By Gary Fenstermacher
In last month’s issue we looked at the pros and cons of aging in place at home or moving to a long-term care facility. This month we’ll assume that the elder has decided to move to a care residence. One of the biggest questions involved in such a move is, “How much does it cost?”
You will not be surprised to learn that the answer is, “It depends.” But you may be surprised to learn that it is often not as much as you think.
Among the major factors determining costs are whether elders retain their current housing and automobile, what kind of long-term care facility is selected, and what level of care is required. Let’s look at each of these factors in turn.
If elders relinquish their current residence and assuming they have one, their automobile, there are considerable savings that become available to offset the cost of long term care. Depending on the elder’s lifestyle, the savings may cover most of the cost of long term care. Just how much is saved depends on the amounts spent on housing, transportation, food and utilities prior to moving to long term care, as well as what type of facility the elder moves to.
There are two ways to look at the type of facility the elder selects. First is the amount and kind of care the elder requires. The amount and kind of care determine both the type of facility the elder needs and the cost of residing in that facility. Care tiers typically begin with assistance with the activities of daily living (such as bathing, dressing, toileting, and medication management) and become more extensive and involved if the elder experiences increasing degrees of physical or mental frailty.
A second way to look at the type of facility is how posh it is. For example, there are assisted living accommodations available in the Tucson region that start at just over $3000 per month (per person) and scale to more than $6000 a month. Though there are exceptions, it is generally the case that higher costs are associated with larger living spaces, enhanced amenities, and (one hopes) better staff-to resident ratios.
When considering the cost of long term care, it is helpful to understand the difference between the cost of the room and the cost of care. Room rent pays for the elder’s private space as well as the indoor and outdoor common spaces, meals, heating and air conditioning, and so forth. Care costs are those associated with the level of staff time and expertise needed to provide proper and appropriate care. Room rents may be subject to standard year-to-year increases, while care costs may be adjusted whenever there is a significant change in the elder’s health.
The cost of long term care is also impacted by the insurance the elder may have. Elders who have long term care insurance will likely experience moderate to considerable reductions in out-of-pocket expenses, depending on the terms of the policy. In the very complicated world of American healthcare insurance, including Medicare, some long term care services may be covered by these policies. Such coverage, however, is often restricted to the provision of short-duration services.
Though long term care is not inexpensive, it is often more affordable than many believe. This is especially the case when the financial obligations associated with housing, automobile, food, and utilities are relinquished upon making the move to long term care.
