Becoming a caregiver usually is the result of loved one suffering either an accident, surgery or a serious illness such as a heart attack or stroke. When it happens it is almost like a bad dream. One minute you are dealing with your normal daily routine and then the next minute you’re sitting in a hospital talking with a strange doctor about how seriously ill your loved one is. At that point, the why and how the illness occurred are irrelevant. What is important is how you can help your loved one prepare for a different and difficult future. After their recovery, if they are an aging adult, living independently may not be a viable option.

Long-term care options

The long term care options for aging adults is dependent on the level of care needed, financial resources, the availability of personal care givers (family and friends), what the patient wants and the situation at their home. The most common major care options are:

Nursing homes: Provides 24-hour skilled nursing care, personal care, meals and on-site medical care. Nursing homes are typically, the most expensive and highest level of care. According to the American Association for Homes and Services for the Aging (AAHSA), the average cost of a semi-private room in a nursing home is $65,385 annually.

Assisted living residences: Provides housing for those who cannot live independently, but do not need skilled nursing care. The level of assistance varies with the patient, but typically includes meals, help with medications, personal care and housekeeping. According to the AAHSA, the average cost of living in an assisted living facility is $32,572.

Senior retirement apartments: Seniors live independently and have their own apartments. Meals, housekeeping and recreation may be provided. Apartment rental fees vary and meals and other services are provided at additional cost.

Living with an adult child: Has been done for ages. The level of care varies depending on the expertise of the caregiver. The out-of-pocket cost can be low; however the intangible cost to the caregiver’s family can be significant. It also provides the opportunities and challenges of intergenerational interaction.

No place like home

Most seniors would prefer to continue to live in their own home, if at all possible. They have lived there for years, they are familiar with the neighborhood and their home is their own space in the world. The cost of staying at home varies with the level of care required. If extensive professional care is required, staying at home can exceed the cost of staying in a nursing home. Determining whether staying at home is a viable option begins with a comprehensive assessment of the patient’s needs and circumstances. Most hospitals and insurance companies can provide a social worker or care manager to perform the assessment.

The assessment helps determine the patient’s ability and capacity to perform the six activities of daily living: bathing, dressing, transferring, toileting, eating and walking, and how much support is needed for each. Next, it looks at the support required for six instrumental or supporting activities of daily living: light house work, meal preparation, supervising medications, shopping for groceries, etc., communication and money management. The assessment also looks at the capability of support from personal caregivers (family and friends) and the amount of required skilled medical support.

Finally, the social worker will look at the home itself to determine modifications and repairs required to safely accommodate the patient. Home modifications could include items such as ramps, handrails, bathroom accommodations, security systems, lighting and etc.

Care providers

If the patient’s needs are beyond the capability of their personal caregivers, there are professional home care organizations that can provide skilled nursing care and home health aides (non-medical care). Most of the professional care is provided at an hourly rate. Two websites that may be helpful are: www.caregiver.org and www.aarp.ort/families/caregiving.

Caring for an aging loved one can have significant impact on our emotions, families and finances. Are there situations in your life that may require that you are the primary caregiver for one of your loved ones? As sensitive as it may be, have you discussed the possibilities with them and how they would like to be cared for? Have you looked at your own situation and how you would like to be cared for? Failing to plan is surely a plan to fail!

(Michael G. Shinn, CFP, Registered Representative and Investment Adviser Representative of and securities offered through Financial Network Investment Corporation, member SIPC. Visit www.shinnfinancial.com for more information or to send your comments or questions to shinnm@financialnetwork.com.)