When Home Care Isn’t Enough
When is home care no longer enough? Here are the warning signs that it may be time to consider assisted living or a nursing home.
Dear Savvy Senior,
My mother has several chronic health conditions and needs a home caregiver to help with daily activities. I know she wants to stay at home as long as possible, but how do I know when it’s time to consider an assisted living facility or nursing home?
–Exhausted Daughter
Dear Exhausted,
Most older adults hope to remain in their own home as long as possible, and with the right support many can. But there may come a point when home care is no longer enough to meet a person’s medical, safety or social needs. While moving to an assisted living facility or nursing home is never easy, recognizing the warning signs early can help you avoid a crisis and make the transition less stressful.
If you answer “yes” to several of the following questions, it may be time to start exploring other care options.
Is home care becoming too expensive?
Eight to 10 hours of care a day, seven days a week, can easily cost $100,000 a year or more. That’s well above the median annual cost of a one-bedroom assisted living apartment (about $70,000), though still less than a private room in a nursing home (about $128,000), according to Genworth’s Cost of Care Survey.
Does she need more medical care?
If your mother needs ongoing nursing care or frequent medical monitoring, a nursing home may be the better choice. If she mainly needs help with daily activities, assisted living may be enough.
Is she falling, forgetting medications or going to the hospital more often?
Frequent falls, medication mistakes and repeated hospitalizations are often signs that living at home is becoming unsafe.
Does she have dementia?
Wandering, confusion or unsafe behaviors can make home care increasingly difficult. Memory care communities provide a secure environment and specially trained staff.
Does it take two people to help her?
If she needs two people to assist with transfers, bathing or toileting, both the cost and safety risks of home care rise significantly.
Is her home still safe?
Stairs, narrow bathrooms and the lack of features like grab bars or a walk-in shower can increase the risk of falls. Home modifications may help, but they aren’t always enough.
Is she isolated or neglecting personal care?
Loneliness, poor nutrition, weight loss, or neglecting bathing and grooming can all signal that she needs more support than can realistically be provided at home.
Is caregiving overwhelming?
If you’re constantly worried, sleep-deprived or neglecting your own health, it may be time to consider a higher level of care. Planning ahead gives your family more choices and helps avoid making an important decision during a medical emergency.
Keep in mind that Medicare generally doesn’t pay for long term stays in assisted living or nursing homes. It only covers limited skilled nursing care after a qualifying hospital stay. Understanding what Medicare covers and what it doesn’t can help you avoid costly surprises.
If you’re unsure what level of care your mother needs, an Aging Life Care professional can assess her situation and recommend appropriate options. An initial assessment can cost $300 to $800 or more. You can also use a senior care advising service like A Place for Mom, which provides free guidance because it is compensated by participating care communities.
To research facilities, visit Caring.com. For Medicare-certified nursing homes, use Medicare’s Care Compare tool at Medicare.gov/care-compare. You can also contact your local long-term care ombudsman to learn about complaints or quality concerns involving facilities you’re considering.
The best time to choose a care community is before a crisis forces the decision, giving your mother more choices and your family greater peace of mind.