Over the last several weeks we talked about a whole bunch of juicy stuff… Click any of the links below if you need a refresher.
- When is it time for an older adult to move out of their home?
- What options are there to keep older adults safe in their home for as long as possible?
- How can a temporary stay away from home improve likelihood of returning home?
Now we are going to talk about 5 options for older adults that can’t live alone in their home no matter how much outside assistance is available.
Move in with someone else
This seems like an obvious option, but I wanted to bring it up just in case you might have overlooked it. Moving in with a family member or friend can be the best option for older adults that are no longer safe to live at home alone. Having someone else to do the cooking, cleaning, bill paying, and grocery shopping might be all that is needed. Some older adults may also benefit from having someone to physically assist with mobility, provide medications, and generally keep an eye on them.
Move someone else in
I’ve seen many successful cases where family members chose to move a college student in with their grandparent. It’s a win-win situation. The older adult benefits from having help around the house and from having companionship. The college student gets to live rent free as long as they’re able to keep up their end of the bargain. This arrangement doesn’t have to be made with a college student. It could work with any person that the older adult and the rest of the family trusts, but I’ve seen it done more frequently with students because they have flexible schedules, and let’s face it….they’re broke!
Independent Living Facility
There are many types of living arrangements that are termed “Independent Living.” Most of the time, an independent living facility is basically an apartment complex specifically for older adults. Sometimes they have emergency alert systems built in to the apartment. Many have the ability to provide transportation for their residents, and they go out on regular outings. Sometimes they have a dining room where meals are provided. On the other hand, sometimes they are simply apartment complexes that offer little to no extra support above what any other apartment complex for the general public would provide. Even then, home maintenance issues and yard work are taken care of which is a huge help to aging adults.
Not only are independent living facilities accessible (generally no stairs or other barriers), but they also provide a sense of community for older adults. This setting allows them to be surrounded by their peers and prevents social isolation. I’ve been in many independent living facilities during my career, and it’s rare to enter one with an elevator that is not plastered with signs announcing the upcoming potluck, book club, or bingo game.
Independent living situations are usually paid for out of pocket. If you have long term care insurance, check with the insusurance company to see if they will assist with independent living. The cost generally starts at approximately $2000/month, but that varies depending on services provided.
There is also something called HUD housing which is a type of independent living for low income residents. Click here for more details on HUD housing.
Assisted living is different from independent living in that it involves 24/7 staff in the building. The staff can assist with things like medication management, dressing, bathing, eating, toileting, etc. Assisted living facilities provide housekeeping and dining services as well.
Different assisted living facilities offer varying levels of care. Some offer a variety of services, but the price will likely go up as the needs increase. There are some assisted living facilities that are specifically for older adults with dementia. These are typically locked units to prevent wandering, and the staff is trained and prepared to deal with behaviors that are common among people with dementia.
Assisted living generally costs $3000-$5000 per month. But remember, this includes dining, housekeeping, and utilities. The price will vary between facilities and will also depend on the amount of assistance needed.
Medicare does not pay for assisted living. Medicaid typically doesn’t either, but there are exceptions in some states. There are several other methods that can be used to pay for assisted living.
- Self pay (out of pocket)
- Long term care insurance
- Life insurance: contact your life insurance agent to determine if you have any “living benefits,” if you can cash out, or if you can sell your policy to a 3rd party.
- VA benefits (for veteran or spouse)
Long Term Care
When people say “nursing home,” they are usually referring to a long term care facility. In these facilities, most of the residents are dependent for most or all of their daily tasks. They might need help to get themselves in and out of bed on and off the toilet. They may need physical assistance to walk or they use a wheelchair. In fact, they may be completely bed bound. Staff assists them with bathing, dressing, and even eating if needed.
Medicare does not pay for long term care, but Medicaid does once the resident is out of money. Long term care benefits can also come from the VA, long term care insurance, or possibly life insurance as mentioned above.
Here are a couple of resources that you may find helpful in the not so pleasant process of figuring out which option is best for your loved one.
https://www.medicare.gov/nursinghomecompare/ This website compares nursing homes and gives an overall rating based on categories such as staffing, quality of care, Medicaid or medicare participation, and more.
www.eldercare.gov This is a free service through the U.S. Administration on aging that assists with finding resources for older adults. In their words…“Whether help is needed with services such as meals, home care or transportation, or a caregiver needs training and education or a well-deserved break from caregiving responsibilities, the Eldercare Locator is there to point that person in the right direction.”
https://www.n4a.org/files/HousingOptions.pdf This is a downloadable pdf from the eldercare website called Housing Options for Older Adults from the National Association of Area Agencies on Aging
http://advocatingfortheaging.com/hospitalform This is a downloadable hospital form that will come in handy as your loved one moves between the hospital and other living facilities. Just sign up and the form will be delivered to your email inbox.
http://advocatingfortheaging.com/safeathome This is another downloadable form that details 10 things that you can do today, to set up your loved one’s home in a way that will keep them safe in their home and out of the hospital. Just sign up and the mini e-book will be delivered right to your inbox.
Join me next week as we wrap up this topic by discussing how to make the transition as easy and gentle as possible when an older adult must move out of their home.