Senior Care Options- Finding the Right Place for Mom

Senior care is a growing industry, and there are more options than in the past. Most people think as they age they move to an “old-folks home,” or a “nursing home.” The truth is, there are far more choices than you realize! Below is a list of senior care options, a brief description of each, and a short group of “pros and cons” for each. Let us know if it is helpful, or if you have questions in the comments.

• Home Care– The most popular senior care option allows adults to stay in the comfort of their own home. This service can be provided by formal caregivers (CNA/NAC, Home Care Aide, etc.) or by friends, family members, and neighbors. Home care is usually billed hourly, and typically falls between $20-$27/hour depending on where you live.
  • Pros– Home is usually the preferred location of adults, no moving or transportation costs, preserves independence, assistance is provided one-on-one, caregivers can provide emotional and social support that improves quality of life, and care is tailored to the needs (you choose what assistance is provided and paid for
  • Cons– If 24 hour supervision is needed it can be expensive, may be difficult to find the right caregiver(s)(especially if the situation is long term)

• Adult Day Programs/Adult Day Care– Older adults seeking companionship and mental stimulation can find it in adult day services, which provide activities and therapy with out-of-home transportation. Hot meals, nursing care and light exercise, as well as art therapy, reminiscence groups, horticultural workshops and other recreations are provided. The average cost is about $65 per day, depending on services offered.
  • Pros– Typically affordable, fair amount of socialization, transportation usually available
  • Cons– Transportation planning can add difficulty, personal services (hygiene, bathing, etc.) are not normally provided, occurs away from the home
• Assisted Living Facility (ALF)- In an assisted living facility, older adults find help with routine tasks, such as grooming, housekeeping, cooking, and taking medication, while having their own full bathrooms and kitchens. Assisted living facilities often look like large, fancy hotels. They are built to resemble a home, rather than a medical facility. Costs vary based on apartment unit size, services offered, and additional fees. Costs are hard to estimate, as they vary by apartment size and care required. In general, most assisted living facilities cost between $4,000/month and $8,000/month (location plays a factor in this, as well).
  • Pros- 24 Hour Supervision from trained staff, social common areas and recreation schedules that offer community with other older adults, more affordable than nursing homes
  • Cons- Communal living, care staff are usually caring for several people and are thus rushed through tasks, higher risk of infection due to increased concentration of sick/frail, costs increase as care increases, often ALF staff limit personal freedom
• Nursing Homes/Skilled Nursing Facility (SNF)- Nursing homes have licensed nurses and physicians on-site, available around the clock in order to handle grooming, dressing and incontinence challenges. They may also deal with care needs that require licensed medical professionals (IV lines, supra-pubic catheters, ventilators, etc.). Most nursing homes devote the majority of their space to short term (acute) rehab patients, specializing in therapy (speech, physical, or occupational). Long term care is paid out of pocket or through state assistance. They are the most expensive care option, sometimes reaching $9,000 per month. Nursing homes often feel clinical, and don’t always have the “home” like amenities of ALF’s.
  • Pros- Medicare can sometimes cover costs, activities and social engagement on site, medical professionals on site
  • Cons- Prices above $7,000/month, lack of personal freedom due to regimented schedule, communal living, care staff usually caring for several people and are thus rushed through tasks, higher risk of infection due to increased concentration of sick/frail, finding the right nursing home can be difficult, long wait periods for assistance
• Memory Care– Memory care has become an increasingly popular option for those with dementia (including Alzheimer’s). Memory Care communities are usually similar to assisted living facilities in structure, but have some additional oversight (usually from a licensed practical nurse). They are locked, have activities designed for those with limited cognitive impairment, and have staff with training related to different dementia diagnoses. Usually memory care costs between $5,000-$9,000 per month, depending on the care needed, location, and size of the apartment.
  • Pros- Safety and supervision with 24 hour care and locked doors, specialized programs, usually higher ratio of staff to residents than ALF’s, others who share diagnosis of dementia
  • Cons- Prices above $5,000/month, decreased personal freedom, communal living, care staff usually caring for several people and are thus rushed through tasks, higher risk of infection due to increased concentration of sick/frail, finding the right memory care can be difficult, long wait periods for assistance, potential for violence/increased agitation, especially difficult for early stage/younger onset active residents as they have few people to relate to
• Adult Family Home (AFH)– An adult family home is essentially a smaller ALF. AFH’s in Washington state have 6 or fewer residents. Owners sometimes live in the home and help with care. Aide’s provide assistance with personal needs, meal preparation, and home making duties. Typically, AFH’s cost between $3,000-$5,000 per month.
  • Pros– Trained staff supervision 24 hours per day, smaller “family” feel, lower costs than traditional assisted living
  • Cons- Fairly new industry so fewer regulations, fewer amenities than ALF’s, less medical professional oversight, high turnover in staff

As an honorable mention on our list, Retirement Homes or Independent Living (IL) communities are homes that don’t offer assistance with activities of daily living. They may share a campus or building with ALF’s, but retirement homes are senior apartments. They will usually offer housekeeping services, some scheduled activities, and 1-2 meals per day. They are primarily for seniors who enjoy living in close proximity to other older adults.

There are more options for senior care today than ever before. Don’t forget to do your research about what is best for you, your spouse, or your parents.