Judson Haims: In-home care or assisted living? Lot to consider for families making decision | AspenTimes.com
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Judson Haims: In-home care or assisted living? Lot to consider for families making decision

Judson Haims
Special to The Aspen Times

Deciding between in-home care and assisted living is a question seniors and adult children will all at some time ponder. Making the decision is very different for those living in metropolitan areas than it is for those in rural areas. While living here in the mountains often adds a layer of complications, they are not insurmountable. Before making a decision, you’ll need to weigh the many pros and cons of each.

Let’s first look at the difference between assisted living and in-home care.

Assisted living facilities (ALF) are designed to provide various levels of personal and medical care to people who have challenges of living alone but do not need medical and nursing care. They are generally designed to offer assistance with daily care like dressing, bathing, monitoring medications, meals, socialization, in addition to some housekeeping and laundry.



The offerings vary from facility to facility. Some offer only assisted living services, while others add independent living offerings for people who need little or no assistance with activities of daily living. Some facilities add another tier of offerings that include skilled nursing and memory care for those needing elevated levels of medical, nursing or memory care.

In-home care is a more private and customizable offering that enables people to remain in the comfort of their home. Typically, the offerings are non-medical in nature and include services such as personal care, which includes: bathing, eating, dressing, toileting, grooming. Household care and health care services also are offered. Depending on the providing agency, these services can include customized meal preparation with focus on healthy diets, cleaning, laundry and shopping. Some agencies will assist in scheduling medical appointments, transportation (insured), medication reminders and assistance with physical exercise and scheduling PT appointments.



Perhaps the No. 1 pro of an assisted living facility may be the offerings for socialization. Most assisted living facilities offer movies, games, poker night(s), music and art activities, and book clubs. Additional benefits of these facilities are that they provide 24/7 access for activities of daily living, which include things such as assistance with medication, dressing, bathing and personal hygiene.

Biggest con for choosing assisted living is immediate access to addressing your individual and personal needs. While staff is available 24/7, most facilities staff a ratio of care providers to patients of either 5-to-1 or as many as 7-to-1. Splitting the middle and finding a facility offering a staff ratio of 6-to-1 would mean that each patient may be allocated 10 minutes of every hour. Other cons include less personal attention, group settings and polices are not for everyone, limited privacy, and less access to higher levels of medical care.

And then explore the costs.

Paying for an ALF or in-home care can be expensive. It’s really important that people understand this. Too many people incorrectly believe that Medicare will cover all the costs for these services. This is incorrect. However, within the past couple of years, Medicare has started to offer Medicare Advantage programs that cover very limited benefits. Hopefully, such offerings will expand. But until they do, do not count on Medicare for your ALF or in-home care needs.

ALFs and in-home care services are most often paid for by assistance from veterans benefits, life insurance policies, long-term care insurance, or out of pocket.

According to the most recent data from Genworth’s Cost of Care Survey, the annual national median cost of an ALF is $51,600 per year. At not much more, the annual median cost for in-home care is $54,912. If you think this is expensive, you should be aware that skilled facility costs are even more expensive. The national median cost of a semi-private room in a skilled nursing facility is about $93,075 and the cost of a private room in a nursing home is about $105,850.

Here in the mountain towns of Colorado, cost for assisted living, nursing, skilled nursing and in-home care is greater than the national average. While it is best to call a local facility and ask for pricing, you can expect to pay north of $4,000 to $5,000/month for basic assisted living, in the range of $7,000 to $8,000/month for a semi-private room of a nursing home, and about $10,000/month for a private room. In-home care agencies most often charge by the hour and range between $35 to $42 an hour. For eight hours a day at seven-days per week, you can expect to pay in the range of $8,500 to $9,000 a month. Many offer discounted rates for longer hours per month and some offer monthly contract discounts.

The Genworth Cost of Care Survey is a great tool for education about costs throughout the country or if you would like to see what average costs are in other parts of the country (go to genworth.com).

If you have questions about care options for a loved one or are interested in learning about resources, our local Area Agencies on Aging is a fantastic resource. The local office is located in Silverthorne and their contact phone number is 970-468-0295.

Judson Haims is the owner of Visiting Angels Home Care in Aspen, Basalt, and Carbondale. He is an advocate for our elderly and is available to answer questions. His contact information is http://www.visitingangels.com/comtns or 970-328-5526.


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