Issue: Aging in-place
Cost Considerations
Costs and expenses are often the major determinate of whether it’s feasible to age in place. The cost of in-home care – even with aides – can be near or above $300K per year for 24-hour support. Nearly one million dollars every three years! Only a small percentage of aging people have the means to support this expense when added to the costs of maintaining a home and other life expenses. This often leads to consideration of senior living facilities and life care communities.
Considerations should include – initial and on-going, quality of the care, food, room, and social environment. Accessibility to the physical location – close to family and/or airports – and ease of accommodating visitors or nearby lodgings. Access to high-quality medical care, training, stability, and satisfaction of the facility staff, accommodations for beloved pets, cultural and social events, and availability of shuttle services.
Cost and contractual provisions can vary widely. Some life care communities require a large initial buy-in – sometimes more than a million dollars for guaranteed future access to assisted living, memory, and skilled nursing care. There is generally a monthly lease/rental fee for the unit to be occupied and some level of provision/expense for meals and other services.
Decisions regarding whether an individual stays independent or moves to a higher level of care – usually at a higher monthly charge – made be made by the care team and not the individual, their family or their treating physician. The ramifications of these types of provisions are frequently not given adequate consideration. Another unanticipated issue is a decline in the functioning of an individual to the point where privately paid caregivers are still needed due to staffing challenges thereby substantially raising the costs of care.
Other types of life care type facilities do not require an upfront buy-in and operate more like rental agreements with deposits and monthly fees depending on the level of service and support an individual requires. These facilities, like the life care communities, offer independent living, assisted living, and memory care. They also have varying levels of activities, social events and medical support.
Decisions on how best to navigate late life issues are personal and complicated. Even when you are convinced that a particular decision is the right one and will not change, it might. I have personally assisted individuals, who were sure they would never move again, suddenly find they needed to relocate due to the serious illness or death of a family member. These types of unanticipated events should always factor into major life decisions – especially ones that involve substantial sums of money.
