Family Decisions: Your Parent Is Declining

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By Ryan McEniff

seniormanIt eventually happens, you and your siblings notice that your mom or dad is not acting the way they once did, maybe memory impairment has increased, or someone is still mentally sharp, but they are not stable when walking and standing. When the family is together as a whole, it provides a great time to starting talking about what the options are.

So what are the options when it’s clear that someone is steadily declining and needs help?

Your Senior Care Options

This article will go through the options most families have when looking for senior care. It will provide the pros and cons of each service and the monetary costs associated with each type of care.

Family Members

Family members are great to be able to help someone who needs a small amount of assistance. Maybe your parent can’t drive anymore but just needs to get out twice a week. Or if the family is large enough, different people can help out for a few hours per week, and all share the responsibilities of helping out.

Cost: Low/Free
Time: Medium/High
Cons: Loss of time. Often one person becomes the main caregiver sacrificing more and more of their own time than other families do and can become burnt out.

Adult Day Services

Adult day services can be an alternative to having private caregivers come in. It allows seniors, especially those with dementia, to be stimulated through physical and mental activities while a family member has time to go to work or get important errands and tasks done.

Cost: Nation average $70 per day
Time: Low
Cons: Adult day patients can often suffer from dementia, so depending on your location, it might not be a right fit for non-dementia seniors who are looking for activities a few times a week. Additionally, care is provided from 9 am to 3 pm M-F, so there needs to be someone available to drop off and pick up. So it might not be ideal for families working full time or those who work on the weekends.

Private Home Care

Private home care services can provide peace of mind knowing that there is a dedicated caregiver that is there only for your loved one. Caregivers assist with ADLs (activities of daily living) and are flexible with their hours to cater to your schedule.

Cost: $20-30 per hour all private pay (no insurance coverage available)
Time: None/Low
Cons: It is expensive. Many families cannot afford the services. Additionally, families and seniors can be very nervous letting caregivers into their home.

Assisted Living Facilities (ALF)

Assisted living facilities provide an active social environment for senior who wish to interact with people their age. The services provide a private or shared room, meal services and transportation services. Additionally, many assisted living facilities have included a dementia unit, which, as the name implies, is for residents who have developed dementia and needs to be in a secure unit with dedicated and trained staff.

seniorwoman2Cost: $3,300 per month depending on location (no insurance coverage available)
Time: Low
Cons: Expensive. What you are paying for are room, food, and transportation. The personal care hours included are minimal, usually 2-5 hours per week. So if your family member ends up needing more care than that, it will be required to get additional attention, usually from a private home care company that will be an out of pocket expense. Finally, assisted living facilities are private pay, and once the money runs out, then you will be asked to leave.

Nursing Home

Nursing homes help people who need more complicated care that they cannot get at an assisted living or through private home care services. Many are new, provide outstanding care, good food, and activities. Nursing homes have a stigma attached to them of places you go to die or once there, no one visits you, but for many places, it is just not true.

Cost: $6,500-7,000 per month depending on location.
Time: Low
Cons: Expensive & Spend downs. Stigmas are a problem. Quality can range drastically, and some nursing homes will try and only accept spend down patients first.

Pro-tip: Nursing homes are not automatically paid for by Medicare or Medicaid, spending down is required (which is when the patients assets are “spent down” with a seven-year look back before Medicaid pays for the services). So if mom or dad is a resident at an assisted living or using private home care, my suggestion is to start looking for at nursing homes when you have over $50,000 left. Reason being, higher end nursing homes will be more accommodating to private pay customers than those that have no money and will be coming to them on Medicaid.

– The author of this guest post is Ryan McEniff, owner of Minute Women Home Care, in Lexington, Massachusetts.