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Weighing the Benefits of Keeping Parents at Home in Old Age

By Martha Michael

Long-Term Care

The upside to living with multiple generations under one roof may have been a bit glamorized by The Waltons on television, but there’s something to be said for the positive effects of keeping seniors at home as they age. Whether your family leans toward togetherness or you take a more modern approach where Grandma and Grandpa live in a community of their peers, it’s a good idea to devise a plan before a health crisis arises.

October is Long-Term Care Planning Month, which is a reminder that now is the time to consider the practical and financial concerns related to the steps you choose for your lifestyle later.

What is Long-Term Care?

Nearly any service that contributes to a senior’s health and welfare can be a facet of long-term care, according to the National Institute on Aging. The most common type of assistance is called personal care. It includes help with activities of daily living -- grooming, using the toilet, eating, and dressing -- in addition to simple mobility assistance. Most long-term senior care is delivered in the home, but some seniors are taken care of in residential or adult daycare facilities.

Factors contributing to the need for care include:

  • Age
  • Marital status
  • Gender
  • Health
  • Family history
  • Lifestyle

Family members often divide the responsibilities, sometimes choosing agency employees for personal and health-related services. And because the aging process is fluid, your decisions need to be flexible. Seniors who at one point solely need someone to administer medications and transport them to appointments may later call for assistance with basics such as bathing and dressing.

Cost of Home Health Care

From homemaker services to health care and emergency response systems, there are a range of costs associated with providing care to seniors -- whether they live at home or in a facility. A live-in caregiver is one option, but there are senior communities and living facilities with varying levels of support.

An article in U.S. News & World Report discusses the difference in cost between assisted living and home care. A survey by Genworth Financial in 2018 found that a home health caregiver costs approximately $4,195 per month, which isn’t much more than the median price of assisted living, which is $4,000 per month. A skilled nursing facility can cost more than $8,000 per month but it provides considerably more health services.

Several factors come into play when examining the financial obligations of each form of senior care, including Medicare and Medicaid restrictions, insurance programs, and whether the individual can receive veteran’s benefits.

"Medicare does not cover the cost of, or help to pay for, assisted living arrangements," says Andrew Shea, vice president of the Medicare sector of online health insurance exchange eHealth, Inc. It means a steep out-of-pocket responsibility for the patient unless they have long-term care insurance, he says.

As the end of the year approaches, seniors should also check into whether they have any available money in their flexible spending account, or FSA. If they choose to apply it to chiropractic care or another benefit, they need to act before the fiscal year ends because, in many cases, the value is lost.

Keeping Seniors at Home

A survey by AARP found that 90 percent of seniors plan to stay in their homes for the next five to 10 years, according to an article in Leisure Care. They typically give a combination of the following five reasons for staying at home as long as possible:

Moving is stressful - For people at any age, moving is one of the greatest stressors among life’s circumstances. When part of the equation involves sorting through an attic full of memories and rooms filled with sentimental furnishings, it compounds the pressure.

They lose independence - Even when a senior’s new living space offers a great deal of freedom, downsizing reduces their autonomy. A smaller home may mean they lose their garden or the ability to entertain big groups, and when they lose the right to drive there is considerable dependence on others.

They have to leave their community - Changing one’s routine is hard enough, but leaving the familiarity of their favorite market, place of worship, and relationships with neighbors are tremendous sacrifices.

They are sentimental about the house - After making some of the most significant memories of their lives, such as raising kids, it’s normal to cling to home base. It’s more than just a structure; the rooms can reflect the sights and sounds of holidays, laughter, and family dinners.

They are afraid of change - Charging into unknown territory is difficult for anyone and shifting into new life circumstances, such as moving, requires a big dose of letting go. New housing certainly changes day-to-day living, but it can also impact the quality of relationships, which can take an emotional toll on a person.

During a pandemic such as COVID-19, when older folks are hit harder than anyone else, keeping seniors at home may be a no-brainer. There are sacrifices and considerations in making such a decision, but there are also countless benefits.

If you do keep Grandma and Grandpa at home, keep in mind the importance of safety precautions. Stairs will become increasingly difficult for them to manage, and you need to eliminate items they can trip on such as area rugs and electrical cords.

Every family is different, but you can capitalize on the strong points of your seniors. Kids become better conversationalists when they practice a wider range of topics with multiple generations, and grandparents can provide an ear when a teen simply needs someone to listen.

There’s no recipe for success, as everyone’s situation has its own pros and cons. Your home may not include a plucky old man dressed in overalls like the ‘70s TV standard, but chances are you could learn to like the friendly banter and nightly sign-off of “Goodnight, Grandpa!”

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