I have no idea what the cost of in home care is by the hour, by the day or by the month from an agency? Has anyone had this type of care and if so how long have you had it and how many hours a day, etc. vs placement in a Ass't Living Memory Care facility. In Caifornia the ALF that I have checked on charge on the average $4,000 per month.
Judith, we are on the east coast-in the NY, NJ, CT tristate area, so you can imagine things in this neck of the woods are expensive. However, I thought CA would be equally as expensive, but I am not sure if the ALF you looked at is $4000/mo.
DH has long term care (LTC) insurance but it has a lifetime cap. It pays more for ALF costs than in-home care costs. Now to answer your questions.
In our area (NJ), in-home care provided by a certified home health care aide (LTC requires the certification if they are to pay) is $21-22/hour with usually a 3-4 hour daily minimum. If you choose to have a live-in aide (which we have) the daily rate is $195-$225 depending on the agency hired. You must provide the live-in with a separate bedroom, 8 hours of sleep time (ideally at night) and their food (they make a grocery list and you buy what they want-within reason). Because the LTC company pays less than half of what it costs per day to have the live--in, we are blowing through our retirement savings in warp speed.
We have had the live-in 3.5 years now and after a 6-8 month adjustment of having a stranger (and usually someone from a different culture/county) we have achieved a level of satisfaction. It still means that you have a stranger in your house which can be disturbing to most people. I must say that I trust DH's male caregiver-he is compassionate, caring, not lazy, would not and has not stolen from us. My concerns with both an hourly caregiver and a live-in are that they are typically on the cell phone several hours during day/night if they are not American and are always looking for ways to increase what they are paid. I don't blame them, I blame the agencies because after 3.5 years the agency has not and will not increase his pay. Also getting a substitue aide on short notice can be challenging.
Even if you get someone who works hourly, it may take several aides before you find one that you like and is good to your spouse. It is disruptive to constantly change out aides, but is often necessary to find a good fit. If you go thru an agency (more expensive than hiring privately) they should come out, evaluate your spouse and then recommend an aide that would fit in your lifestyle. You should be able to interview a few people they think are a match. And you should be able to ask for a different aide if the one you have isn't a good match.
Hiring an aide privately has a lot of risks associated with it-paying withholding taxes, ensuring they have a background check, you would need to purchase workers comp insurance thru youur homeowner's policy to ensure you are covered if the aide gets hurt/injured on your property.
Memory care ALF's in our area run between $6500-$10,000/ month. The live-in aide costs us about $6000/mo but at this stage I want DH home and am not sure an ALF will take him because he's not sleeping at night.
JudithKB, I use an agency called Granny's Nannies. Their minimum is 5 hours a day but any number of days you want. They charge $14.00 an hour here in Florida. They require continuing education for their employees and have worked out well for us. I have found them to be very professional.
Thank you Anchor and LFL....this is very interesting. I had no idea about in home care. I don't think I would like a live in...The problem I have probably is the same problem most people have. None of us know how long of a trip this is going to be and financially, I figure I could handle things in an ALF for 4 to 6 years, but with my dh being 65 in a couple of weeks...who knows how long he could last.
JudithKB, There are other good points to bring someone in to stay for how ever many hours you need them to be there. I called around and all the ones I called also included light house work, helping your LO shower and other things. It will take some of the pressure off you and at the same time allow you more time to relax even when you are at home. Also none of the ones I called required a long term contract so you could try them and if it ends up not being what you need discontinue the service and try something else.
JimB
PS: I also called around to get an idea incase I needed to place Kathryn for some reason in the future and found that would just between 4,500 and 5,100 a month.
I have a cleaning lady every other Weds. After I had her for several months (she was highly recommended to me) I asked her if she would be willing to watch my dh on Wed. while she cleaned and I would pay her extra for those 4 hours. She agreed and now I have every other Weds. off. It has been great. I had not been out of the house without my dh for at least a year and a half. I hadn't worked outside the home for years and I just felt so confined. This has been wonderful. I asked her last week if she would be willing to do this every Weds. and she has agreed. Also, I have found an ALF that does respite care and sometime in the future I am going to take advantage of that to go to Northern Ca. to see my daughter. This same place charges $130 a day for respite care with a minimum of 3 days. I didn't think that was too bad. Also, placement is $4,000 a month.
I am really surprised that the amount for ALF in other parts of the country is higher then here in Ca. Ca. usually is the most expensive place for most every thing. What I didn't know is how many hours and what the hourly rate would be if I wanted to keep my dh at home instead of place him in ALF.
I've been told that in home care requires that the caregiver has their own bedroom and bathroom. In my house that is just not possible. It is 3-2.5. I would have a very difficult time with someone here and worrying about the animals. Plus, I don't want to shop and cook for someone else; I just don't.
You asked about cost so I won't go into my spiel about why H should be in ALF. The places I have been looking at which are larger facilities, not private homes or boarding homes, are about $5000 per month. In my opinion they are very nice, and include meals, snacks, activities, beautiful gardens.
My husband is in an ALF here in central FL. His fee is 3500.00 per month. He is in a companion room. He shared with a lovely gent who recently passed. He has the room to himself now. He enjoyed the company. His long term ins. is for 5 years in the facility on 3 for home health care. He is 80 yrs old and other wise pretty healthy. Who knows how long this will last. Alf was our best alternative. You really have to do a lot of reseach to find the right place.
Thank all of you for your comments. I like this ALF that I visted a week or so ago. Great patio area with trees and nice lawn. It was not real large place but not small either. The one thing I really liked is they have an RN on duty 24 hrs. a day. Also, it is very close to where I live. They told me that at meal time they try and keep the Alz. that are aggresive in one area and the ones that are able to to have some conversation in another area. I thought that was good also.
Assisted Memory Care Units in our area of PA are 5800.00 per month,the non-profit require you to show 250,000.in assets for the patient.my best friend went in one last year and they all had the same requirements.Since medicaid won't kick in for ALF's what do you do when your 250,000 runs out? That is why ,if I have to place DH it will be in a NH so when money is gone ,he will be eligible for medicaid.There are on;e a few NH's in oue area that don't accept medicaid.
I found it to be a challenge to find ALF's that would even accept Medicaid residents in NC. Those that do, ration the number of beds they have available because the ALF is paid less and, unfortunately, the care is not always on a par with the Private Pay residents. All states have different Medicaid eligibility requirements. But I found that a law firm and financial planner can assist in both legally sheltering assets and making application to the county/state for Medicaid eligibility. Most facilities charge $6-8K/mo. for Private Pay. It is difficult, but some states do reimburse the facility through Medicaid for the full cost of care the ALF charges for Private Pay residents.
Judith, like Ocallie said there are some ALFs which have Medicaide rooms. That generally means that after 2 years of private pay they may accept your spouse in a Medicaide room assuming they have been Medicaid qualified. Preference is generally given to people who are already residents of the ALF. But as Tom mentions, they are limited to a certain percentage of the total beds in the facilicity. That goes for ALFs and NHs. Typically once a resident is on Medicaid, they are moved into a room with another resident. Medicaid rooms are typically shared with another person. It is my understanding that the Medicaid reimbursement to all facilities (ALF or NH) is based on the Medicaid reimbursement guidelines and is significantly less than what you pay as a private pay resident. As I said previosuly ALF care in NJ ranges from $6500-$10,000 based on the facility AND the required care. Be sure to look at the brochures and ask about "extra" charges-there are many over and above the basic rate in most ALFs. Also, if your spouse has difficult behaviors (constant pacing, up at night, combative with staff/other residents) the ALF may require you to hire a FT aide in addition the the staff to manage him/her which turns out to be an additional cost of $195-$225/day.
I know you don't want a live-in aide, but a Tom says, if you do, they need to have a separate bedroom and a separate bath if possible. And they are supposed to have 8 hrs sleep at night, so don't expect them to get up in the middle of the night if there's a problem.
My wife was admitted as a Medical Assistance (Medicaid) resident pending the application and approval for assistance. This process took 4 months. I paid the private pay rate until it was approved. I forward my wife's monthly Social Security check to the Memory Care facility in MN. ($1,200). The state pays the full balance based on my wife's level of care that is needed. In her case, almost $5K/mo. Private room (physician ordered) and all residents receive the same excellent loving care.
I know of a man in my area who has 24 hr care in home for wife which costs him around $3k/week. Most agency and nonagency care is around $20/hr on our area, which is Puget Sound area, Wa state.
I was astounded to read above that to be in a particular ALF THE PATIENT would have to have $250,000 in funds himself. If he used up all his funds, then I would have to have the same amount for myself to qualify? Wow!
At my husbands ALF there is no medicaid. Everything is privately funded. For medicaid you need a nursing home. There must be skilled nursing care at all times. They are more expensive than ALF's. Our long term health care covers Don. We will have it for 5 years. Home care would only be for 3 years. It takes a lot of research and soul searching to make this important decision. He has been there since late Sept, he's very content but I am still trying to adjust.