Categories
Caregiving Planning Ahead

Assisted Living vs. Nursing Homes – What is the Differance

What Is Assisted Living?

Assisted living is a great choice for seniors who can no longer live alone, but want to stay active and social. These communities have a 93% satisfaction rate, so your aging loved one is probably not picturing what they will be like when they move into an assisted living community.
 
In assisted living, seniors get long-term housing and care. They are usually active, but may need help with activities of daily living (ADLs), such as bathing, dressing, and using the toilet. In assisted living, seniors can expect personalized care, nutritious meals, a wide range of social activities that cater to their interests, and a sense of community in a safe setting.
 
When you are looking for a place for your aging loved one, know that many assisted living communities have health standards for admitting residents. For example, your relative may need to be able to eat on their own or transfer between a bed and wheelchair without help.

What services do assisted living communities provide?

Assisted living communities provide services and amenities that help seniors stay healthy and active. This may include things like keeping them physically active, providing intellectual stimulation, and helping them stay socially connected. Some of those services include restaurant-style dining, activities based on resident interest and many more.

Who can benefit from assisted living?

Assisted living communities are for seniors who want to stay independent but need some help. The community will help them with things they can’t do by themselves, but they will still be able to live their life the way they want.


How much do assisted living communities cost?

The cost of assisted living can vary depending on the community, its location, and the services it offers. Generally speaking, assisted living communities — which offer more amenities and care services than independent senior apartments — tend to be more expensive. However, the difference between the cost of assisted living and nursing home care is significant, since nursing homes offer full-time medical care.
 
The average cost of living in a retirement home in the United States is $4,300 per month, according to Genworth’s most recent Cost of Care Survey.
 
 What is a nursing home?

 

Nursing homes are places where elderly adults who need a lot of help can go. Nurses and other people who work there help these people with things like bathing, dressing, and eating. These facilities offer the highest level of care for seniors who don’t need to be in a hospital, but do need a lot of help every day.
 
Nursing homes often have certain requirements that need to be met before someone can move in. These requirements can include a doctor’s prescription, a physical examination, and state approval. If your loved one doesn’t meet these requirements, then they may need to consider moving to an assisted living home or another type of care setting that is more appropriate for their needs.
 
What services do nursing homes provide?
 
Nursing homes are a place for older adults who need care 24 hours a day. In addition to the services offered by assisted living communities, nursing homes offer many medically related options:
 
  • Providing long-term care that is both palliative and preventative
  • Administering prescription medication, including injections, is a process that must be done with care in order to ensure the safety and health of the patient.
  • Meal options that must meet the daily nutritional requirements and the unique dietary needs of each resident, including diets that are pureed or liquid
Skilled nursing care is an important part of many nursing homes. This means that there are trained professionals available to help your loved one at all times. If your family member is very ill or has a serious medical condition, they may need specialized care from the licensed health care professionals in a skilled nursing home, instead of the senior care aides who are highly trained but may not be medically certified.
 

Who can benefit from nursing home care?

Nursing homes offer more care than assisted living communities. This makes them a good choice for seniors who need significant medical care and also want companionship, help with activities of daily living, and on-site amenities. If your elderly loved ones require a greater level of care, a nursing home may be the right fit. These seniors may:

  • Require a lot of care because of a chronic condition or poor health.
  • Be unable to take care of oneself without help.
  • Have progressive conditions.

How much do skilled nursing facilities cost?

Nursing home costs vary depending on the location, state funding, and not-for-profit status of the nursing home. Generally speaking, skilled nursing facilities are more expensive than other senior living communities because the residents require more help with medical needs and personal care.

The cost difference between assisted living and nursing home care is significant. The median monthly cost of nursing homes in the U.S. is about $7,989 for a semi-private room and $9,086 for a private room, according to Genworth.

Unlike many assisted living communities, nursing homes can often be paid for using government assistance for lower-income residents.

How do you decide which care type is best for your loved one?

In the past several decades, senior living choices have expanded as the needs and expectations of older adults have changed. Finding the right option that meets your loved one’s needs is an important part of keeping them healthy, active, and safe. The best way to decide which care type is best for your loved one is by talking to those with experience with these care types.

How CircleOf Caring App can help?

CircleOf caregiver app is great for keeping track of your loved ones. The app allows you to enter information about your loved one’s medical condition, medications, and appointments. The app also has a calendar feature that helps you keep track of when your loved one needs to be seen by a doctor or take their medication. The Caregiver app is a great tool for caregivers and their loved ones.

Categories
Caregiving Community Planning Ahead Technology

8 Tips to Make Your Care Calendar

Planning and managing a calendar Being a caregiver in the family requires time and effort in managing a lot of responsibilities for the loved one. It can feel like a full-time job, and at times, can be overwhelming. Caregiving centers around relationships and time. Two valuable gifts. When you share the responsibility with your friends and relatives, everything becomes a lot more manageable.

 A caregiver calendar will help you delegate important tasks and coordinate with others.  Organizing time and tasks helps avoid caregiver burnout as well as significantly improve the quality of care your loved one receives.

Read below for a few tips on making a calendar for your circle:

1. Make a list of everything that’s needed

Before you start delegating tasks, it’s important to have a clear understanding of the different things that need to be done to care for your loved one. It can be general tasks like routine bill payments or checkups, as well as very specific ones like a particular type of soap you need to use for sensitive skin. Take note of the length of time these tasks take to make sure that everyone can adequately make room to accomplish them in their schedule. 

2. Assess your helpers’ skills and schedules

Knowing your helpers’ skills and vacant time will help you decide which tasks you can delegate. If someone has a background in finance, then maybe they can help with handling the budget and expenses. If someone has a background in nutrition then maybe he or she can help take care of their diet. When it comes to coordinating schedules, if someone is working on the night shift, then maybe they can visit in the afternoon so you can step out to run errands. Knowing generally what everyone’s skills, hobbies and schedules are will help you create a caregiver calendar that benefits everyone. 

3. Create a schedule that works for everyone

Try mapping out a schedule that takes everyone’s skills, schedules, and interests into account. Create a few variations to know which one works best for all. It’s not just about the one giving care but also the one being cared for. Different conditions will require different kinds of care, from the duration, frequency, to the actual tasks themselves. 

Consult everyone involved and get their opinion. Clearly define the needs of the one being cared for, and the responsibilities of each caregiver. Most importantly, make sure that the one being cared for is on board and comfortable with the plans you’re making.

4. Keep everyone informed

It’s important that everyone generally understands the condition of the person they’re caring for.  This helps build your care circle camaraderie and to be consistent with the person you are taking care of. 

Of course, some information can be sensitive and shouldn’t be shared with the public. However, knowing the situation can actually make others spring into action and help out. Find a balance between what needs to be communicated to your caregiver group and what is better kept to a smaller group. 

5. Create a good working relationship

While we want to count on our family to lend us a helping hand, it’s very important to set boundaries and respect them—that’s why having a caregiver calendar is instrumental in helping everyone stay accountable when it comes to their assigned tasks, while allowing them to tend to other aspects of their lives. 

When it comes to caregiving, always proceed with compassion and patience, for the one you’re taking care of as well as the ones you’re sharing the responsibilities with. Consider their hours of work, whether or not they will have enough energy to do tasks right after their shift, or if they can help in some other way that doesn’t require them to be physically there. Respect their time and needs as well. 

Know what they’re comfortable with in terms of the help they can give. Some might be more willing to share their skills and time rather than help financially. Every kind of help matters. Take the time to let them know they’re appreciated.

6. Learn to prioritize

As you build your care calendar, you’ll notice certain patterns, overlaps, or inconsistencies. This is an opportunity to prioritize the needs of the one you’re taking care of. Identify which tasks are critical and time-bound versus flexible. What are the things you have to do personally and what are the tasks that you can delegate to other caregivers in your family? 

Take the time to teach other caregivers how certain tasks are done so that you can confidently leave those to them in the future. Find ways to lighten your load, so you can provide a consistent quality of care for your loved one. 

7. Simplify tasks

Learning to break down complex tasks can be an easy way to reduce the back-and-forth between caregivers in the family. Simplify tasks into easy steps to help guide them on what needs to be done. For example, if the task is to have a checkup, then it needs to be broken down into simpler tasks like setting up the appointment, getting certain tests done if needed, and the actual doctor’s appointment.  

This will allow other caregivers to chip in and volunteer to do the task if they have more capacity to help during that time. 

8. Take advantage of available technology

Nowadays, there are many ways to coordinate with caregivers in your family from group chats, to emails, to video calls. Make good use of these tools to efficiently communicate with others certain updates or changes to your care schedule. These also allow you to keep even the family members that are abroad or in another state up to speed, creating solidarity among everyone.

Keep your care calendar organized. Make sure that every caregiver is informed of pending tasks as well as other important updates with CircleOf. Privately share information and coordinate care conveniently and securely with the app so you can take care of your loved one, while also making sure not to forget to take care of yourself. Schedule in time for breaks and a bit of pampering for yourself knowing you have other caregivers to rely on.

References

https://awareseniorcare.com/caregiver-daily-schedule/

https://www.senioradvisor.com/blog/2016/06/using-a-calendar-to-share-caregiving-responsibilities/

https://myhometouch.com/articles/how-to-set-up-a-caregiving-schedule

www.seniorhousingnet.com/advice-and-planning/how-to-create-a-care-calendar-for-family-caregivers

https://dailycaring.com/4-tips-get-family-to-help-with-elderly-parents/

https://www.saundershouse.org/article/3/20/2018/how-coordinate-care-aging-parent-your-siblings

https://www.nia.nih.gov/health/how-share-caregiving-responsibilities-family-membersA family

Categories
Caregiving Finance Planning Ahead

Elder Care and Money: A Shock for Many Family Caregivers

Today, most long-term care doesn’t happen in an institution, rather it takes place in our homes. This is one reason that family caregivers are a rapidly growing demographic across the U.S. It is estimated that 95% of community-dwelling seniors today rely on help from unpaid family or friends. Family caregivers are providing high levels of care to loved ones and juggling other competing priorities in their lives. This makes family caregiving a pretty overwhelming experience. 

Care needs change, often, and many times in ways that are out of control of the caregiver. There are countless tasks that need to be completed daily, taking considerable time out of the caregiver’s schedule. It’s all enough to make most caregivers throw up their hands. But then there’s the expense of elder care. The fact that caregiving requires so much out-of-pocket spending is often a major surprise to caregivers, and a big contributor to feelings of overwhelm and stress. 

This month, we partnered with Elder Care Solutions to highlight key topics related to the costs of care. They work with families across the nation to tackle the financial strain of elder care and guide them towards a more financially positive caring and aging experience. 

Let’s start by taking a look at the realities of care costs. Here’s a breakdown of the types of care and their costs so you can make informed decisions about the level of care that’s right for your elderly loved one(s). 

The Realities of Care Costs

Type of careWhat it isCosts and coverage options
Home Care / Homemaker Services / Home aidesHelp when you need an extra hand. 

Home care staff typically includes certified nursing assistants to support individuals staying at home. 
Usually available 24-hours a day and 7-day a week, including holidays

Will create tailored care plans for occasional or ongoing assistance.

Services can be scheduled in increments (i.e. 2-hour block up to 24 hours)

Types of care tasks provided: 
Laundry
Dog walking
Companionship
Taking out garbage
Making bed
Changing linens
Organizing/cleaning closets
Meal preparation
Transportation for errands, shopping, doctor appointments
Bathing 
Dressing 
Hygiene
National average hourly rate is $26/hour

Covered by insurance policy: SOMETIMES
 
Covered by Medicare: NO (unless you are also getting skilled nursing care)

Covered by Medicaid: YES

Covered by VA benefits:
Adult Day CareDaytime care for loved ones that can not stay home alone safely. 

Usually available for a 12-hour window during the day (i.e. 7AM to 7PM).

Have professional staff to assist with various health needs during the day. 

Enrichment activities are offered including music, group outings, art, exercise, games, etc. Provide meals and snacks during the day. 

Individualized care plans.

Most have support groups for family caregivers.

Types of care tasks provided: 
Medication management
Memory stimulation
Meals 
Health assessments
Health monitoring
Dementia care 
Post-hospitalization recovery care 
Physical, occupational, and speech therapy
National average: $78 per day

Covered by insurance policy: SOMETIMES
 
Covered by Medicare: Most often NO

Covered by Medicaid: YES

Covered by VA benefits: YES
Home HealthComprehensive care for individuals with the aim to get better from their illnesses. 

Available 24-hours a day and 7-days a week. 

Professional nursing and therapy services.

Individualized care plans. 

Many provide family caregiver and patient education. 

Types of care tasks provided: 
Medication management
Pain management
Care coordination
Wound care
Nutrition management
Injections
National average: $27 per hour

Covered by insurance policy: SOMETIMES
 
Covered by Medicare: Covers physical, occupational, and speech therapies at home.

Covered by Medicaid: YES

Covered by VA benefits: YES
HospiceComprehensive care for individuals facing life-limiting illnesses. 

Available 24-hours a day and 7-days a week. 

Care is overseen by a physician and comes with a healthcare team including nurses, social worker, dietitian, physical therapists, occupational therapists, respiratory therapists, speech therapists, pharmacists, etc. 

Many offer additional therapies such as music, art, pet, and bereavement.

Types of care tasks provided:
Medication management and monitoring
Patient and caregiver education
Pain management
Skilled nursing
Tube feedings and enterals
IV medication administration 
Comfort care
National average: $160-$200 per day for Level 1 in-home care 2-3 days a week.

Covered by insurance policy: SOMETIMES
 
Covered by Medicare: YES

Covered by Medicaid: YES, if the physician deems “terminally ill”.

Covered by VA benefits: YES
Assisted LivingPersonalized care for elderly loved ones in a residential living situation. 

Provides 24/7 care, but only to a certain level. 

If a resident needs higher levels of care, home health agencies can come in and provide nursing care, for an additional cost. 

Care is provided by professional staff.

Types of care tasks provided: 
Medication management
Assistance with bathroom, dressing and grooming
Housekeeping
Meal preparation
Laundry
Transportation services 
Socialization
Memory care in some
National average: $4,500 per month

Covered by insurance policy: NO 

Covered by Medicare: NO

Covered by Medicaid: May cover specific services within the assisted living facility.

Covered by VA benefits: Some under the Aid and Attendance benefit.
Nursing HomeA nursing home provides long-term residential care by licensed practical nurses and nurse aides under the supervision of a registered nurse. The goal is to provide a safe, comfortable and caring environment for people who are unable to live independently.

Types of care tasks provided: 
Dressing and bathing
Meals
Physical therapy
Occupational therapy
Speech therapy
National average: $7,900 per month for semi-private room$9,000 per month for private room

Covered by insurance policy: Possible

Covered by Medicare: Only if at the skilled nursing level of care.

Covered by Medicaid: YES, for certain services within the nursing home.

Covered by VA benefits: YES
Skilled Nursing CareSkilled nursing care is residential care provided by trained registered nurses in a medical setting under a doctor’s supervision. It’s similar to the level of nursing care you get in the hospital. 

Many times patients go from the hospital to a skilled nursing facility to continue recovering after an illness, injury or surgery. 

The goal is to get well enough to go home.

Types of care tasks provided: 
24/7 nursing care
Meals
Bathing
Physical therapy
Occupational therapy
Speech therapy
Wound care
IV therapies
Injections
National average: $7,900 per month for semi-private room$9,000 per month for private room

Covered by insurance policy: YES

Covered by Medicare: YES, typically for 100 days.

Covered by Medicaid: YES

Covered by VA benefits: YES
Palliative CareSpecialized medical care for serious illnesses. 

The focus is on relief of symptoms and quality of life. Not necessarily just for dying patients. Can be provided alongside curative care.

Care is provided 24/7 by specially trained doctors, nurses, and other specialists.
 
Types of care tasks provided: 
Pain management
Management of depression and anxiety
Management of nausea
Emotional support
Spiritual support
Covered by insurance policy: YES

Covered by Medicare: YES, typically for 100 days.

Covered by Medicaid: YES

Covered by VA benefits: YES
Resource: This tool by Genworth allows you to choose your locality and see the costs of different levels of care:  https://www.genworth.com/aging-and-you/finances/cost-of-care.html

Let’s look now at some common financial concerns for caregivers. As we talk about each, we provide a tip to help you start considering how this might apply to your situation. 

Financial Concern 1: Medicaid 

As you can see from the chart above, having Medicaid makes paying for care a whole lot easier. Medicaid is society’s safety net for providing long-term care service when we’ve outlived our financial resources. Problem is, most people today ARE outliving their financial resources! 

Many families start thinking about Medicaid eligibility when they see care costs piling up. So why doesn’t everyone use Medicaid to cover their care needs? Well, it’s really tricky. Here are some major reasons why. 

  1. There’s a lot of paperwork required to tap into this benefit. Not just a lot, but also fairly complicated to complete. So, it’s best to assume Medicaid could be a real need in the future and plan for eligibility early. Most families wait until the need has already arrived and then realize significant consequences for having waited that long. 
  2. The qualifications are scary. It is entirely possible to be flat broke, needing care, and still be ineligible for Medicaid according to their rules. Medicaid acceptance is based on financial eligibility. This means that total assets cannot exceed the criteria, which is around $4,000 for a married couple. Checking and savings accounts, retirement accounts, annuities, and cash-value life insurance plans are all counted, to name some. This makes eligibility a really difficult decision for families, especially when they’ve worked hard to save and want to leave a legacy. There are tactics, however, for families to become eligible and protect assets. 
  3. There are penalties. There is a 5-year lookback period for Medicaid applicants related to any prior gifts made by the applicant. These will be penalized or could result in Medicaid denial. The rationale is that since the benefits are need-based, the applicant’s gifts made prior to application should be considered as countable assets. One guarantee for everyone applying for Medicaid is the surfacing of any mistakes. They will reveal themselves. Better to learn about them earlier, when a plan can be put into place to mitigate them, then they pop up during a worse time.

Tip: Becoming eligible for Medicaid is separate from using it. The best plan is one where timing is the top concern. WHEN will funds hit the critical figure so it’s time to pull the trigger on using Medicaid? Your best planning partner here is an attorney specializing in Medicaid eligibility. It is common for your first consultation to be free, so tap into that resource soon.

Financial Concern 2: Taxes: ‘Tis the season! What family caregivers should know about taxes.

When it comes to long-term care and taxes, carefully consider the following. Benefits from long-term care insurance are generally non-taxable and the premiums are deductible. Although, state laws may differ, so best to learn as soon as you start using a policy. Additionally, pay attention to previous non-taxed income years, as well as when certain expenses qualify as deductible. The key here, recruit help from a tax expert. 

The good news is there are tax benefits! 

  1. The 2017 federal tax law expanded the Child Tax Credit (CTC) to allow taxpayers to claim up to $500 as a nonrefundable “Credit for Other Dependents,” including elderly parents. There are some criteria that have to be met. 
  2. Care costs are normally deductible, but only to the extent that they exceed 7.5% of your Adjusted Gross Income. 
  3. You may use Flexible spending accounts (FSAs) and health savings accounts (HSAs) to pay your dependent’s medical bills, copays, insurance deductibles, over-the-counter medical supplies, personal protective equipment, and even for some treatments not covered by insurance. Remember, if you pay using an FSA or HSA, you cannot take a tax deduction for that bill as a medical expense.
  4. For the 2021 tax year, you can claim a portion of up to $4,000 in caregiving costs for one person and up to $8,000 for two or more. This tax credit does not require that your loved one qualify as your dependent in certain circumstances. But there are rules for when you can claim it.

Tip: Tax law is constantly changing, obtaining professional tax advice, preferably from a CPA is critical. If possible, one who works regularly with caregiving tax issues. You’ll find these professional fees will pay for themselves twice; often in measurable tax benefits. Check out the AARP article about taxes HERE to dive deeper into the criteria for tax benefits above.

Financial Concern 3: Getting Paid: With so many family caregivers providing 21+ hours a week on care tasks, it’s easy to wonder if this could be a job you can get compensated for. Can a family caregiver get paid for the care they provide?  

  1. Some Medicaid-funded programs are available to pay family caregivers.
  2. Most Long-Term Care insurance policies will permit the family member who has earned certain credentials to be paid at market rates.
  3. The VA pension benefit for wartime veterans has a program under which family caregivers can be paid.

Tip: Because most family caregiver paid programs exist either through or in conjunction with Medicaid, your residential state will impact what is available to you. The Family Caregiver Alliance has a Services by State tool. After finding your state, check the “Caregiver Compensation” section to see what is available. 

While finances can be a shock when caring for loved ones, there is empowerment in knowing some solutions. You can start down a more empowered path when you start accessing tools, like the CircleOf app, and resources to overcome your unique care challenges. 

Kimberly Whiter

Kimberly Whiter is the CEO of Elder Care Solutions. She is on a mission to tackle the financial crisis happening across the U.S. as families face the overwhelming and unsustainable costs of elder care.

Categories
Caregiving Community Planning Ahead

Legacy: Projects to Celebrate and Preserve What’s Most Important

When people think of “legacy” they often focus on money, property or major accomplishments. But legacy, on a deeper level, is the most personal of subjects. It’s all about what matters most to the individual. If you have a friend or family member who is thinking about their legacy, or if you yourself would like to explore the topic, read on for some ideas and inspiration from the Farewelling editors. 

Collecting Video Tributes After a Loss

One great way to honor a loved one’s legacy is to create a beautiful video montage of family and friends telling stories and sharing memories about the person they’re honoring. You can organize this yourself or use one of the new companies making it easier, such as Tribute.com. 

The process: invite your family, friends, colleagues, and anyone else you’d like to make a short recording on their phone or camera. After editing, or using a software tool to put the videos together, you can share the final compilation at a family gathering or by posting it online or sending it to whomever you like. A group video tribute can be a great element at a virtual event or an in-person remembrance.

Creating a Legacy Project

A legacy project is a physical creation that shares your personal message. It can involve life events, biography information, personal accomplishments, wisdom and knowledge, philosophy or faith traditions, hopes, and dreams.

Choose a medium that speaks to your personality and preferences. The goal: share what meant most to you.

Journaling Is An Easy Way to Share Your Legacy.

Document your life story through the written word. Journaling can be a therapeutic way to work through thoughts and emotions and record these things on paper. Or you might prefer a digital journal, which can be as simple as writing your story in a word processor or using an online service such as Storyworth. Either way, here are some tips:

  • Document a list of values that are most important to you.
  • Share significant life accomplishments and why they matter in your experience.
  • What are your wishes and dreams for the future?
  • Do you have any life lessons or advice you would like to share with the family?
  • Write down major life milestones and details about those events.

Scrapbooking: Tell the Story of Your Life Through Photos, and Other Captured Memories

Scrapbooking is a lovely way to display pictures, papers, postcards and other memorabilia from your most treasured memories. If you like working with your hands, it might be enjoyable to pull out the colored paper, stamps, and other crafty items. Or, there are many low-cost digital scrapbooking tools you can use online. 

Which Legacy Project Is Right For You?

Sometimes getting started on a project like this is the hardest part, but don’t let that stop you. Pick a legacy project that speaks to you, then dedicate just an hour or two a week to work on it yourself, or with your loved one. Over time it will start to take shape, and you’ll have a treasure to share with your loved ones that they will cherish for generations to come.

Karen Bussen

Farewelling is the revolutionary online platform transforming how we think about–and plan for–funerals and end of life. Join them on social media @myfarewelling for more.