How Much Does Senior Care Really Cost?

As far as senior care goes, when it comes down to it- one thing people really care about is how much does it cost?
So today I want to share what senior care actually costs. All figures are averages– and depending on circumstances (level of acuity), cost can increase significantly. Rates were based on Genworth’s Annual Care Costs report.*

Homecare– (this is what Capability Homecare  provides)

  • Caregivers are assigned to a specific client and assist with medication, mobility, personal care (assist with toilet, catheter & ostomy care), bathing, meals & nutritiion, housekeeping, transportation, skin care, and ADL’s.
  • For 8 hours a day of service- it can cost around $240 a day (average cost is around $30 per hour, most agencies have a 4 hour per week minimum). Care can be short term or long term. Care is usually paid for privately or with LTC Insurance.

Assisted Living

  • Facilities that provide supervision or assistance with activities of daily living (ADLs); coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Meals, housekeeping and care are provided. Caregivers assist residents, but are not assigned one on one.
  • Depending on how much care is needed- costs can range from $6000 a month to upwards of $7000+. Memory care is often more expensive. AL is paid for privately or with LTC Insurance.

Adult Family Home

  • Homes that have been configured to provide housing, meals and care for between 2- 6 senior residents. They are often for people with dementia, but each home is very different and specialize in their own specific care.
  • Because there are so many homes in the Greater Seattle area, we recommend using a Placement Specialist to find the best fit for your specific needs.
  • Most homes have a home doctor/ or nurse practioner who regulary visit the residents (billing Medicare)
  • Cost can be around $6000- $7000 a month.

Skilled Nursing Facility

  • This is more of a hospital type setting. Often seniors will share a room with another person. There is a MD on staff as well as nurses, caregivers, social workers and rehab staff.
  • If there has been a hospital stay (with 3 midnights) Medicare will pay for services- for a limited time. Sometimes, after Medicare stops paying, people chose to continue on at a SNF and live in the Long Term Care wing. The average daily cost for private pay in a SNF is $320 (semi private) and $420 (private) a day.

Adult Day Care

  • Drop off daycare where seniors can socialize with other seniors, enjoy a meal and participate in an activity or outing. Seniors enjoy the companionship of other seniors and have access to staff.
  • Average cost of Adult Day Care is around $100 a day.

Home Health

  • Services include Wound Care, PT, OT, Speech therapy, Social Work and sometimes a bath visit. Clinician comes to the client’s home to provide services on a short term basis.
  • This is generally covered by Medicare- and must be received under doctor’s orders and meet certain requirements (patient must be considered homebound). Different than Homecare- but the two services complement one another and often get confused.

Hospice

  • Must be determined by MD and meet certain criteria. Nurses and caregivers provide comfort care for terminally ill patients.
  • Medicare benefit.

Long Term Care Insurance

  • Often a great way to pay for many of these services. It does require advance planning (usually around 10 years), but can be a lifesaver if needed. Be sure to buy from a trusted agent and do your homework!

Elder Care Attorney

  • Speak to an Elder Care attorney who can help protect your assets and do long term planning for your estate.
For more information about any of these options, please call Capability Homecare. We have many trusted partners that we would be happy to refer you to. 
*https://www.genworth.com/corporate/about-genworth/industry-expertise/cost-of-care.html
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Discharging from Hospital- A Capability Caregiver can Help

hospiceIt’s not unusual for us to get a call from a family while their loved one is in the hospital. An unplanned hospital visit can often bring a lot of stress and anxiety to families. Regular life has just been completely interrupted and things might never be the same.

There are so many things to consider:

  • Will my loved one get to go home?

  • Who will take care of them?

  • Who will help them with bathing and personal care?

  • Who will ensure they are safe?

  • Who will make sure they are taking their medications correctly?

  • Who will be there to help them if they fall?

  • Who will keep them company and make sure their needs are being met?

  • Who will help them move around the house?

  • Who will answer their call for help in the middle of the night?

All of these questions are very common and are realistic concerns that many of our clients have.

We are more than happy to go to the hospital and meet with the prospective client and their family. We offer a complimentary consultation to get to know the patient and understand their unique needs and answer any questions that the family might have.

Being at the hospital gives us a chance to talk to the nurses and the physical therapist to get a better understanding of how we can help. We can then set up a plan of care so that as soon as the patient is discharged from the hospital there is a caregiver ready to help.

The best thing about hiring care (as opposed to moving to an Assisted Living where you are locked into a longterm contract) is that the amount of care you receive is flexible.

We can provide help for as little as 4 hours a day, to overnight- round the clock care- so whatever your loved one’s specific needs are- they can be met by Capability Homecare’s capable and highly trained staff. Call us today to see how we can make the transition home go smoothly. 425 679 5770.

Having a successful plan in place BEFORE it is needed can help speed up the recovery process and  prevent re-hospitalization.

National Fall Prevention Awareness Day

With today being Falls Prevention Awareness day, I thought I would share some important tips of preventing falls.

According to the National Council on Aging, there are 5 things one can do to prevent falls:

  1. Talk to your doctor and get an assessment of your risk of falling

  2. Review your medication with your doctor, sometimes side effects may be causing falls

  3. Find a good balance and exercise program

  4. Get your vision and hearing checked every year

  5. Ask your family for help and support

This last one really hits home with me because my grandfather had a couple of falls and in hindsight we should have seen it coming.

Shortly after my grandmother passed away we started noticing changes in my grandfather. Not anything significant, but we did recognize that he moved a bit slower and lacked the energy we were used to seeing. Since he had just lost his wife, we figured this was just part of the grieving and aging process and thought nothing of it, until my mom started getting phone calls in the middle of the night. “Judy, can you come over here?’ he would ask- and in a panic my mom would drive over to his apartment to help him out.

It was usually something small he needed help with- sometimes he was waking from a dream and was frightened, other times he had been incontinent and needed help. My mom would settle him down, get him cleaned up and back into bed safe and sound. This was mildly inconvenient for my mom, but not a huge deal since the phone calls were fairly infrequent. Until the night when the phone call was more serious, he had broken his hip and this changed everything.

Looking back, we should have recognized those early phone calls for what they were- a cry for help. He was a prideful man, and fiercely independent- and we wanted to honor that in him by allowing him to live independently- but at the same time, here was a person who was clearly in need of some assistance.

Because of the lack of support, he had a fall. Luckily, he was able to call 911 and was taken to the emergency room. He had broken his hip and would need surgery. This meant that his life was going to change dramatically. He could no longer live in his apartment- instead he was moved to a skilled nursing facility where he could have more supervision and medical care to recover from his surgery.

Unfortunately, being the strong willed person that he was, he still kept trying to get out of bed on his own- and about 2 months after the first fall- ended up falling for a second time and breaking his hip on the other side. This meant another surgery- and even more recovery.

At this point my family decided to hire private care through Capability Homecare to supplement the staff at the skilled nursing. He needed more supervision than the SNF could provide.

Having someone by his side to help with getting ready and into bed was important. And once he was asleep, knowing someone was right there in case he got up un the middle of the night allowed him (and my mom) to sleep soundly knowing help was nearby. He could get up and use the restroom when he wanted, knowing the aide would assist him in getting there and help with cleaning up any accidents. In the morning when we woke up, someone was right there to assist him in getting out of bed and dressed for the day. This brought peace of mind to the entire family and is a decision I only wish we had made earlier.

If you have a loved one who you think might have had a fall (or two), or be at risk for a fall, consider hiring a caregiver to give them the support they need. Many falls can be prevented- and a caregiver can be on hand to ensure that your loved one is safe.

Capability Homecare can help with bathing (most falls occur in the bathroom), or help with preparing and eating meals, they can help with ambulation (getting in and out of bed and chairs) and can help getting up or down stairs. They can assist your loved one with the ADL’s that may no longer be easy to do all alone.

Let Capability Homecare help keep your loved one safe.

Observation Status

Did you know that you could go to the ER for chest pains, stay in the hospital for 2 nights- and Medicare Part A  might not cover your expenses? If you are not admitted the hospital (meaning you have been put on ‘observation status’) than your coverage is different than if you had been actually admitted as a patient.

This is an important distinction that many people need to be aware of! Whenever you go to the hospital, be sure to ask DAILY if you are considered inpatient or outpatient. Just because you have spent the night (or several nights) in the hospital DOES not mean you have been admitted as an inpatient.

Let’s say for example you go to the hospital for an outpatient procedure- while you are there, your blood pressure spikes and the doctor decides to keep you overnight to keep an eye on things. This does NOT mean you have been admitted to the hospital, and Medicare Part A will not pay for any of the expenses incurred during this hospital stay.

Even when your primary care doctor writes an order for you to be inpatient, don’t assume that you are admitted. The hospital can still make the decision to put you on observation (outpatient). In this type of situation, the hospital must inform you in writing of this change. Be alert for any paperwork that you receive while in the hospital.

There are a few reasons why inpatient versus outpatient is so important- namely because the cost of services while you are in the hospital will vary depending on your status. X Rays, Lab work, even prescription costs will be different depending on whether or not you are admitted or under observation.

Another very important reason to make sure you are actually admitted to the hospital is because if you need to go to a Skilled Nursing Facility after being in the hospital, medicare part A will only cover your expenses after a 3 day inpatient hospital stay. The daily rate at a SNF is

  • Days 1–20: $0 for each benefit period.

  • Days 21–100: $152 coinsurance per day of each benefit period.

  • Days 101 and beyond: all costs.*

*Keep in mind that you can receive custodial care in the privacy of  your own home for about the same price. Call Capability Homecare today to learn more. 425 679 5770.

For more information about Medicare and what is covered, click here!

Part 3, A Patient’s Rights

It’s important to understand that as a patient in a Skilled Nursing Facility you have rights.

These are copied directly from the medicare nursing home website, which can be found here.

You have the right to be told in writing about all nursing home services and fees (those that are charged and not charged to you) before you move into the nursing home and at any time when services and fees change.

The nursing home has to notify you before your room or your roommate is changed and should take your preferences into account.

The nursing home must provide you with any needed social services, including the following:

  • Counseling

  • Help solving problems with other residents.

  • Help in contacting legal and financial professionals

  • Discharge planning

If your health allows, and your doctor agrees, you can spend time away from the nursing home visiting family or friends during the day or overnight, called a “leave of absence.” Talk to the nursing home staff a few days ahead of time so the staff has time to prepare your medicines and write your instructions. 

You can’t be sent to another nursing home, or made to leave the nursing home, unless any of the following are true:

  • It’s necessary for the welfare, health, or safety of you or others.


  • Your health has improved to the point that nursing home care is no longer necessary.

  • The nursing home hasn’t been paid for services you got.


  • The nursing home closes.

You have the following rights:

You have the right to appeal a transfer or discharge to the State.
The nursing home can’t make you leave if you’re waiting to get Medicaid.
 Except in emergencies, nursing homes must give a 30-day written notice of their plan and reason to discharge or transfer you.
 The nursing home has to safely and orderly transfer or discharge you and give you proper notice of bed-hold and/or readmission requirements. 

You have a right to form or participate in a resident group to discuss issues and concerns about the nursing home’s policies and operations. Most homes have such groups, often called “resident councils.” The home must give you meeting space and must listen to and act upon grievances and recommendations of the group. 

If possible, I would recommend printing these out and keeping a notebook with pertinent information in it (including either a copy (or a note of where it can be located) of your power of attorney (both medical and durable), a list of all medications, lists of phone numbers of families and all doctors, and any other information that you think should be included.

Part 2 Skilled Nursing Facilities in Seattle

One of the most important things to understand when thinking about Skilled Nursing is that you have a choice.

You have control over where you or your  loved one will go- and it’s important that you carefully consider all your options before making a decision. The last thing you want to do is to have to move!

We are very fortunate in the Seattle area because we have so many wonderful SNF’s to choose from.

Last week I talked about things to look for when selecting a skilled nursing- refer to that list to help you evaluate each one. As I mentioned last week, be sure to tour as many as you can- and don’t be afraid to ask questions!

If you are assisting your parents in selecting a place a SNF, I would say one of the most important criteria is proximity to your home. Chances are you will be visiting daily (and sometimes even in the middle of the night) and you will want it close to home! Trust me on this one.

Below is a list of my favorite Skilled Nursing Facilities in the area. I have included ones from all over- and personally toured all of them.

Crista

Kline Galland

Mission

Life Care of Kirkland

Bothell Health Care

Springs at Pacific Regent

Bayview

Mirabella

Issaquah Nursing and Rehab

Covenant Shores Health Center

Cascade Vista

Parkridge

Emerald Heights

Park West

Providence Marionwood

Washington Care Center

Ballard Rehab

Another thing to consider- if finances allow- is to hire extra help to provide overnight care. We did this with my grandfather, and while it was expensive, it also gave us peace of mind knowing that if he needed to get up in the middle of the night (which he frequently did), or had issues with incontinence (which he frequently did) someone was right there to assist him.

Keep in mind, many SNF’s have less staff overnight, so be sure to ask about the patient to staff ratio. If the patient is a fall risk, or has incontinence issues- it may be worth the extra money to have private help.

Be sure to read next week when I discuss the rights for patients in nursing homes!

What to Look for in Skilled Nursing

 Part 1 in a 3 Part Series on Skilled Nursing

What to Look For

Back in the old days most people knew they would one day end up in an ‘old folks home’ as we used to call it.

Today many people are choosing to age in place and bring the care they need into the privacy of their own homes.

Yet, some people do need skilled nursing care– and in those cases a Skilled Nursing Facility is the perfect option.

By definition, a skilled nursing home is:

A place where “… care of every patient be under the supervision of a physician, that a physician be available on an emergency basis, that records of the condition and care of every patient be maintained, that nursing service be available 24 hours a day, and that at least one full-time registered nurse be employed… ” Source: The Free Dictionary.

Skilled nursing facilites offer care in a variety of ways:

Some offer care for those who have been discharged from the hospital, yet aren’t quite ready to return home.

Others use skilled nursing facilities for their Long Term Care needs- meaning this is where they will live the rest of their lives- receiving nursing care and sometimes hospice care.

Whatever your reason for needing a skilled nursing facility, there are many things you should consider before deciding on one. As soon as you know (or think) that skilled nursing is going to be needed, talk to as many people as you can (not just the hospital discharge planner) to find out which one best suits your personal needs.

If possible, it is highly recommended that you tour each facility on your list and look for certain things such as:

  • Is it well maintained inside and out?

  • Is the decor pleasing and warm?

  • Is the facility free from odors?

  • If there are odors, are they handled quickly?

  • Do all rooms have private bathrooms?

  • Are there electric beds?

  • Is the attitude of the nursing staff caring and friendly?

  • Are meals nutritious and appealing?

  • Is the kitchen clean and orderly?

  • Does a registered dietician, or professional service, plan meals?

  • Are there individual and group activities and a monthly calendar?

  • Are arts and crafts offered?

  • Are there special outings?

  • Are non Medicare patients allowed to visit home?

  • Do they have an active volunteer visiting program?

  • Do they provide in-house physical therapy?

  • Is speech and occupational therapy available?

  • Are therapists licensed?

  • Are religious services, or transportation to churches offered?

  • If privately owned, is the owner available?

  • If managed by an outside service, how do their other facilities compare?

  • What is the reputation in the surrounding community?

  • How does the facility treat residents with similar needs?

List provided by medicare.gov