According to the AARP, 76% of Americans age 50 and older want to live in their current home for as long as they can. Finding a way to avoid a nursing home stay is often a good choice for all involved, as long as the person's safety isn’t compromised. Given the high cost of living in a nursing home, other options are also bound to be less of a financial burden.
The median cost for a full-time home health aide in the U.S. is $4,576 per month, according to Genworth. If you don't need full-time care, the costs will be lower, and Medicare may pay some of these costs. The median cost for full-time homemaker services nationwide is $4,481.
Another option related to living at home is adult daycare. This choice is much like assisted living, but you live at home or with a family member and spend either the entire day or a portion of the day at a care facility. Average rates vary from state to state, but the median cost per month is $1,603. Unfortunately, Medicare doesn’t pay for adult daycare, but Medicaid may be an option.
Other programs help those who choose to live at home. Meals on Wheels, community centers for seniors, help with shopping and transportation, and free legal services may be available in your area.
While living at home is preferable for many, it's not possible for everyone. Here are some options for those who are not able to remain in their home, including a nursing home, as well as their median costs.
- An accessory dwelling unit (or a mother-in-law suite) is an area of a home that functions like an apartment—though remodeling costs to add one can be high.
- Assisted living facilities are for mostly independent people who may need help with personal care or housekeeping. Prices range from $3,000 to $5,000 per month.
- If your loved one needs specialized care, a nursing home may be the best arrangement; the median monthly cost is $8,821 for a private room.
Accessory Dwelling Units
An accessory dwelling unit, sometimes known as a "mother-in-law suite," is an area of a home that functions like an apartment. It often has its own bathroom, kitchen, living room, and bedroom so the person living there can keep their independence while still having loved ones around when their help is needed.
The cost of remodeling or adding on to a home might be cost-prohibitive, but if the home already has usable space, the cost of remodeling might be lower than that of other options over multiple years.
As with all of these choices, there are pros and cons to accessory dwelling units. They can be disruptive to the family, especially if a senior has dementia or another illness, but they could always receive home health or homemaker assistance as needed.
Assisted living facilities are for people who are mostly independent but may need some help with personal care and/or housekeeping tasks. Residents are typically mobile but live in a fully staffed facility with a private or semi-private room.
There’s no universal definition of assisted living, so each location may offer somewhat different services. The price difference of assisted living versus a nursing home is substantial. Prices vary by area, ranging from $3,000 to $5,000 per month. At a national median of $4,300 per month, the annual cost comes in at $51,600.
Medicare does not pay for assisted living services. If you or your loved one do not have the money to pay for assisted living services, consider applying for Medicaid, which may help. If you have long-term care insurance, it should pay for at least a portion of the costs, depending on the language of your policy.
Medicaid is a state- and federally funded medical health care program. Amounts and types of coverage can vary greatly, depending on the state in which the patient resides.
If you’ve exhausted all other alternatives, or your loved one needs specialized care for dementia or other conditions, a nursing home may be the best arrangement. A nursing home provides 24/7 medical care along with rehabilitation, socialization, and housekeeping.
Because the care is specialized, it comes at a much higher price than other options. The median cost of nursing home care is $7,756 per month for a semi-private room and $8,821 for a private room: $93,072 and $105,852 per year, respectively. Many facilities charge an all-inclusive rate, but some will have a la carte options.
As with assisted living and other residential facilities, Medicare probably will not cover the costs. The person living there may deduct the entire cost of nursing home care on their taxes if they are in a nursing home for medical reasons. If they are not in a nursing home for medical reasons, they can deduct the costs of medical care, but not the costs of meals and lodging.
For people who don’t have the funds to pay for nursing home care, some health insurance, long-term care insurance, and life insurance policies can be tapped to cover costs.
Medicaid will typically pay for care if the patient meets the low income and asset requirements, but they will need to spend down assets to meet those qualifications.
If the patient is likely to need Medicaid to cover the cost of a nursing home stay at some point in the future, be sure the home accepts Medicaid for payments before they move in. Most nursing homes accept Medicaid, but not all of them do.
If you’re a veteran, you may qualify for full or partial coverage from the Department of Veterans Affairs (VA) at certain locations approved or run by the VA.