Just shy of $3,000 for a level three care for my Mom. Total cost a month $8024.00 a month.

Extra costs for diapers, needs of resident, ie if Hoyer lift needed, surprise bills from doctor's visits, etc.......I am on Long Island, New York, and after her stat in the first ridiculous snf for "rehab", I needed to find an assisted living place with an enhanced license. My mom had vascular or mixed dementia, and became bedridden and incontinent after yet another fall, back in April 2020......after that last fall, bedridden and incontinent.

Assisted living with an enhanced licenced in New York ranged from close to 5 k to more like 10k dollars a month.

I chose the less expensive one, even though further away, as I didn't think that my mom had the mental capacity to enjoy sitting under an umbrella on a ritzy patio, alongside an underground pool.

I took her out of the place and ended up paying for two months.

When I met her at the ambulette as she was being discharged, one of the administrator administrators handed me an envelope with lab values and unsued meds.

The lab values contained many abnormalities........very high platelet counts, that the ordering doctor didn't even tell me about.

I called an ambulance once home and my mom was admitted to the hospital......I had the choice of chemo, readmission to a snf, or neither.......I said that I wanted her evaluated for hospice. That was the first of two different hospices, I renounced the first as I didn't understand all the rules and regulations of Medicare.... traditional bs the Medicare hospice benefit, and I still wanted to be able to bring her to the ER if the need arose

It did......the day night after I renounced the first hospice I couldn't keep up with the diarrhea and diaper changing ..... everything was getting contaminated....called 911…......she tested positive for clostridium difficile in hospital.......what an absolutely brutal time I went through with all this

The whole thing was awful, and social workers and administrators nasty and hard to work with.

Mom died in march 2021, and I am presently in therapy as I find it hard to unclench after this brutal ordeal .
My best wishes and hopes to you and your loved one.

I made a huge mistake selecting an AL for my mother the first time around. The facility I chose was beautifully furnished and decorated but every service was ala carte. She ended up falling and eventually going to skilled nursing. She was able to recover and return to AL. I went back to view an AL I had previously rejected because it wasn’t as visually appealing but it was very clean. Everything is included (private room & bath; three meals; assistance with everything). She has resided there for 7 years, gets excellent care and is very happy. The facility has semi private rooms which is a plus because residents tend to populate common areas and activities instead of sitting in their rooms. There’s a sense of community which the first facility did not have. The things I didn’t like about this facility the first time I saw and rejected it turned out to be the features I like the most now.

My Dad wanted to cut cost of having daily caregivers so he looked into Independent living.... we found one facility that looks like a Victorian 4-star hotel. Dad crunched the numbers and found it would be far cheaper than what he is paying now and living at home. Plus he will be around people closer to his own age group which he really likes, plus dining in a common dining room, activities, and transportation. He will now have more freedom :)

Yes, there are added cost besides the monthly rent... he will need to pay a set utility fee which includes electricity and cable [finally Dad will have cable TV and internet... very inexpensive]. He gets one meal daily with the rent [either lunch or dinner] and if he wants the other meals that is a set monthly fee which comes to $7 per day. The food is very good, nothing fancy, just good old fashioned meals. Plus a mid-afternoon snack of coffee and the threat of the day plus entertainment.

If Dad needs more help, yes there is a daily fee for someone to come in to help Dad with a shower, another daily fee for pill management, etc. Right now Dad will bring his regular Caregivers but cut their hours instead of all day-all evening to just mornings.

This article is spot-on in terms of its warnings about the risks of extra costs on top of what is often a glorified hotel room. Gourmet meals don't matter much if the resident can't independently operate their oxygen canister, or if they are too impaired to want to get to the common dining areas to enjoy the 'gourmet meals'. And home care agencies aren't always better. Some of the personal care aides they send have taken an educational course of only a few weeks and it becomes clear early on that caring for elders wasn't exactly their mission in life. And that's understandable considering what they get paid. Look out for agency-provided caregivers who approach you offering to work privately. They have probably figured out that what they are getting paid from the agency is far less than they could earn in a private pay job.

Seahawk lady describes a nice situation for some seniors but if the one lady who runs the place gets a back injury who is her back-up? I don't know how anyone could work 24/7/365 taking care of 5 seniors. It's one thing if you had 5 children, who are progressing towards independence, while you are young. But I would have to question the safety and "sustainability" of the group home model, the only way to make it sustainable is to hire more workers....and right there the cost goes up.

Hello everyone! Thank you for your comments. I can only speak to a few scenarios I've seen when I worked part time as a RN in Home Health. There are regular residential homes which are licensed to take in Seniors who live in a regular home atmosphere with a couple who can take in 5 seniors, each of whom have their own bedroom with three bathrooms in the home. Meals are provided and everyone eats at the dining table. The lady is a retired RN who bought the large home planning on making it a live in arrangement to care for 5 seniors. She administers the medications and she and her husband assist in ADL for her five 'friends', as she calls them. I've seen this situation work well. The entire group frequently take trips together and go on a lot of outings. Obviously it wouldn't be a situation for someone with a lot of physical needs but their home was built with safety rails, designed for what it's being used for. There is even an outdoor hot tub, used only under supervision and small swimming pool area. The Pharmacy they use delivers all medications and she is in contact with their Doctors with any needed updates. Her charges are extremely reasonable running around $100 a day. Their SS checks cover a lot of their cost to live there with their savings or family members covering the rest so the total is about $3,000 per person a month. That is 15,000 a month for 5 residents (for those who love math) and quite feasible for she and her husband (who works out of the home) to maintain. She often helps them by paying their bills for them, with their family's permission and provides a monthly summary to the designated family member and the resident themselves. She said she got the idea from her church group talking about there being no alternatives available other than home health care or Assisted Living. Her church group also visits with the residents and volunteers a lot in helping with medical appointments, etc. This gives the person a feeling of family living but not being charged sky high prices for nothing more than a over inflated apartment. She has a waiting list of 65 people who probably will never get in because no one is leaving. There also is the communal cat and small teacup poodle who alternates sleeping with the residents at their choice. So residential home living is a viable solution but finding that situation is rare. If more people considered adult family living situations that might become a growing trend to fulfill the cracks in the current choices. BTW, for two people in Seattle AL costs about ten thousand a month with extra charges as has been discussed. In response to a suggestion about live in companions, I wouldn't think it would be too difficult to arrange for a certified bookkeeper to either give the caregiver a 1099 Independent contractor form each year for tax purposes (which is what is used for household help). A total amount of say, 12,000 a year, wouldn't generate that much in tax for a retired person who was living in. In my experience, I've seen the negativity that too frequently surrounds home health care situation by family members and/or patients themselves but I think if everyone would just realize that fear often manifests itself out as anger and focus on alleviating the fears of the family and/or patient, a lot of those situations could be solved. I just feel there's a wealth of resources out there who haven't been tapped and it would only be a matter of organization to bring together those who need to still be needed and are physically capable to live in and help care for others which would solve their loneliness and those who need help but cannot afford Al situations. Right now it appears to be a either/or situation for aging care and I believe there can be other solutions if one is creative. Adult homes is the term being used for group living situations in a residential setting. We need more adult homes for the aging which are far more affordable and gives much more personalized, individual care. Sure there will be issues, but there are already more issues in the two choices currently facing the aging. I honestly believe, probably because I've seen it myself, adult homes promotes the patient to be more socialized with still being able to be in their own room and have privacy if they so desire but give them a feeling of still mattering and feeling safe and secure in a family setting with their care needs being met.

I have a friend that thought one of these care homes would be the perfect solution for grandma. They moved grandma three times trying to find a care home that would work. Grandma ended up in a nursing home because of the meds needed to control her behaviors. A whopping 10K a month and three moves later!

Forgot to reiterate another detail--as someone mentioned above, there is no guarantee you will stay in any particular ALF--they can evict you for any reason (read contract) and I have several.friends whose parents were evicted for either behavior issues, disagreements with new management (these places do get bought out), needs exceeding capacity, and when they ran out of money. The last one--keep in mind the ALF is not obligated to find you less expensive room across town. They would charge an hourly fee to do that (just like every other thing they have on their menu of services--including $40 to change a light bulb at one place!).

Many people put off making the move to independent living/assistive living until they need care, after all, why move to what is essentially a very expensive apartment when you can still manage in your familiar home? Families often wrongly assume that once mom & dad are in assistive all living their needs are being taken care of, especially distance caregivers who are not able to see for themselves. Even hospitals will discharge someone more readily to assistive living because they assume care will be provided, but if not contracted and paid for it will not. I live I have heard of many seniors falling through the cracks of the elder care system, not ill enough or not able to find a place in a nursing home, yet living with inadequate care in assistive living or bankrupting themselves with paying for the extras they need.

Siblings definitely don't understand, unless they have been the hands-on caregiver. I sent mine the glossy brochures from various ALF's, and all they looked at was how much was the rent per month (as printed in the brochures). The sibs never read the fine print. Also the sibs failed to consider multiple items that costs lots of bucks--which would add $15- $20,000 per year, in Depends, prescriptions, eyeglasses, orthopedic shoes, doctor bills, cell phone, meals not included in the ALF meal plan, etc. When I informed the sibs about this, they claimed I was inflating the costs. And even my mom could not understand -- the rent WOULD increase every year, and could even increase with only 30 days' notice. As I consider my own senior years I am very determined to avoid any facility. They are designed to appeal to a very urgent and "capstone" of Life need.....but their motivation is money, it has to be. Nobody would ever just build an ALF for the fun of it!

Seahawk, recent post discussing a lot of these issues . https://www.agingcare.com/questions/how-calculate-the-cost-for-caregiver-185299.htm.
24x365=8760 hours of potential caregiving per year. Constant availability - potentially no relief under your scenario (try getting last minute agency help in that a narcissistic elder will accept). And if a small stipend is given, the person is an employee. Which makes them subject to labor laws, payroll taxes, vacation time off even if not paid, time off or overtime wages.
As glad points out (from 4 years in the trenches with 2 frail elders and whackadoodle siblings), this type of arrangement would need a LOT of support, planning and planned relief for the live-in that frankly many families are not willing to provide or elders to pay for.

Welcome, Seahawk.
This is a good idea, but I have a hunch that those providing the care would eventually find out it is more than they had bargained for. Though family of the elderly would love the idea, it would preserve resources of the elder leaving more for family. There are care homes, where a group of 3-6 elders live, with a live in caregiver and additional assistance through the day. These facilities in my area charge in the area of $3,000.00 a month. However, many families find that it is necessary to move the elder many times to find an appropriate fit. When you have a care home that is working, it is a very difficult balance. If a newcomer comes in and upsets that balance they are often asked to leave within days.

So many just do not realize what 24/7 care entails. And it is not just the care needed, often behaviors become extremely problematic.

I'm wondering why there isn't a group/organization who could match retired people who don't want to live alone, widows or widowers who would welcome an opportunity to live in with people who need some caregiving in exchange for room, board and a small stipend. Seems to me this would be a win win situation for someone who doesn't want to live alone, seeks a surrogate family of sorts who is able to provide 24/7 live in care for one's parents by housekeeping, cooking, doing errands and helping one's parents with ADL. Should they need time away a agency could provide fill in help until they return. I can't find a organization that is doing match making like this and feel it's certainly a solution for many seniors, both those who need help and those who want to be active, have a comfortable safe living environment and connect both sides. Anyone know of any organization/agency doing this? I'm new here (first post) so not sure I'm doing this correctly but would love to hear others thoughts about this as a solution.

Davidaaron51: your 200% correct.

Well thought out and definitive.
Our loved one's who reside in these facilities are simply put...
...human commodities.

If your loved one has dementia it is very likely that a 24/7 private caregiver will be necessary during the adjustment period. This happened in my Mom's case, she needed a companion for the first five weeks 24/7. Then they went to eight hours through sundowning and bedtime. The additional cost to my mom? About $2,500.00 a week. That is on top of the $6,500.00 a month! Private caregivers are no longer necessary so the cost is $10,000.00 a month less than it was initially.

Great article! Thanks.

Important article, assisted living works best if not much assistance is needed. However, elderly normally prefer to remain at home with support during this largely healthy portion of their retirement. If you have to supplement either in person or pay a home health aid to enter the assisted living for the elder, probably assisted living is not a real good option. Cost will quickly escalate to the nursing home level. I think most assisted living line the pockets of the owners at the expense of the elder and their families.

Agree with lots of investigation before being involved with most assisted living arrangements.

My mother has had a history of depression. She is 78 years old. Now that my Dad has passed she can get away with more time in bed. She will not get up for nobody . She sleeps till 4:45 pm then eats supper as she is asked many times and hungry then goes back to her room and watches TV until 10 or 11 pm. I am her daughter and have taken care of her but can not watch this cycle anymore, it is effecting my health. She wears depends and pees right through them as she will not get up. Her bed needs to be changed everyday. Doctor's have tried medication, failed. She says she is at peace when she sleeps. I am at the point where I can not go see her in the evening (when she is up) without getting emotionally upset and sometimes upset with her. Her room smells of urine and she does not take hardly any shower;s. The Assisted Living in Va is great! They love her and take good care but feel sorry for her. They have activities and she will not go. I have tried everything. They bring in her Breakfast but not lunch to encourage her to go to lunch in the dining room. ( but she won't). Makes it for supper 70% of the time and is starved. She has diabetes and is on more insulin. She really does not care. She calls me for everything and assistance with her TV, which they would help her but she would rather call me. She sucks on sugar free candy for her dry mouth and throws the wrappers on the floor. She lays guilt trips on me and I sometimes they work. I also get upset with her and explain that she is putting in no effort. Help!!!!

Right on target; look very carefully and compare with home care. the cost of assisted living in my experience was prohibitive. Home care much more affordable and more independent.

I wish they could sign a lifetime guarantee of costs not going higher than when they entered. I mean, the seniors themselves are on a fixed income (or it might go down, way down, as in 2008). It's ridiculous to expect them to pay more and more and more.

Very timely article. The unknown costs and skyrocketing prices will lead to more aging in place of the boomers. I have tried to explain to siblings that the cost is not fixed, there are many opportunities in a contract that will raise costs. What is $5,000 today could actually be much more.