Published August 17, 2012
United Methodist Foundation for the Tennessee and Memphis Conferences
Planning for retirement and senior care is a very important activity. The activities of daily living for a senior person include eating, dressing, bathing, and walking or moving. At some point you will likely need assistance in one or more areas.
An important consideration will be the cost of providing that care. By retirement, it is helpful for you to own your own home, be debt free, and have retirement income and savings. Retirement income will frequently include Social Security, your IRA or 401(k), a pension plan and investment earnings.
Typically, you will be involved in three different levels of care. These three levels start with home healthcare, defined as assistance with the activities of daily living by a home healthcare aid or nurse. The second level is a more formal assisted living or independent living facility. In an assisted living facility, there are more staff and a higher level of assistance.
Finally, the third level is skilled nursing care. This is 24-hour nursing care in a facility that is designed to provide a higher level of medical assistance.
Home healthcare is popular for several reasons. First, it is the least expensive of the three levels. Home healthcare will vary significantly depending on the level of services provided. However, it frequently will cost from $10,000 to $30,000 per year.
Home healthcare is preferred because a senior person wants to maintain his or her independence. While the cost is generally reasonable, there are many organizations and providers who can give you good quality care. A key decision for home healthcare is the person who will be the caregiver. Family is often the first option. If you have a child or other relative who is willing to provide assistance, you may be able to live quit comfortably in a family home or perhaps in an attached apartment.
The next level will frequently be a service provider such as a home healthcare aide. The aides visit on a regular basis and provide assistance. Many individuals are able to manage well by themselves as long as they have a home healthcare aide who makes regular visits.
A third level of home healthcare may involve visits by a practical nurse or registered nurse. The nurse may assist you with various types of care and check to see that you are using your medications or other types of therapy in a beneficial manner.
There are safeguards that should be carefully considered for home healthcare. The organizations that provide home healthcare are generally licensed by each state. You can check into their certification and also their reputation. It’s also helpful to have a family member who is in regular contact with the senior person who is receiving home healthcare.
As you age and become more senior, it may be appropriate for you to stop driving and to depend on others for transportation. In addition, the family protector can watch to see that you do not make inappropriate expenditures or become vulnerable to any type of abuse.
Independent or Assisted Living
A second level of care is independent or assisted living. This level of care typically has a cost of $40,000 to $65,000 per year.
Many facilities provide both independent and assisted living. Independent living permits the individual to live in a residential facility, but to have a reasonably high level of control of his or her life. With independent living, the person will live in his or her own apartment or small residence and frequently retains a vehicle and the ability to drive. Independent living often offers a meal plan so that the resident can choose to eat in a common dining area.
Assisted living occurs in a more structured residence with a higher level of staff services. The assisted living facility will involve staff who regularly assist residents with the activities of daily living.
Long-term care includes several levels of care. The two most common levels are skilled nursing and intermediate care. Skilled nursing will provide around-the-clock care from a license practical nurse or registered nurse. The cost of skilled nursing care may be $80,000 to $110,000 per year.
Intermediate care facilities also are intended to care for residents that have chronic illnesses or impairments of health. These facilities offer 24-hour staff care. However, they will not always have a registered nurse and may use a vocational or practical nurse staff.
It is extremely important with long-term care to examine the facility. Is the facility owned and managed by a for-profit or a nonprofit? What is the affiliation of the organization?
A person may be in a skilled nursing home for several years. Because the costs are very significant, the financial strength of the organization is quite important. If the organization at some point in the future has a financial shortfall, it may find it necessary to reduce services. This could have a great impact on the care of a senior person.
Other areas to consider are the facility and the services. What is the location of the facility? You should review the cleanliness of the rooms and the public areas and try to determine the general feelings of current residents toward the facility. Many care facilities offer a number of different types of services. Some of these are social or recreational while others are therapeutic and health related.
Finally, how are the levels of staffing and the food service for the facility? A good facility will have a caring and adequate staff and food service team for the number of residents.
Alzheimer’s is a challenging disease because it leads progressively to very high care requirements. Because of the staff and facility requirements, Alzheimer’s care can cost $100,000 or more per year.
There are three general levels of Alzheimer’s. Early-stage Alzheimer’s involves some short-term memory loss, difficulties with routine tasks, and mood swings. Middle-stage Alzheimer’s patients may start to show confusion about time and place, loss of memory, and wandering. With late-stage Alzheimer’s, there is a loss of cognitive function and eventual physical deterioration.
Home care is possible for early-stage Alzheimer’s. A family member can provide the level of care needed. It is important that the caregiver understands the risks and takes protective actions to minimize the potential for the senior person to wander off and become lost.
The next level of care is an organized senior residence with a measure of independence. This will provide 24-hour care, but still enables an early or middle-stage Alzheimer’s patient to have some level of control of his or her activities.
Finally, for advanced stages of Alzheimer’s, the senior person will need 24-hour residential care. Family members should examine the rooms, consider the staffing levels and review the policies regarding medication for those Alzheimer’s patients.