The COVID-19 emergency has only strengthened the desire seniors have to age in place - at home - an already favorable position among older adults. In fact, 90% of seniors prefer to remain in their homes as opposed to moving to an assisted living facility, a new survey from American Advisors Group (AAG) found. And rightfully so. We are comfortable at home; we cherish our homes, and we want to stay where we feel safe, secure, and surrounded by the ones we love.
But when we receive a diagnosis that has particular challenges in advanced stages, we wonder if that is possible. With the right safety and support measures in place, it is. More than ever, we have options to receive care within the home -whether that means getting a prescription from a medical doctor to have home health services for nurses, aides, and therapies, or choosing additional companions to support us and our caregivers. There are also many services available that can help fill the gaps through end of life, including Palliative and Hospice care options - allowing you to have the equipment, supplies, and medical attention you need commonly found in assisted living and skilled nursing facilities that are often covered by insurance and conveniently setup and removed from the home as needed.
My dad wanted to stay home, and I promised I would do everything in my power to help him stay home. It took a great deal of work and commitment, but together, my mom and myself were able to keep him home through his end of life with the right help and support. In the more advanced stages, we had to learn the proper techniques for transfers and mobility so that we didn't hurt ourselves while helping him from the Occupational Therapist. We had to make some minor modifications to the home to be able to get dad from room to room with his wheelchair and safely shower. We had to setup the hospital bed in the living room where space was available. We utilized home health care whenever we qualified after a hospitalization or an infection to bring therapies into the home when he could not longer get out of the house to attend sessions in person. And, we finished our journey with hospice who covered the costly supplies associated with incontinence and nutrition, as well as the needed medical equipment.
But choosing home doesn't come without its challenges. Caregivers and families must have honest conversations, really look in the mirror, and ask themselves if they are up for the challenge of full-time care for their loved ones. Not everyone is cut out for this role. And if you find yourself reaching breaking points where you are unable to provide quality care to your loved one, neglecting your loved ones needs out of exhaustion, or simply have found that it is just too much physically or emotionally for you as the care partner -- you may find that choosing an assisted living or memory care facility is a better option for your family. It takes a village; caring for a loved one is more than any one person can do on their own.
The other consideration is safety. If your home cannot be equipped for a safe journey, a community living option may be a better selection. Also, should your loved one be diagnosed with a condition that puts themselves or you as their caregiver in great danger physically, there may be a need to be flexible and move to the appropriate facility. Even if you choose home, it is always a good idea to know your options in your local area just in case you try home and see it isn't achievable for your specific scenario.
Choosing home can be one of the most affordable options, especially if you have a support system willing to share some of the care needs. While there is expense to hiring home care companions that isn't covered by insurance - many facilities also require families to hire additional assistance for those patients who may be more demanding or need more extensive hands-on care and attention. Many families find themselves questioning why they would choose a facility if they are only going to end up needing to pay for additional care that could have been as easily provided at home. It's important to understand the average staff to resident ratio and how each facility operates in advance of making the decision to forego home.
When it comes to budgeting for care in a facility or at home, you should expect to pay on average $15,000 a month out of pocket for 24 x 7, full-time care. That's why having friends and family for additional support is critical in helping to cut those fees in half. Medical insurance doesn't cover the cost of residential facility rent fees, nor home care companion services. However, long-term care insurance policies can significantly help if you purchase the policy around the age of 55-60 prior to a diagnosis. Most insurance plans can help offset expenses on average of $300,000. And some insurance policies now offer a percentage of return for any investments not used. That wasn't the case in many original use it or lose it policies. It doesn't come without a steep investment, but it can provide peace of mind. I encourage you to shop wisely with a financial advisor and source that you trust that has your best interest at heart when it comes to long-term insurance plans. There are many scams, and it is important to know which policies can be trusted and offer the greatest return.
If you do choose home, be sure to involve family, friends, neighbors, and members of your community. Many people can assist as volunteers to help offset some of the expenses. It is also very important to stay socially connected - and if your spouse or child is your care partner - they must take the appropriate breaks to get respite.
There is no right or wrong choice. In fact, be grateful if you have a choice, because so many don't based on their financial or family situations. At the end of the day, you must choose the best-case scenario for you and your family. Neither choice comes without pros and cons.
Engage Care Partners can help you discern what might be the best choice for you and your loved ones. We ask the questions and present the pros and cons of both choices, so that together, you and your family can determine which option is best for you. We also offer family mentoring and mediation services to help families get on the same page for the best option and understand what support is needed for home to be a successful choice. Should you choose home, we can help to asses your home for safety as well as build an appropriate care plan for you and your loved ones.