Forbes magazine said recently that care for those with Alzheimer’s disease and related dementias could “break Medicare”. During 2017 alone, the cost of caring for those with Alzheimer’s and dementia in the United States will be about $259 billion. In Idaho, the monthly cost of nursing home care averages $7,290 and assisted living averages $3,240. Because of the staggering cost, figuring out how to pay for long term care is an incredibly important part of protecting a family’s hard-earned life savings when they need help with long term care.
One of the first steps in figuring out how to pay for care is to better understand that long term care can take many forms. It generally consists of getting help with the activities of daily living, such as eating, bathing, managing medications, dressing, transferring in and out of chairs or bed, etc. While most understand that long-term care can occur in a facility setting, it can also occur at home.
In-home care can be especially useful, because it can extend the amount of time a loved one is able to stay at home. However, this convenience comes at a price. The average cost of in-home care in Idaho is about $20 per hour. Caregiver spouses needing respite for three hours a day can average an in-home care bill of about $1,800 per month. Having a caregiver come into the home during the day while a family member works a full time job might cost $4,000 per month. If 24 hour in-home care is necessary, the cost can easily run $15,000 per month.
Assisted living communities, the most common form of long term care, can range in cost from $2500 to $5500 per month. In Idaho, memory care for a loved one with advanced dementia usually occurs at an assisted living community; the cost of memory care is usually on the upper end of the assisted living price scale.
Skilled Nursing is the most expensive form of long term care because it requires the highest degree of physical assistance. Skilled nursing level of care is required when a loved one’s care needs advance beyond the level of care available at an assisted living community. Skilled nursing care in Idaho can range from as low as $6,000 per month to more than $9,000 per month.
When faced with the cost of care, families are best prepared by researching possible care providers and communities to get a good idea of the options and the costs available to their loved one. Some families may choose to hire a care manager to help them navigate this selection process. Others may take advantage of independent placement services that help find facilities best suited for that particular senior and budget. Once the family understands the care options available, they can better review the senior’s current income and savings to budget for the care plan.
Finally, families often look to see if any benefits might be available to help pay for long term care. For example, the VA has a monthly pension program (often referred to as “Aid and Attendance”) available to qualifying veterans and their spouses that can help pay for long term care. This pension program can provide hundreds of dollars a month to help offset the cost of long term care. In addition, the Medicaid program may cover some or all long term care costs for seniors who qualify financially.
Both the VA pension program and the Medicaid program have rules that can be complex. However, both programs generally require that seniors meet certain asset and income limitations to qualify. Seniors who need to utilize such benefits must carefully plan to protect their income and assets, especially when one member of a married couple needs long term care and the other may live independently for many more years. Spending the couple’s retirement on care can leave the healthier spouse impoverished, so good planning for such a situation is vital.
It is possible to navigate the maze that is paying for long term care. But paying for care while protecting assets and income requires getting informed early and making careful decisions. Talk early with potential care providers and take the opportunity to sit down with a good elder law attorney who can guide you through the process and help you preserve assets and income.
David J. Wilson
Ahrens DeAngeli Law Group