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It is far more costly to pay for seniors in nursing homes than when they age in place in their own homes. Yet, too few of them have the resources to allow it to happen and their children cannot afford the expense of running two households plus care needed. It makes financial sense for states to enact legislation to allow elderly to age in place rather than be admitted into nursing homes. How do you feel about advocating for this with your state representatives?

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Facilities are often short staffed and so busy with tasks they don’t treat people always with empathy. It’s one task after another . I’m trying to keep my Dad in his home and he’s 94 and my husband in his home he’s ill too
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Here in NYC, it is possible for an elder who would ordinarily be in a NH to stay at home with Medicaid-paid 24/7 aides.

The hidden "cost" is on the adult children or friends of the elder. I have been the "friend" in the past and currently have a friend who is the daughter; let me tell you, comparing what it takes to keep a frail demented elder "at home" to maintaining them in a NH is a no brainer. Managing aides who don't get along and who tattle on each other; arranging for the elder to get to doctor appointments; dealing with bedbugs; aides who have no medical knowledge.

My mom got MUCH better care, more consistent care and had more expertise in a Nursing Home. She had access, on site to psychiatric, dental, podiatry and general medical care. The staff included RNs, APRNs and Medical doctors who could advise us about medication and treatment.

My friend's mom is suffering from terrible, terrible anxiety related to her dementia. In my mom's case, there was a geriatric psych to treat my mom. My friend? She decided that her mom takes "too many meds" and stopped her mom's valium.
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It is only more costly to be in a nursing home if you do not require substantial care.

As soon as you need a significant number of paid person-hours every week just to stay safe and well, the sums fall apart.

"Aging in place" is seen as desirable in every care context that I've ever come across, not just recently but ever since I first heard what a nursing home was, back in the seventies. It's making it safe and affordable that is difficult.
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According to census records, most elders do age in place. Only 3.1% of over age 65 are in a NH with the over 85 group making up the majority.

Its very interesting to look at the various charts and graphs showing how and where seniors live.
Here is a link.

https://www.census.gov/content/dam/Census/library/publications/2014/demo/p23-212.pdf
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It is by far cheaper for my mother with dementia to be in a care facility than to stay in her home. And, frankly, easier on me -- I live an hour's drive away. My mother would never admit she needed assistance (despite her ability to care for herself obviously becoming an issue). She would become angry when I tried to broach the subject. Second, the in-home care company that I finally convinced my mother to let me hire, was not that open with me about my mother's failing health. I think the company was more interested in the paycheck than reporting to me what was REALLY going on from day to day. I would ask pointed questions and get "Oh, she's fine." I would push back -- it was a problem. When I see the commercials about "angels" and "gentle hands" and "loving hearts" that will help you keep your loved ones at home, I roll my eyes. When my mother finally needed 24/7 care, it was clear that the $22.00/hour cost of the care-giver company (with the actual care giver probably getting half) would break-the-bank. Aging in place is an ideal -- not only do you have to oversee your aging parent when they "age in place", you also have to oversee the caregiver as well.
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Enshope, your idea sounds great but in reality someone will need to pay for that elder to age in place. And that someone would be the taxpayers. I really doubt that the average taxpayer would vote "yes" for this legislation which would double their sales taxes, double their income taxes, double their real estate property taxes, double their school tax, double their car taxes, etc.

My Dad was in his 90's when he decided it was just too much work maintaining his home. Plus he was paying $20k per month for professional caregivers [3 shifts per day] who were licensed, bonded, and insured. Yes, $20k per month. Thank goodness he had saved for this rainy day.

My Dad decided it was time to sell his house and move to senior living. He was so relieved not to worry about house repairs.... no more real estate property taxes... no more paying someone to mow his lawn, and shovel the snow... no more homeowner's insurance.... no more buying groceries so that the caregivers could prepare his meals... no more paying all the utilities... no more retrofitting the house to make it easier for Dad to get around.... etc. Oh, he also sold his car.

By moving it was costing Dad $5k per month for Independent Living, and when his dementia was progressing, he moved to Assisted Living/Memory Care at the cost of $6k to $7k per month. The monthly rent included 3 meals per day, weekly housekeeping, weekly linen service, cable TV, and a handyman on call. In Memory Care, Dad's housekeeping and linen service was daily.

Big difference compared to $20k per month aging in place. When my Mom was in a nursing home/long-term-care it was $12k per month, but she needed a village to take care of her. Even though was Mom was a meer 90 lbs, it took 2 Staff members to pick her up and place her in her wheelchair.

Another issue with aging in place, can the elder afford to keep the house running smoothly? Can that person afford to replace the refrigerator or stove when it can no longer work correctly? What about the furnace? A broken water pipe? Etc.

Aging in place would create an issue in the resale of homes. The inventory would be down, and when inventory is down, prices go up. The first time buyer would find it difficult to purchase a home.
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I agree with Tacy. It's expensive to stay in your home if 24/7 care is needed. When she mentions 9.25 an hour thats just a CNA and private pay. If you want to be on the up and up, SS at least needs to be deducted and matched. If u hire an agency, it will be more for CNA care. CNAs are limited to what they can do, giving shots is one thing, they r not allowed to give them. Some states not meds unless they have extra training.

If you hired at $10 an hr thats $240 a day x 7 days =$1680= $87,360 a year. A nice AL is 5k to 7k a month. You get a nice studio apt. Three meals a day. An RN, CNAs and Med techs. There is no guarantee that the aides you hire will come to work when in ur own home. Then what will the senior do?

Then another problem is the home is not equipped for the seniors disabilities. Maybe 2 story with no bath downstairs and person can no longer do stairs. Doors need to be widened so a wheelchair can get thru. Shower not excessible. Railings have to be installed. There are lots that has to be considered before someone is able to stay in their house.

The state governments paying out this kind of money so people can stay in their homes will never happen. Medicaid is being cut back. What needs to be done is stop telling seniors they can stay in their homes. They need to realize that this is not always an option. People who have tried to keep a Senior in their home will tell you its hard getting it all to work. Sometimes Dementia/ALZ makes it impossible. You are still leaving responsibility to family who may have to work or have health problems of their own. We have Seniors caring for Seniors.

What needs to be done is the cost of healthcare come down. Prescriptions more affordable. ALs cheaper.
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The problem with most people's arithmetic is forgetting to multiply the carer wage by three to cope with the 24 hour shifts. Providing one-to-one care is always more expensive than shared care, whether it's for children, post-operative, or aged care.
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