Wouldn’t your loved one prefer to live out their lives in the comfort of home rather than in a nursing facility? Most older adults, needless to say, would choose their own homes. But for any number of reasons, from physical or mental health issues to dwindling finances, staying at home doesn’t always seem possible.
If someone close to you appears to be headed for a nursing home, some alternatives can forestall the need for such a move. By making adjustments to living arrangements, strategic family planning, and designating family caregivers, long term care in the home may be possible.
How To Take Care Of Elderly Parents At Home
Adult children that want to care for their aging parents at home, or in their parent’s home, have options. Many primary caregivers find that through planning and medical directives, in-home care is highly doable.
There are numerous ways to accomplish elder care at home, including:
Share care
As an older adult’s need for in-home care begins to mushroom, even the combination of paid and family caregiving may quickly become too expensive. Some find care to be too time consuming and exhausting. Many people discover they’re able to share caregiving (and its costs) by pooling their resources.
Use adult day care
One way to make in-home care work is to supplement it with adult day care. Your loved one can spend a few hours to a full day at an adult day care center. This gives the primary in-home caregiver time tend to other matters or get a break from caregiving.
The benefits of adult day care aren’t just for the caregivers. Adult day care centers typically offer meals, activities, exercise, and transportation. These centers provide the person in your care a change from the isolation of home, socialization with others, and activities they might not otherwise participate in. Many adult day care centers accept people with mild to moderate Alzheimer’s or other forms of dementia.
Adult day care centers charge less per hour than in-home caregivers, sometimes $25 to $75 for a full day, depending on location and services provided. Also, many centers offer sliding-scale fees.
Neither Medicare nor other health insurance pays for adult day care, but many state Medicaid programs do. Also, the Department of Veterans Affairs (VA) operates its own adult day care centers for veterans who qualify.
There are more than 3,500 adult day care centers currently operating in the United States; probably at least some are centers close to you.
Hire free or low-cost companion care
Skilled in-home care can cost $20 to $30 an hour or even more. If the number of hours needed for care begins to mount, consider what type of help is necessary. If your loved one can get by with partial assisted living care, companion care may be the right option for you.
Companion care could be part or full time and assist with regular routines. Care can offer companionship, help with household chores or have someone present for safety and security.
If lower-cost (or free) companion care is workable for your family member, here are some sources of such help:
Senior-to-senior programs
In some areas, local government or nonprofit organizations operate an agency that connects local senior volunteers with other seniors in need of companion care.
To learn about whether such a senior-to-senior program exists near you, call toll-free at 800-677-1116.
Churches
Some churches have programs in which congregation members volunteer to provide free in-home care for older adults. These programs usually provide only a few hours of help a week, but even that can make a big difference to a family caregiver.
If you or your loved one belongs to a local church, find out if it has a care program.
Local high schools and colleges
Many high schools and colleges offer community service programs where student volunteers provide free local services for older adults. Student volunteers aren’t usually capable of providing extensive care, but often they can run errands, perform household chores, and provide companionship for older adults.
Many colleges have student employment centers where students list their availability to provide care for pay, usually at rates considerably lower than those of professional caregivers.
In-home care agencies
Most in-home care agencies offer different levels of care, including lower-cost companion care. Here’s one way to find out about and compare in-home care agencies near you.
Check out your backyard
For some people, having a loved one move in with them would make providing care much easier. It could eliminate the need to move to a nursing home altogether. But lack of space and the intrusion on the privacy of both the family and the person being cared for often make such a move impractical.
One solution is the addition of a small, separate living unit in the backyard or other open space at a family home. Backyard units may be temporary or permanent and can be fitted with special features designed to aid older adults.
The addition of a separate living unit is neither simple nor cheap. Still, these costs are considerably less than even one year in most nursing homes. Once the unit is no longer needed, it can either be removed or kept and used for other purposes.
Get creative with financial tools
If lack of cash is the reason your loved one can’t remain at home, consider two overlooked resources.
Reverse mortgage
If your loved one owns the home he or she lives in, a reverse mortgage might raise enough money to pay for in-home care. Unlike a conventional mortgage, none of the reverse mortgage loan amounts have to be repaid until the homeowner dies or permanently leaves the home. The money from a reverse mortgage can be available to pay for in-home care as long as the homeowner continues to live in the home.
Cash for life insurance
Certain life insurance policies can be cashed out with the insurance company itself for 50 to 75 percent of the policy’s face value. Some policies permit these “accelerated benefits” or “living benefits,” as they’re called, only if the policyholder is terminally ill.
A “life settlement” (also called a “senior settlement”) may also be possible, which involves selling the policy to a life settlement company for a lump sum. The amount of the settlement depends on the policy benefit amounts, the policy’s monthly premiums, and the policy holder’s age and health. The settlement company pays the policy’s premiums until the person dies, and then it collects the life insurance benefits.
Investigate the Department of Veterans Affairs (VA) Benefits
If your family member is a veteran, or a spouse or surviving spouse of a veteran, they may be able to qualify for VA benefits. These benefits will enable them to remain at home instead of entering an assisted living community.
In-home care and adult day care programs
The VA provides several long-term in-home and community care programs, known as “extended care.” These programs offer non-medical assistance to help certain veterans maintain their independence. Extended care is available to a veteran with a service-connected disability or to any veteran who has very low income and needs long-term care.
Extended care can include:
- In-home health aides and homemaker services
- Adult daycare, which provides health maintenance and rehabilitative services to veterans in a group setting during daytime hours, either at a VA or community facility
- Community senior living centers, offer care for veterans with chronic stable conditions (including dementia) and veterans needing rehabilitation or short-term special services
- Being able to remain at home sometimes depends on the physical configuration of a person’s living space. The VA offers several types of cash grants to help veterans modify their homes to make their homes safer and more accessible.
- Eligibility for cash benefits for veterans and their spouses vary depending on the nature of military service, the existence of a service-connected disability, and income.
To get free information or assistance regarding any VA benefits, contact one of the VA’s Vet Centers, which are located in every state. You can also get assistance by contacting the VA’s Veterans Benefits Administration Office nearest you. The VA’s toll-free telephone helpline at 800-827-1000 is also available for any questions
Options For Care Outside Of The Home
In some cases, keeping a family member inside the home is just not an option. If taking care of elderly parents at home is not going to work, there are a variety of assisted living facilities available. These facilities provide companionship, health care, and aid to aging seniors.
Some options for out-of-the-home care can include:
Moving in with a relative, friend, or neighbor
Living alone increases the need for caregiving.
Many older adults address this problem by sharing their living space with someone else who’s in similar circumstances. This might mean sharing one or the other’s existing home or getting a new place together. Roommates can then help support each other while sharing some family and paid caregiving, reducing both the burden and the cost.
Shared family and paid caregiving
There may be someone who lives close to the person you’re caring for who also needs regular in-home care. Assuming that the two of them get along and accept the idea, it may be possible for them to share in-home caregiving.
One of them could be taken to the other’s home and, if both physical setups allow, they could alternate between the two places. Care could be for a whole day or a few hours, either by a paid or family caregiver. A comfortable chair or bed could be added to one or both places to make this more workable.
Move to a less expensive area
If in-home care gets too expensive, consider moving your loved one to a different, less costly, location. The cost of living and the cost of an in-home caregiver varies substantially in different areas of the country.
More affordable living options can include:
- Moving away from urban areas. These areas tend to be more expensive than rural ones.
- Getting away from the coast. Both coasts are generally more expensive than the South, the Southwest, and much of the Great Plains and the Rocky Mountains.
By reducing costs, it may be possible to afford considerably more in-home care in a new, less expensive location.
Consider assisted living
Assisted living facilities are usually far less costly than a nursing home. There may be assisted-living facilities near a family member who can provide regular companionship and extra support beyond what the facility offers.
If your loved one needs regular monitoring but not constant supervision, then it may pay to look into an assisted living facility. These facilities offer help with certain aspects of life, like showering, eating, or basic healthcare.
Find out about and compare assisted-living facilities in your area.
Look into Medicaid
Medicaid does not include non-medical, long-term, in-home care as a standard part of its coverage. As a way of allowing Medicaid recipients to remain at home, some state Medicaid programs have established Home & Community-Based Services (HCBS).
HCBS programs offer Medicaid coverage for a limited amount of in-home care and adult daycare. These programs only operate in some states, and the eligibility and benefits rules vary from program to program.
To find out more about the availability of an HCBS program where your loved one lives, contact a local Medicaid office at Benefits.gov.
Ask about the PACE program
If you’re caring for someone with low income, the Program of All-Inclusive Care for the Elderly (PACE) could help.
PACE Benefits
The PACE program provides full medical coverage plus comprehensive community care. These benefits are provided at adult daycare centers but also in-home care. Benefits include transportation, meals, and social services for frail older adults who would otherwise need ongoing care.
If someone is accepted into PACE, a program team will assess their specific care needs. The team will develop a care plan and be responsible for providing all medical and care services.
PACE Eligibility
PACE is only available in certain areas, and eligibility is restricted to low-income adults over age 55, usually those eligible for Medicare.
Some PACE programs are limited to people who are eligible for Medicaid, and for these enrollees, the program is entirely free. PACE programs also accept people whose income or assets are slightly too high for Medicaid eligibility. In these cases, there is a monthly premium for medical care.
To learn whether there’s a PACE program operating where you live, or how to contact the program, see the Medicare official website.
Resources & Support For Taking Care Of Elderly Parents At Home
If you are concerned about providing a loved one with the right care in a home or care facility, let North River Home Care help. We offer free assessments to assist you in making the right choice for your family.
