Deciphering Types of Housing and Care –
Let’s get down to the business of explaining the types of housing and medical care available to aging parents. In order of degree of care:
Home Health Care – Ordered by a doctor and provided as needed on an hourly basis in the person’s place of residence. Common services include:
- Assistance with some or all activities of daily living;
- Occupational, speech, and physical therapies;
- Help managing medications;
- Periodical checking of vital signs such as blood pressure, temperature, heart rate, and breathing;
- Evaluation of the patient’s safety at home;
- Coordination with other providers, including physicians.
Things to Keep in Mind: According to the Genworth 2015 Cost of Care Survey, the median hourly rate of a home health aide is $20 in the United States and $22 in Colorado. However, costs can vary widely by location. Take a look at the link below for additional cost information in your state or metropolitan area.
A search tool of home health care agencies is available below. Your parents’ doctor may recommend a particular agency. Ask if the doctor or the medical practice has a financial interest in the agency or in making a referral.
Background requirements for the individual caregiver vary greatly by state. Check with your state’s regulatory body to see what background and licensing requirements are in place, and ask the agency if their standards exceed your state’s minimum.
Assisted Living Facility – A bridge between home health care and full-service nursing homes. Designed for individuals in stable health. Common services include:
- A licensed staff on-site;
- Significant assistance with up to two activities of daily living;
- 24-hour general monitoring;
- Provision of meals;
- Housekeeping and laundry services;
- Help managing medications;
- Recreational and social activities; and
- Arrangements for transportation.
Things to Keep in Mind: No national regulation of assisted living facilities exists, and regulations vary significantly from state-to-state. A record of regulatory violations may be available from your state. See below for a link to Colorado’s violation and complaint database.
More than 80% of assisted living facilities are for-profit. Costs often range from $25,000 to $50,000 per year. Frequently, a base rent is charged and additional services are assessed on an a-la-carte basis. Ratings of facilities are difficult to obtain, and many referral sources are provided compensation by the facility.
Nursing Home – The most extensive medical treatment available outside of a hospital. Nursing homes deliver three primary service types:
- Skilled nursing;
- Rehabilitation from injury, disability, or illness;
- Long-term care usually provided for a specific physical or mental condition that precludes the patient from residing in an assisted living facility.
Nursing homes include 24-hour supervision and emergency care with a Registered Nurse available at least part of the time. Some facilities offer specialized care for Alzheimer’s and dementia.
Things to Keep in Mind: Nursing homes are subject to national regulations. The comparison tool below offers helpful information, including ratings, participation in Medicare and Medicaid programs, facility ownership, and inspection results.
Nursing home care is very expensive, often ranging from $48,000 to $96,000 per year.
Background on Home Health Care: http://www.medicare.gov/what-medicare-covers/home-health-care/home-health-care-what-is-it-what-to-expect.html
Genworth 2015 Cost of Care Survey: https://www.genworth.com/corporate/about-genworth/industry-expertise/cost-of-care.html
Federal Home Health Agency Search: http://www.medicare.gov/homehealthcompare/search.html
Colorado Assisted Living Database: http://www.hfemsd2.dphe.state.co.us/hfd2003/homebase.aspx?Ftype=pcbhpp&Do=srch
More Information on Assisted Living: http://www.eldercare.gov/eldercare.net/public/resources/factsheets/assisted_living.aspx
Federal Nursing Home Comparison Tool: http://www.medicare.gov/nursinghomecompare/search.html
This covers Part 2 of 3 in our Caregiving for Aging Parents blog series. Stay tuned for:
Part III: Financial challenges as parents age.