Dear Attorney Tully: My mother is 90 years old and in poor health. I want her to stay home for two reasons. She feels more comfortable at home and it is a lot less expensive than a nursing home or assisted living. How can I keep her home and how can we keep the costs down?
Answer: The cost of healthcare in the United States continues to skyrocket. We are often asked when it comes to long-term care, which type of care is cheaper. A common misperception is that receiving care at home is less expensive than receiving care at an assisted living facility or a nursing home. While in most cases this is true, you need to look at all of the costs. According to Andrea Cohen, CEO of Houseworks, a private home care agency in Boston, Massachusetts, which type of care is the cheapest depends on the amount of care needed. Cohen explains that home care starts out being the most cost effective, but if continuous care is needed, a nursing home ends up being the least expensive option. The differences in expenses, depends on whether the senior requires just a few hours of assistance a day, many hours a day, or around-the-clock attention.
One reason that assisted living can become more expensive than home care or nursing home care is that most assisted living facilities do not provide personal care as part of the basic fee. Instead, most facilities require residents to purchase such care from the facility or an outside provider at an extra charge.
Another difference between home care, nursing home care, and assisted living care is that Medicaid (Title-19) in most cases will not pay for assisted living care. Medicaid is a benefits program which is primarily funded by the federal government and administered by each state. Sometimes the rules can vary from state to state.
As life expectancies and long term care costs continue to rise, the challenge quickly becomes how to pay for these services. Many people cannot afford to pay $15,000 – $20,000 or more per month for the cost of a nursing home, and those who can pay for a while may find their life savings wiped out in a matter of months, rather than years.
Home care may be even more expensive if the cost of maintaining one’s home is factored in. Of course, money is only one consideration in choosing where to receive care. Many, if not most, seniors would prefer to stay home if at all possible. Other factors include the ability to access quality care, proximity to family members, the regimentation at an institution, and even the quality of food provided.
