Home care and nursing home care – some facts

In the United States, over 65 million people provide home care to someone who is ill or disabled.

Elderly people who live at home and have trouble with 3 or more activities of daily living require an average of 9 hours of assistance per day (from paid or unpaid caregivers), and once they reach age 85  they require about 11 hours of assistance per day.

There are about 52 million caregivers assisting adults over age 18, with about 44 million caring for adults over 50; around 15 million family caregivers help people with Alzheimer’s and dementia.

ltcstudyTwo out of three (66%) people who receive home care rely solely on family members, usually wives or daughters. Another 26% receive a combination of family care and paid help; and 9% receive paid help only. Of family members caring for the elderly, 30% are themselves over 65, and 15% are age 45–54.

Nursing home patients are 75-80% women. Many of them care for their husbands at home, then have no one to care for them.

Lost income and benefits over a caregiver’s lifetime are estimated at $283,716 for men or $324,044 for women.

The great majority (80%) of elderly people who need assistance live in private homes rather than institutions. However, community-based care accounts for only about 18% of long term care expenditures for the elderly. Care in a skilled nursing facility (SNF) costs four times as much as paid care at home. In addition to being less expensive, home care is what most Americans prefer.

For those who need nursing home care, the average price per year of skilled care in a semi-private room is $82,000 in 2016. It varies by region: Texas is $55,000 a year; California $91,000; Connecticut $148,000; Alaska $292,000. Skilled care in a private room is about 10% more. Assisted living costs are about half of nursing home costs.

By contrast, private paid care in a patient’s home costs about a third as much as care in a nursing home, depending on how much care the patient needs. However, if the home patient needs round-the-clock skilled care it can cost $10,000 – $15,000 a month, which is comparable to nursing home costs or even more expensive.

About half of people who go into a nursing home will stay no longer than 6 months; the other half average 3-4 years.

It is estimated that unpaid family members take up 2/3 of the cost of long term care. Long term care insurance can help pay for both home care and nursing home care. Two LTC insurance companies include a (limited) cash benefit that can be used to pay family members, many of these policies have Partnership asset protection. Also available are life policies with long term care riders and some companies have a cash benefit.

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