According to an article written by Keren Brown Wilson, PhD. In Volume 47 of The Gerontologist, the first written use of the term ‘assisted living’ occurred in 1985.
At that time, the early models of assisted living emerged as a more desirable alternative for older adults who were destined for nursing facilities.
Following their introduction in the mid-80s, assisted living facilities grew rapidly despite concerns from regulators regarding affordability and the lack of licensing oversight. Today, there are thousands of communities in the United States alone, and assisted living facilities costs have increased by 67% since 2004.
Assisted Living Cost and What’s Included
Although license requirements vary by state, assisted living facilities generally offer room and board, meals and a communal setting with on-site staff for a base monthly fee. That fee differs based on the size of your room and whether you are sharing that room or living in it privately.
In addition to the base fee, clients receive assistance as needed with bathing, dressing, grooming and medication administration consistent with their needs. As a resident’s needs increase, their care fees also increase until such time they are no longer considered appropriate for an assisted living setting.
Since every facility differs in terms of how they charge for and provide services, it’s important to review the contract in detail and understand how fees and annual increases will be calculated.
In 2018, assisted living costs rose 6.67%,which was the highest spike among all long-term care segments, so it’s critical to evaluate future increases when considering the affordability of an assisted living facility for your loved ones.
Brookdale Senior Living, one of the largest middle-market assisted living providers in the United States, states on its website that the average Brookdale assisted living resident pays a range of $3,400 to $4,600 in total monthly fees. Higher care residents or residents investigating assisted living communities in CCRC’s should expect to pay over $5,000 per month for services.
Home Care (also known as Aging in Place) Comparison
When comparing home care costs to assisted living costs, Genworth uses a weekly estimate of 44 hours of in-home companion care and assumes an hourly rate of approximately $21.00 per hour. Annualizing at 52 weeks, Genworth calculates that if a client were to receive a little over 6 hours per day, 365 days per year, they would pay an average of $4,000 monthly for that service.
So, with costs roughly the same per month, and with assisted living including meals, room and board, and 24/7 supervision, it’s easy to conclude that for those individuals who need 24/7 care, assisted living may be the most cost-effective option.
But when you dig into staffing levels and the model a bit further, the cost of actual care provided breaks down. Let’s use an example to illustrate this further: In North Carolina, the staffing requirement for a 60-person facility requires less than 1 hour of staffing time per resident per day. (Source: 10A NCAC 13F .0606 Staffing Chart).
How much care each resident receives is dependent upon their individual care plan, but for residents who need basic assistance with medication, dressing and bathing, receiving care in the home could be more affordable and higher quality than that received in a facility.
Take the following proposal for example:
Certified Nursing Aide: three hours per day, seven days per week
- Medication reminders
- Assistance with bathing, grooming and dressing as needed
- Assistance with eating and preparing CarePods meals
- Transportation to and engagement in community events that interest the resident
Registered Nurse: visits twice monthly to monitor care. Available to client and family every day by phone for care oversight and coordination questions.
Prepared Meals: One ‘dinner-sized’ meal per day; freshly prepared by expert Chefs and delivered to our client’s home ready to eat in person.
Virtual Assistant: Coordinates scheduling and client’s calendar with family; orders snacks and supplies as needed. Handles errands.
Personalized Wellness Program: Developed by a geriatric wellness expert to address this individual’s physical, mental and emotional needs. Administered daily in the client’s home and overseen monthly by our Wellness Leader.
Board Certified Geriatric Pharmacist: Reviews client’s medication history monthly or following a significant change or concern and provides recommendations accordingly to client’s Registered Nurse manager who coordinates with family and physicians.
Emergency Monitoring Device: Provided to client and customized based on need so client has access to assistance 24/7.
With all services combined, the total cost for all of the above was a fixed $3,395 per month. This represented a cost savings of approximately $1,605 per month or approximately $19,260 annually as compared to the $5,000/month assisted living facility she was considering.
In addition to the cost savings, the client was receiving service in the environment of her choosing, and benefitting from three hours per day of hands-on, personal care as well as ongoing in-home oversight from an Registered Nurse. For this client who very much wanted to stay in her home and just needed basic daily assistance, the aging in place numbers worked.
For clients whose needs are significantly greater, loved ones should evaluate how much hands-on care they are able and willing to provide. For those clients, assuming their loved ones qualify for assisted living and have access to an affordable facility, they may find it to be more cost-effective than receiving care at home as the client’s needs grow.
There is no one-size-fits-all approach to aging, but with options for staying at home increasing daily, it’s important for families to dig into the details of each care option before making a decision. Professionals in home care, assisted living and at companies like CarePods can help you set goals and facilitate sound decision-making for you and your loved one.