In home care for older adults can be a game-changer, but is it always the best financial decision? Seniorly breaks down home care costs to help you make informed choices for your family.
As we age, it's natural to need a little extra help and support to maintain our independence and quality of life. Indeed, a study by the AARP reports that 77% of older adults aged 50+ want to age "in place" - another term for staying in your home as long as possible.
And while that statistic may change as the senior living landscape evolves, there's also an equal level of innovation happening in the home care service market. Today, there are so many types of in home care services available, whether you need assistance with daily tasks, seek companionship, or require medical care.
So while the topic may seem daunting, we've done our best to break it down into key questions and answers that help you make the most informed and educated decision for you and your loved ones.
The cost of in home care varies widely based on several factors; geography, complexity of care, the number of hours, and whether you are going through an in-home care agency or hiring someone directly.
Having said all that, Genworth reports show that the national median cost of care for part-time (20 hours a week) personal care aides is about $2200 a month, while the cost of a home health aide is about $2300 per month. Given the increased level of complexity involved for a home health aide, that's not a material difference. On the higher end of the spectrum, rates in New Hampshire are about $2730 per month for homemaker services and $2817 per month for home health aides, while in Louisiana those same monthly services are reported as $1640 and $1690 respectively.
If you're looking at private in home care, you'll likely be paying an hourly rate. The national median hourly rate for in home care is between $26 and $27 per hour for homemaker or home health aide services. On the higher end, workers in California earn about $32 per hour while on the lower end, in home health care in West Virginia earn runs about $18.50 an hour.
In-home care costs largely depend on several key elements, most of them being driven by labor market conditions.
Using an agency to provide in home care services can simplify the process of finding a qualified caregiver. However, it's important to be aware that agency-provided care can come with additional costs compared to hiring a caregiver independently. Agencies typically charge higher hourly rates, which can range from $25 to $50 or more, depending on the services and level of care needed. These higher rates often cover the agency's overhead costs, caregiver screening, training, and ongoing supervision, as well as insurance and bonding for their caregivers. While the cost might be higher, using an agency offers several advantages such as ensuring the caregiver is properly vetted, providing backup caregivers in case of emergencies or absences, and handling administrative tasks like payroll and taxes. When choosing an agency for in-home care, it's essential to research and compare multiple agencies in your area, taking into account their fees, services offered, and the quality of care provided.
If you're interested in working with an agency, Seniorly recommends the following:
Hiring a caregiver directly for in-home care can be a more cost-effective option compared to using an agency - but it comes with its a unique set of responsibilities. When you hire a caregiver independently, you become the employer, which means you are responsible for negotiating salaries, managing payroll, and handling taxes. The hourly rate for a direct-hire caregiver can vary widely depending on factors such as experience, qualifications, and location, but it generally ranges from $15 to $30 or more. Although the rates may be lower than agency-provided care, keep in mind that there are additional responsibilities, such as conducting background checks, checking references, and ensuring proper training for medical services for the caregiver. You may also need to consider expenses related to workers' compensation, liability insurance, and backup care in case your primary caregiver is unavailable. If you're interested in hiring a caregiver directly, Care.com has a wide network of personal caregivers.
If care needs are limited to support for activities of daily living and medical needs are not complex, it's likely you're trying to figure out whether assisted living is the right way to go.
An assisted living facility is a residential care option that provides older adults with a private room or semi-private living space, assistance with daily activities, meals, and access to various services and amenities. The cost of assisted living varies based on factors like location, room size, and additional services, but in 2021 the national average monthly cost was around $4,500.
On the other hand, in-home care costs depend on the type and frequency of care services needed, and as we shared above, hourly rates can range from $15 to $50 or more. For some older adults, in-home care may be more affordable, especially if they only need part-time assistance or are living rent-free in their own homes.
However, as the number of hours of in home care increases and home health care aides approach the standard 40 hour work week, assisted living costs start to look a lot more attractive, providing better value to older adults than home health care services. Assisted living communities provide a more structured environment with built-in socialization opportunities, regular activities, and access to 24/7 support - and that's why we love them. Although when asked most older adults would say they want to age in place, that solution may not always be the best for their overall level of engagement. An assisted living community provides not only support for care needs, but stimulating activities, connection with other adults and physical fitness options.
When it comes to choosing between in-home care and moving to a nursing home (sometimes referred to as a skilled nursing facility), there's a lot to consider. In general, families contemplating this kind of choice are facing more complex medical and health issues so in both cases, the costs tend to be more expensive than simple support for activities of daily living.
In-home care allows the older adult to stay in the comfort of their own home and maintain a sense of independence. A medically-trained home health care aide might provide medical assistance for things that family caregivers don't feel qualified to do, like changing catheters or administering certain medications. Plus, in-home care can be tailored to the individual's specific needs and preferences.
On the flip side, a nursing home offers a higher level of medical care and supervision, making it a better fit for those with more complex health issues or who need constant monitoring. While a nursing home can be more expensive than in home care, there's no doubt that nursing homes also provide greater oversight, staff coverage and training.
Ultimately, it comes down to the individual's needs, financial resources, and personal preferences when deciding which option is best. Should you decide that in home care is the right solution, it may be beneficial to work through an agency for skilled nursing coverage, as they can provide the staff support and coverage needed for daily health related services that you might find in a nursing home.
Paying for in-home care services for older adults may seem daunting at first, but there are various options and resources available to help cover these costs:
In-home care can be a viable and cost-effective alternative to nursing homes or assisted living facilities, especially for older adults who value their independence and wish to remain in the familiar surroundings of their own home. If you're considering in home care, it's important to evaluate the level of support you require, the associated costs, and the quality of care provided by the agency or caregiver. Ultimately, the decision will depend on your individual needs, preferences, and of course, your financial resources.
Marlena del Hierro is Vice President of Partnerships and Seniorly’s Lead Gerontologist. Marlena earned her Master of Arts degree in Gerontology from San Francisco State University and her Bachelor of Arts degree in Human Development from California State University. She also serves in an advisory capacity for Jukebox Health. As Seniorly’s first employee, Marlena is a vocal advocate for evolving the aging paradigm, and is a frequent contributor to public discussions about aging. She has served as a resource for media outlets like WGBH, FOX News, CNBC and the Today Show.
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