Wednesday, July 01, 2009

Self-paid long term care: compare the options: in-home could be the most expensive


I found another reference on how to choose among long term care options, particularly in “self-pay” situations. The reference is on a site called prosaically “health.com”, and it is here. The title of the article is “How to Choose Between Home Health Care, Assisted Living, and a Nursing Home.” The article aims at US markets, although the costs seem to behave similarly in Canada and Britain. Remember, in general (except in a few countries) purely custodial care is typically not covered except for the indigent (Medicaid in the US); it is generally not covered by Medicare (hospice offers some coverages however).

One particularly important point is that 24-hour-care is likely to be the most expensive option in many cases. That would be particularly the case if one goes through an agency, that would have to send workers out in shifts. If an individual caregiver finds a live-in and does all the legal paperwork (IRS, EIN, immigration, etc) sometimes it could be much less expensive, but doing so may not be all right for many people. In many communities, 24 hour home health could cost close to $200000 a year.

By way of comparison, a nursing home in a similar area may typically cost about $7500 a month, or getting a little under $100000 a year, and an assisted living tends (after purchasing unbundled services with most residents need) in higher cost areas to be about $5000 a month. A recent film about assisted living in Britain found similar numbers, showing active seniors in north London paying about $4000 a month.

Caregivers are always concerned about whether their elders or parents will really get adequate care in these settings.

The best earlier reference that I found for comparison was on this blog Feb. 20, 2008, with the major source the John Hancock Life Insurance Company.

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