According to the U.S. Centers for Disease Control and Prevention, eight out of ten older Americans are living with health challenges of one or more chronic diseases, including high blood pressure, Alzheimer’s disease, heart disease, depression, diabetes, etc. People with chronic disease account for three quarters of America’s direct health expenditures costing more than three times as much to serve compared to others. While the impact on the healthcare system is obvious, less so is the emotional and financial impact on families and family care givers.
Whether it’s an aging spouse, parent or other loved one, the time may come when some form of long term care or residential care services must be considered. The traditional alternative and the fear of many aging adults is permanent placement in a nursing home and the negative preconceptions this evokes. While over half of U.S. residents living in some form of residential care facility are residing in nursing homes, senior care and senior housing have evolved over the years and a wide range of options are available depending on available financial resources and the level of care needed.
The level of care required is typically evaluated based on an individual’s ability to perform Activities of Daily Living (ADL) and the degree of assistance they require to perform such tasks. These tasks include: bathing, dressing, toileting, transferring (like from a bed to a chair) and eating. The more assistance that is needed for a greater number of ADL tasks means that a higher level of care is required.
Adult Day Services and Private Duty Home Care are intended to support family care givers and to allow aging adults to remain in their homes or the homes of their loved ones. Typically home care is feasible with only low to moderate assistance with several ADL tasks. Both services are self-pay and are not reimbursed by medical or long term care insurance plans. The national average cost for Adult Day Services is around $70 per day and Private Duty Care ranges from $4,800 to $14,000 per month (8 hours to 24 hours per day services).
Assisted Living Communities are designed to provide home like settings while providing the required level of assistance with ADL tasks (three quarters of residents typically require assistance with 1 or more ADL’s). The national average rate is $3,000 to $4,000 per month depending on the level of services provided above the base rate. Assisted Living care is self-pay and may be reimbursed by long term care insurance policies.
Skilled Nursing care is provided when around the clock licensed nursing care is required for medical conditions following a three day hospitalization and is reimbursed directly by Medicare and commercial medical insurance plans. Medicare beneficiaries are eligible for up to 100 skilled nursing days per year.
Residential Nursing Homes typically have some Medicare certified skilled beds where the average stay is 20 days, but the majority of their beds are for long term Residential Nursing care which is provided to those who need complete care for ADL activities. More than two thirds of all nursing home care is paid for by State Medicaid programs (individuals must be Medicaid qualified). The national average self-pay rate for Nursing Homes ranges from $6,820 to $7,750 per month (semi private to private rates). Long term care insurance plans may cover all or part of the cost for this residential care.
To find out more about senior care options in your area that would best your loved one, you can consult with a Nurse for free at Room & Residence Inc. (firstname.lastname@example.org).
By Patrick N. Lee, CHE, MHA Chief Operating Officer Room & Residence Inc.
Categorised in: Assisted Living
This post was written by Jay