibility for caregivers’ benefits, vacation days, and sick days and have a replacement caregiver available in case your regular caregiver calls in sick.
Though most seniors want to stay at home, if they are going to be home alone just with a caregiver coming in at different times, social interaction is extremely important, especially with those suffering from dementia. In this type of situation, strongly consider Adult Day Care in your community if in-home care is going to be your option.
Care. Assisted Living options range from small, family Residential Care Homes to larger, full-service communities with hundreds of residents. The smaller locations are similar to living in someone’s home with live-in caregivers who provide assistance. The larger locations (communities) are more like Senior Apartments with caregivers providing 24/7 assistance. More and more seniors are becoming residents of small, large and specialized Assisted Living facilities including dementia care. Generally speaking, Assisted Living is for people that need help with the activities of daily living (ADL’s). ADL’s are considered the routine activities that people tend do everyday without needing assistance. There are six basic ADL’s, including eating, bathing, dressing, toileting, transferring (walking) and continence. If someone has some form of dementia, like Alzheimer’s there are locations that are licensed to properly care for individuals with this disease.
Costs. According to the 2012 MetLife Market Survey, the national average monthly base rate in an assisted living community was $3,550 in 2012. Regardless of size, base rate fees often cover only some of the total costs of needed assisted living services. Communities will vary on the number of services that are included in the base rate. The national average monthly base rate for Alzheimer’s and dementia care is $4,807.
Caution. There are many choices for those needing assisted living and/or dementia care and supervision. Selecting the wrong community or residential care home for your loved one can make things even more difficult. Consider using a professional in senior care placement who is familiar with the various options, including care, costs and location. They can then suggest the best options for your loved one to continue to age in a safe place.
The MetLife report “Aging in Place 2.0, Rethinking Solutions to the Home Care Challenge” states “although a large majority of older Americans say they want to age at home, it is often more easily said than done. Today’s care infrastructure, technologies, existing housing, funding sources, and the businesses and services available are not being fully realized in order to achieve the promise most hope for as America ages.”
In addition, hiring in-home help may be a temporary fix for a permanent problem that will turn into being more expensive. Dementia is always going to progress, and a person with dementia is going to become less functional and more needy over time. Be careful of the promises you make to loved ones regarding long-term care. You may be promising something that could be less safe at a far higher cost.
Frank M. Samson, CSA is a Certified Senior Advisor and Founder of Senior Care Authority based in Sonoma (Seniorcareauthority.com.) The company provides support to families throughout California to locate the best In-Home Care, Dementia Care, Independent and Assisted Living for their loved ones. Frank also hosts “The Aging Boomers” Mondays at 2 p.m. on SUN 91.3FM and Sunfmtv.com. Reach him at .939.8744 or Frank@seniorcareauthority.com.