Assisted Living or In-Home Care: Which way to go?

By CarePatrol 

Getting older presents unique challenges and often causes decreased independence.  Even though many seniors are staying active longer, the body still slows down over time, and eventually, everyone is going to possibly face this difficult decision for themselves or their loved ones.

If it has become apparent that you or a loved one is at this intersection of life, there are two basic directions to be considered.

In-Home Care

Many people desire to age in place by staying at home as long as possible. You can hire a caregiver directly or by going through a Private Duty Agency. Hiring a caregiver directly as a live-in situation does have some difficulties due to many state laws regarding overtime and benefits which must be provided by an employer.  Private Duty agencies charge by the hour and usually have a minimum of hours to be used per trip of the caregiver.  Working with an agency has the added benefit of easily replacing or substituting caregivers and rotating shift schedules to avoid the overtime issue, though its convenience usually indicates a higher price than hiring a private caregiver directly. Agencies also do background checks and vet their staff, so if you’re looking for peace of mind and you don’t have the time to recruit a caregiver directly, consider working with a renowned agency in your city. Ask family and friends or placement agencies for referrals or search online for the perfect fit.

Home care may be the best option for you if you’re needing part-time assistance and if it is safe for you to stay in your home.  Home care is most commonly used for those needing part-time assistance and is more affordable than moving to an assisted living facility.  When the need for help rises, so does the cost of care. When you need full-time 24-hour care, it may be time to consider other options due to the costs associated with not only the caregivers but also the expenses of the home itself and meals.  Hypothetically, if a 24-hour Private Duty caregiver costs $25 per hour, the expense is $600 per day or $18,000 per month before adding in the other costs associated with the home and meals.

Many people see all senior living communities as “Nursing Homes” but there are three types or levels to consider.

Level one of senior living is called Independent Living.  This is much like living in your own apartment or condo at a senior community.  In an Independent Living community, you have staff who provides meals and checks in with you each day to see that you are safe.  There are usually no caregivers provided or any hands-on care, but you do have the peace of mind of having your home cleaned, meals provided and people around at all times.

Assisted Living

Level two of senior living is referred to as Assisted Living.  This level becomes necessary when you or your loved one can no longer do some or all of their Activities of Daily Living or ADLs.  ADLs are defined as things like bathing, toileting, grooming, dressing, self-transferring from a bed or a chair, and being independently mobile.  

Assisted Living communities usually are consisted of apartments or private rooms where caregivers are on staff and are always available to assist with ADLs.  Meals and utilities are usually included as part of the monthly rent/care fees.  The cost for Assisted Living typically runs less than half of what In-Home care with 24-hour caregivers would.

Another form of Assisted Living is provided in smaller residential homes where the client lives in a private or semi-private room.  This is usually a cheaper option than living in a larger community and the caregiver ratio to residents is usually higher.  Most homes have only ten or fewer residents.

Prices generally vary, as do services and amenities, so be sure to do your research before settling on one. Communities often require large entrance fees upfront while smaller residential Assisted Living homes usually don’t.

If you choose an Assisted Living option, you will also have the added benefit of less responsibility, because the burdens of housekeeping, shopping, cooking, laundry, yard-work, and more are provided.

Memory Care

Some Assisted Living facilities, both large or small, specialize in a slightly higher level of care called Memory Care which is needed for clients with dementia or Alzheimer’s.

Skilled Nursing Facility (SNF)

The third level of senior living is called a Skilled Nursing Facility or an SNF.  This is where there are registered nurses and doctors providing care due to more critical health conditions.  A stay at an SNF is the only level in which insurance will consider paying for a period of time to address the more critical needs.

There are some larger communities that provide all levels of care from Independent Living to Assisted Living (with or without Memory Care) and Skilled Nursing.  These types of facilities are called Continuum of Care Retirement Communities or CCRC. Prices typically increase as you move up levels of care and require more assistance.