The Cost of Assisted Living vs. In-Home Care is…

There are really two costs you are weighing when determining the cost of assisted living vs. in-home care options. The first is the black-and-white financial costs associated with each. The second is the physical and emotional costs associated with transitioning into a new home and community versus remaining independently in the comfort of your own home.

Ideally, families should sit down and create long-term, senior care plans ahead of time. This way you can ease the path forward when age-related issues make it harder for loved ones to stay at home without some sort of assistance.

Financial Cost of Assisted Living vs. In-Home Care

Each year, Genworth Financial posts a comprehensive analysis of long term care costs by state and type of care. Although the costs for in-home care are going up, it is still more affordable to bring care into the home than paying for residential-based options with steeper, base-level, monthly fees.

The following statistics are per-month costs specific to Massachusetts, based on 44 hours of care per week. You can visit Genworth Financial’s Cost of Long Term Care page for state-by-state comparisons.

• In-Home Care (including personal and hygiene care): $5,186
• Assisted Living (does not include personal/hygiene care): $5,640
• Nursing Home (semi-private room): $12,473
• Nursing Home (private room): $13,212

When visiting prospective assisted living facilities, make sure to read the fine print carefully, and verbally inquire about additional care (hidden care) costs that are not reflected in their base “per-month” quote.

In-home care costs are comprehensive, encompassing all of the services provided by a caregiver on a given day.

On the other hand, assisted living quotes typically cover the standard services (housing, meals taken in the dining room, social activities). They charge additional fees for extra services such as hygiene care, transportation, mobility assistance to meals, medication reminders, laundry services, increased care needs, etc.

Finance Savvy: Scaling Long-Term Care

An important thing to keep in mind is that long-term care doesn’t have to mean one or the other. Taking a scaled approach to senior care is a smart way to save money on the front end so you have it to spend if your loved one’s needs increase beyond the realm of in-home care.

For example, let’s say you noticed signs an aging parent needs support to remain at home. That doesn’t necessarily mean it’s time to move to an expensive assisted living community.

Instead, you may find that shorter daily or weekly shifts with a companion provide routine safety checks, light housekeeping, and laundry services, transportation to weekly appointments and activities, and personal connection and engagement. These services can be scaled up or down, depending on the senior’s needs.

In that case, the 40-hour a week in-home care costs cited above could cost far less at the beginning, slowly achieving that full-time cost over time.

If and when you feel your loved one’s needs are served best by an assisted living facility, you can make a gradual transition in that direction, having saved thousands – or tens of thousands – in the months/years leading to that point.

The Physical and Emotional Costs of Transitioning to Assisted Living Communities

While children of aging parents may breathe a huge sigh of relief upon depositing parents in a beautiful, assisted living community where meals, social activities, and landscaping are all accounted for – this isn’t always the best for their parent. The trauma of moving out of a home someone loves, having to make new friends, and being pulled out of the local community can have devastating effects on his/her well-being.

Also, waiting too late (after a major illness, severe memory loss, or excessive physical decline) can diminish – rather than enhance – a senior’s quality of life. The transition is simply too physically and emotionally exhausting.

If assisted living is the plan seniors should transition:

• With an open heart and a desire to simplify and start a new chapter
• Well before an acute “need” arises so s/he has time to settle in and enjoy the higher-quality of life s/he’s seeking
• When the costs for non-medical and medical home care at home exceed that of an assisted living community
• If the physical/memory care needs of the client exceed what the home care agency can provide

Considerations for Aging in Place

The Urban Institute published in an insightful and informative piece addressing the overwhelming desire of American seniors to age-in-place, rather than move into assisted living.

Their point, and we agree, is that the desire to age-in-place must be met with sound preparations to age in place safely while maximizing physical, social, and emotional wellbeing.

If your parent lives in a large, multi-story home, aging in place is only beneficial if they are willing to be accommodated via:

• Accessible changes that create safe, single-story living (ramps, grab bars in bathrooms, rearranging cabinets/kitchen/bath so most-used items are easily in reach, elimination of trip hazards, etc.)
• Willing to accept help with driving, errand running, light housekeeping, etc.
• Prepared to have someone come in to support age-related decline via mobility assistance, transportation, errand running, grocery and meal support, etc.

Plans to age-in-place must accommodate the senior’s typical social schedule, ensuring they attend their standard lunch dates, religious services, movies, meals out, etc.. If aging-in-place translates to sitting stagnant at home, mostly alone, it is not the healthiest option.

Paying for The Costs of Assisted Living vs. In-Home Care

Once you’ve made a decision, you’ll need to plan how to cover the costs of care. If there isn’t a robust savings or retirement account in place, these costs can feel overwhelming. Fortunately, there is a wide range of funding options at your disposal.

Read our post How to Pay for In-Home Care, which outlines some of the most common resources, including public and private insurance funds, personal assets, veteran’s benefits, reverse mortgages, and so on.

Your free assessments with home care agencies and touring prospective assisted living options (and asking the right, detailed questions) are the best way to determine whether assisted living or in-home care is best for you.