Often as a family sees their loved one decline they struggle to determine whether they should look in to moving them to an assisted living community or hire home care to come in to provide care. Much of the struggle comes from mom or dad not wanting to leave their long-time home, thinking an assisted living is a nursing home, but also assuming home care is more cost effective.
This is a very personal decision and each situation is different. That's why I think it's important to understand the differences between the two options so you can make the decision that is best for you or your loved one.
What Is An Assisted Living?
An assisted living is an apartment community of adults typically over the age of 55 yrs that need a little or no assistance with activities of daily living. The residents come and go as they please, have access to recreational activities, and enjoy the convenience services offered which often include; housekeeping, laundry service, meals, transportation, and access to an emergency response system.
An assisted living is also licensed to provide nursing services. Services are regulated by the state. In Iowa, assisted living level of care is able to assist with; dressing, bathing, medication management, one person assist transfers, manageable incontinence, and reminders. Please note that although the guidelines allow the above services, not all assisted living communities choose to provide all of these services. Be sure to ask when doing your research or you may find yourself having to make another move.
Most rooms are smaller one-bedroom and two-bedroom apartments that the resident furnishes with their own belongings. This level of care is meant to extend the independence and quality of life of the aging adult in an environment that provides daily oversight by staff to help reduce incidents.
Average cost in Iowa for assisted living level of care with median services runs between $4,000-$5,000 per month. Assisted living communities are private pay, can accept long-term care insurance, and Veterans benefits. Many no longer accept Medicaid (Elderly Waiver) because reimbursement often takes months to receive (if they pay at all) and the community ends up having to provide services while writing off thousands of dollars. This lack of reimbursement causes the community to have to raise rates, which is unfair to other residents. Therefore, many have chosen not to accept Elderly Waiver any longer or limit the number of Waiver residents they can have.
What is Home Care?
Home care is having a trained home health aide come into a senior’s home to help them with activities of daily living for a few hours a day all the way up to 24/7 care. It is one on one care meant to help the aging adult live longer in their home. The convenience services a home care aide can provide include; companionship, meal prep, grocery shopping, transportation, prescription pick-up and light housekeeping.
Direct care services can include; medication reminders (not administration), bathing, dressing, incontinence care, mobility assistance. Please note that medication administration must be done by a Registered Nurse. Many home care companies do not employ RNs. Those that do employ an RN and offer medication administration have an increased hourly rate for those services. Be sure to ask these questions.
Home care is charged at an hourly rate which a minimum of 2 hour increments. The hourly rate can run from $21-$28 per hour. Rates are discounted for clients who receive many hours of services. Home care is private pay, can accept long-term care insurance, and Veterans benefits.
Here's a snapshot comparison of these two care options in reference to cost: Assisted Living-24/7 convenience services and access to nursing services for a 30 day period= $4100-$5500 per month or $136-$183 per day. (depending on size of apartment and chosen services)
Home Care- 24/7 convenience services and access to aide services (minus medication management) for a 30 day period= $15,000-20,000 per month $500-$700 per day(depending on the companies hourly rate)
I used the above example simply to compare apples to apples. However, if you are only needing home care services for a few hours per week, it would obviously be less expensive than assisted living. Overall, you need to determine what's best for your situation.