Whether you are counted among the elderly yourself, or you are responsible for a senior loved one, there is a choice that you might have to make.
If the senior is not able to function without the assistance of supervision, should you opt for in-home care, or would a nursing home (or assisted living) would be better for them?
Several psychological, emotional, cultural, and even ethical issues might influence this decision, but in this article, we will discuss its economic angle.
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In-home care is the assistance and help provided to people who can’t function on their own due to age or illness.
We are only talking about senior citizens in this article. So for them, the degree of in-home care can vary a lot. In over half the total in-home care scenarios, the immediate family is usually the primary care-giver.
This gets a bit hard when family members have to deal with their other obligations like a full-time job or education.
This is where care professionals come in. They can help the elderly in the place of their family. The help and care they provide may vary greatly, depending upon how much help the senior needs.
The in-home care provider might only be required to keep an eye on the seniors, help prepare food (or provide already prepared food), medication, and to keep them engaged.
This type of care is fairly common. But if the senior is too aged to function, the in-home care might be very different.
The care-giver may need to feed the senior, provide toilet care to bedridden seniors, and might even be required to provide emergency first aid if needed.
The variety of tasks involved and the level of care needed by a senior has a lot of influence on the cost of in-home care.
Average Cost Comparison: In-Home, Assisted Living and Nursing Home
The cost for in-home care can be very different depending upon the state you are in, and the type of help or supervision needed by the senior.
But we can compare the national average cost of in-home care, with assisted living and a nursing home.
A straightforward difference between the two is that a nursing home is a medical facility, with healthcare professionals present round the clock.
The facility itself is more of a hospital-like setting. This is preferable for seniors with fragile health and terminally or chronically ill.
An assisted home-care facility is great for seniors that are relatively functional in their everyday life. They can walk or get around on their own.
They only need “assistance” in their daily life chores, help with their medicine, and provision of basic amenities.
According to Genworth’s Cost of care data, nationally, the assisted living costs the least, and nursing homes cost the most. In-home care cost nearly as much as assisted living. The monthly averages are:
In-Home care: $4,290 (Homemaker services) and $4,385 (Home health aide)
Assisted living: $4,051 (Full-time) and $1,625 (Day health care)
Nursing home: $7,513 (Semi-private room) and $8,517 (Private room)
What is the cost of seniors living in their own homes?
The cost of seniors living in their own homes can be broken down into many elements. But the most cost-driving factor is hired care-giver.
Care-Giver / Health Cost
The professionals can charge very differently depending upon the services you require and the time they are required to be there.
We can divide the in-home care providers into two categories: Home care aides and Home Health aides. The most commonly used hired professionals are home-care aides.
The health aides are usually only hired on a temporary basis.
In-home care-givers, on average, charge $21 an hour. This varies based on the state you are in. The typical range is $16 to $28.
Medical aides cost a little bit more (on average, $22 an hour). This data is compiled based on agency based care-givers. Independent contractors and small local services might cost significantly less (about 20% to 30% less).
This is ideal for people who only require the in-home care of certain occasions (when the family members who are the primary care-givers are busy or away).
Seniors who live on their own might also sometimes require such services when they are feeling down.
The daily rates can fall anywhere between $200 and $350 per day.
They can be higher if you are hiring a nurse, rather than a simple care-giver. The daily billing arrangement is usually necessary for seniors who require 24-hours daycare.
In situations where the care-giver has to stay awake at night to keep an eye on the senior, a rotation of two care-givers is usually required. But this is something that the agency or service you are working with has to take care of.
Note that it may or may not include the cost of care-giver’s meals.
Just like the hourly cost arrangement, there is an over-night arrangement when the senior requires assistance (or assistance from someone other than a family care-giver) only part of the day.
This is usually required by seniors who need to be looked over when they are sleeping because they might need to get up multiple times in a night for water for toiletry needs.
These arrangements usually cost a bit less, somewhere between $120 and $200 a night (10-12 hours).
Food is another cost factor for seniors in in-home care, but it’s not as big of an expense.
According to USDA’s moderate food plan, 71+ old seniors can spend somewhere between $250 and $280 a month on food.
If they eat rather lavishly, the cost can go up to a range of $300 to $345. If you are hiring a full-time care-giver whose meals are on you, you can double that amount.
Understand that this doesn’t include any special dietary plans or supplements.
If seniors are on a special diet, the cost can vary a lot depending upon how much the cost of the ingredients in the food being prepared at home, or you have to buy pre-packaged food. Any of these factors may drive the monthly food cost up.
Other expenses for in-home care will again depend upon the condition of the senior in care.
If the person is mobile, can do most of the day to day things on their own like cooking a meal, taking care of the home, etc., then the cost can be significantly lower.
A senior individual like that might only need care-givers to help temporarily or partially.
But the expenses start to add up if the senior individual’s help begins to deteriorate. If they can’t cook their meals on their own, someone might have to cook it for them.
If it isn’t included in the care-giver’s plan or contract than you might need to make some other arrangements that might cost you more.
The home also needs to be prepared for the elderly, especially the bathrooms.
Depending upon how much comfort you want to provide and how much cost is needed, the cost can be from a couple of hundred bucks to a lot higher.
If the elderly can’t walk around, you may have to invest in mobility devices. But this is an expense that you will have to bear even if you put the senior individual in an assisted care facility or a nursing home.
This cost breakdown is highly subjective to the senior’s condition and the presence of a primary care provider within the family.
The cost might not be the most significant in-home care benefit, but its psychological and emotional benefits are hard to challenge.
The senior gets to be in a familiar environment. This makes getting around easy, even in frail health.
And even if seniors are not living with the family, living in the same neighborhood and surrounded by people they know is a great way to have a relatively more engaging life.
Also, seniors that qualify to live in an assisted home can usually get by with partial in-home care. This makes it a relatively cheaper option.
The in-home care costs go up if the senior is a health risk and requires much closer monitoring and assistance. Not many assisted homes will take in a senior like that.
And if they are to be placed in a nursing home, in-home care will by far be the better (and cheaper) option.
In most cases, in-home care comes out of your own pocket. But there are exceptions as well. An example is Medicare’s PACE program.
It isn’t valid for all states, but it may pay (fully or partially) for in-home care. If the senior is a veteran, the VA may pay for in-home care. Another option is insurance.
It might cost a lot if you only get it after the senior needs in-home care. But if you plan ahead, and get an insurance that covers in-home care cost, you might save a lot of money down the road.