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Elder Care and Senior Caregiving: Find Help for Family Caregivers

Also known as elder care, senior care is designed to offer aging individuals options for personal and health care services that can help meet their needs during the golden years. Many people mistakenly believe that exploring elder care options implies ‘going to a home' or ‘finding a place to die,' but nothing could be further from the truth. In fact, there are numerous reasons why seniors and their loved ones may seek out elder care options.

Often, our aging loved ones begin to feel secluded in the home as they have less independence and access to getting around town, and many grow weary of cooking and cleaning instead of simply enjoying hobbies and activities. Sometimes, seniors just need short-term care posts-surgery or after suffering an injury. Whether you are considering temporary, part-time, full-time or in-home care, here's what you should know about choosing the right assistance and options for payment.

What Elder Care Options Exist?

Regardless of the level of care needed by an aging loved one, there are in-home and out-of-home elder care options suitable for most individual's needs, desires and overall budget considerations.

Sub-Acute/After-Hospital Care – This type of facility managed care is common post-surgery or accidents and are designed to help patients recover and return home to live independently.

Adult Day Care – Those looking for a place that provides daytime senior care accompanied by activities to keep participants engaged may find this service invaluable—especially when  caregiver errands or some downtime is necessary.

Long-Term Care – Seniors who require full time 24/7 assistance and medical care may find this to be the best option, as licensed health care providers and trained assistance aid your loved ones around the clock.

Assisted Living – Assisted living elder care still allows seniors to enjoy independent living in residential style units with the comforts of home. Meals, activities, medical care and other services are available to residents who require only minimal assistance.

Home Care – Home care services can be customized to meet each individual's and family's needs. Options include part-time home health aides, private nurses and Medicare certified home nurse visitations, which are often necessary after a surgery or injury.

Hospice Care – Seniors with serious chronic illnesses or those in need of end-of-life care can benefit from hospice care, which provides options such as in-home or facility nursing care, heath aides, pain management, spiritual support and assistance with planning final arrangements for loved ones.

When You Can't Always Be There: What to Look for in a Senior Caregiver or Facility

As much as family and friends want to help out elderly loved ones, there are simply times when someone cannot be there. With so many options available for caregiver assistance, there's no reason not to give outside assistance a chance when the need arrives. However there are several serious considerations to evaluate when choosing an in-home provider or a care facility. The most essential ones include:

  • Reputation: Utilize the power of the Internet and telephone communications to do your due diligence when exploring how well regarded a provider is within the community and or the BBB. Take time to investigate personal and professional references or testimonials provided by caregivers and facilities.
  • Experience & Qualifications: This aspect is extremely important to check out, as some states only require on-the-job experience to be home health providers while others require licensing, certification and/or insurance for senior care positions. Look for providers with confirmed experience and who have completed a program such as the American Red Cross Family Caregiving Program or the Certification for Homemaker/Home Care Aides from the National Association for Home Care and Hospice.
  • Flexibility: How flexible do you need your potential part or full-time facility's or in-home provider's hours to be? As your needs for elder care change, how well with they work with you?
  • Special Considerations: If your loved one requires special care for memory conditions or a serious illness, you can do a quick search on our site to find nearby providers who can help. Of course, if a facility is your choice, ensure that they offer activities that your senior enjoys. Naturally, cost is always a consideration, so read on to learn more about options for paying for elder care.

Elder Care Marketplace

The care needs of the elderly population are significant. As they age, people face numerous, overlapping problems related to isolation, failing health, and physical and mental limitations. The problems of the frail elderly are magnified when the elderly person lives alone, especially when they and their children are geographically separated. Elderly people with health or other physical or mental problems are often referred to as the “frail elderly” to distinguish them from those who are elderly but still healthy and independent. Many of the elderly have no one nearby who can provide assistance to them. One out of five have no living children. One-third of those with living children live more than 30 minutes away from their children. Many live alone.

Some quotes and articles which illustrate the scope of the problems:

A study by Montefiore Medical Center and the Albert Einstein College of Medicine in New York and United Hospital Fund found the “vast but vulnerable base upon which our chronic care system rests” The study estimates unpaid caregiving for ailing adults costs $200 billion per year, and notes “The estimate dwarfs actual spending for home health care ($32 billion) and nursing home care ($83 billion) and is roughly equivalent to one-fifth of the nation's total annual health care costs.” (Source: National Council on Aging)

“We've learned that while people usually prepare for career, retirement, and the generation that follows, they do not anticipate caring for a parent. Few realize the time involved, or the lifestyle changes they will encounter in caring for a parent. Instead, people tell themselves that “I'm sure Mom and Dad have that covered. They have insurance and then there's Medicare.” Or we've heard, “We'll cross that bridge when we get to it.” But when adult children suddenly have to cross that bridge, they look frantically for answers and options. (Source: National Council on Aging)

“More Americans worry about paying for long-term care than paying for retirement, according to a survey of 1,000 adults. The survey, released by the National Council on the Aging (NCOA) and John Hancock Mutual Life Insurance Co., also found that seven out of 10 Americans flunked a quiz about the basic facts of long-term care. In addition, 48 percent of respondents indicated they have done little or no long-term care planning. (Source: National Council on Aging)

27% of Baby Boomers think they are covered by long term care insurance, but very few actually carry this coverage. 80% do not know how long term care is paid for and 25% say they are unwilling to consider paying for any additional insurance to cover these costs, according to a report from the American Health Care Association.

Older adults are concerned about their security but someone else is worrying about them more: their adult children, according to a study released by The National Council on the Aging and SecurityLink from Ameritech, a division of Ameritech Corporation. ” (Source: National Council on Aging)

Though more dramatic than most, the incident was one of many that play themselves out every day and illustrate the need for expanded adult day care and assisted living services, aging activists say. The Associated Press highlighted the issue in a nationwide story Dec. 22, noting that demand for the “guilt-free alternatives to nursing homes is growing rapidly.” (Source: National Council on Aging)

Nearly 7 million Americans provide care or manage care for a relative or friend aged 55 or older who lives at least one hour away, according to a survey cosponsored by The National Council on the Aging (NCOA) and The Pew Charitable Trusts… Long-distance care is a large and growing concern to baby boomers. The average age of the caregivers interviewed was 46, and nearly half of them were boomers. The survey indicates that approximately 3.3 million boomers are providing long-distance care. We expect that the number of long-distance caregivers will more than double over the next 15 years as the baby boomers and their parents age. (Source: National Council on Aging)

The number of persons requiring formal care (mainly nursing home care) and informal care (mainly care at home) will rise sharply even if the share of persons at each age remains unchanged. Accordingly, there will be a large increase in the numbers participating in various entitlement programs, such as Social Security and Medicare. Living alone presents an additional risk, and the risk mounts when the person living alone has no children or siblings. These characteristics are more common among those 85 years and over as compared with those under age 85. At ages 65 and over only 2 percent of the population have these characteristics in combination, but at ages 85 and over perhaps 6 percent have them. The outlook for the longevity and health of the elderly is not altogether clear. There will probably be a substantial increase in life expectancy, even at the older ages, but there are also likely to be large increases in the number of persons with poor health and disabilities, including Alzheimer's disease (and in persons requiring nursing home care and home care), if only because of the massive population increases projected to occur. (Source: Aging into the 21st Century)

Federal and state governments paid 41 percent of the costs of chronic care in 1987; private insurance paid 33 percent, and individuals paid 22 percent out-of-pocket…Nursing homes are a particularly costly segment of the chronic care continuum, a primary reason most reforms in the chronic care system include methods to help people remain independent and out of institutions for as long as possible. Recent data indicate that Americans pay 33 percent of the total costs of nursing home care out-of-pocket ($23 billion). The public sector pays an even greater share: Medicaid's 52 percent represented an expense of $36 billion. (Source: Chronic Care in America, A 21st Century Challenge)

GAO noted that: (1) spending for long-term care for the elderly totaled almost $91 billion in 1995, the most recent year for which expenditures from all sources were available; (2) almost 40 percent of these dollars were paid for by the elderly and their families and almost 60 percent by Medicaid and Medicare; (3) these amounts, however, do not include many hidden costs of long-term care, since an estimated two-thirds of the disabled elderly living in the community rely exclusively on their families and other unpaid sources for their care. (Source: General Accounting Office)

Statistics from Profile of Older Americans 1998:

  • The older population-persons 65 years or older-numbered 34.1 million in 1997. They represented 12.7% of the U.S. population, about one in every eight Americans
  • The older population itself is getting older. In 1997 the 65-74 age group (18.5 million) was eight times larger than in 1900, but the 75-84 group (11.7million) was 16 times larger and the 85+ group (3.9 million) was 31 times larger
  • Almost half of all older women in 1997 were widows (46%)
  • About 31% (9.9 million) of all non-institutionalized older persons in 1997 lived alone
  • While a small number (1.4 million) and percentage (4%) of the 65+ population lived in nursing homes in 1995, the percentage increased dramatically with age, ranging from 1% for persons 65-74 years to 5% for persons 75-84 years and 15% for persons 85+
  • In 1994-95 more than half of the older population (52.5%) reported having at least one disability. One-third had a severe disability (ies). The percentages with disabilities increase sharply with age (Figure 6). Over 4.4 million (14%) had difficulty in carrying out activities of daily living (ADLs) and 6.5 million (21%) reported difficulties with instrumental activities of daily living (IADLs). [ADLs include bathing, dressing, eating, and getting around the house. IADLs include preparing meals, shopping, managing money, using the telephone, doing housework, and taking medication].
  • Older people accounted for 40% of all hospital stays and 49% of all days of care in hospitals in 1995. The average length of a hospital stay was 7.1 days for older people, compared to only 5.4days for people under 65. The average length of stay for older people has decreased 5.0 days since 1964. Older persons averaged more contacts with doctors in 1995 than did persons under 65 (11.1 contacts vs. 5 contacts).

The Internet and Elder Care

Many people become isolated as they age, due to the multiple diseases and disabilities that sometimes accompany the aging process and the resulting problems getting around or accessing transportation. This isolation can lead to declining physical and mental health. The resulting loneliness may also contribute to the all too familiar stories about older people who have been duped into writing checks for “loans” to friendly strangers or responding to slick pitches for non-existent or unnecessary products and services.

Sometimes the elderly are geographically removed from their children. A recent study by the National Council on Aging estimates there are nearly seven million adult children who live an hour or more away from the parents they are caring for. These adult children can't easily monitor the quality of care which is given, prevent strangers from exerting undue influence over their parents, or tell whether their parents are truly healthy, safe, and secure. That distance contributes to their worry, and to their guilt.

The Internet is playing an emerging role in mitigating some of the problems relating to caring for the frail elderly, by reducing the impact of distance and geography:

  • It can serve as a tool to connect isolated seniors to the world around them.
  • It can provide elders with easy access to health and care information from their home, on demand, at sites like the WellnessWeb and Eldercare Web.
  • It can connect elders to sites which provide them with entertainment and recreation, and provide a forum for social interaction with others who are isolated at places like The Third Age.
  • It can help home-bound seniors continue to contribute to society through the development of personal sites which make their expertise available to others. For example, Food and Life is written by Rosemary Fisher, a 79 year old woman who says she has been able to reverse her own osteoporosis through diet and help her husband to reverse his heart disease and fight dementia through diet.
  • It can provide caregivers with information about aging services in all parts of the country, information that is available any time of the day or night, regardless of the time zone of either the child or the parent. Eldercare Web is one site that provides this information.
  • It can serve as a vehicle for caregivers and healthcare professionals to easily stay in contact with elderly people who remain in their own homes, through e-mail, chat groups, “telephony”, or even video applications.
  • It can make lifelong learning possible through distance education provided by hundreds of university sites.
  • It can develop new relationships, such as mentoring and intergenerational connections. The Service Corps of Retired Executives (SCORE) provides volunteer opportunities for retired executives to counsel businesses, and Generations United is part of a national network of intergenerational sites developing programs where seniors help young people and vice versa.

To make these things possible, more seniors need to be connected to, and comfortable using, the Internet. They will need the proper equipment, configured to adapt to their handicaps or impairments. They will need training on how to use the equipment and Web tools effectively. There are a number of studies and on-line initiatives to do this, such as the Senior's Computer Information Project.

We've just scratched the surface. As the collective creativity of the people connected to the Web continues to grow, we'll see even more ways to tap into this new resource.

Finding Elder Care Information on the Web

Much of the information you need is regional in nature. Use the assisted living directory search to start looking for help near you.

Medicare

The Medicare in the United States will pay for the cost of many hospitals, physician, and home nursing services, and some other healthcare services as well. Medicare is a federal health insurance program available to nearly everyone in the USA age 65 or over. The http://www.medicare.gov site has lots of additional information for consumers about the program, and what it covers.

Medicaid

Medicaid is a state-run program to cover health care costs of people who have little or no money. Because it's state-run, most information will be found in the individual states.

State information available varies widely from state to state. In some states, it's easily identified as the Division or Office of Medicaid. If that doesn't help, try agencies with names like Human Services, Health Services, Medical Services, or Medical Assistance, or check the sites of the Areas on Aging.

Other State Services for the Elderly

Other state programs vary widely by state. Services may include financial assistance, property tax relief, utility cost relief, free or low-cost legal services, housekeeping, meals and other in-home services, etc. In many states, an agency has been created specifically for overseeing aging services. Generally, it's called the Department or Division or Office on Aging. If there is no such agency, look for agencies with names like Family Services, Social Services, or Human Services.

More information will be available at the sites of the Area Agencies on Aging. These aging services sites are often good sources of information on lots of aging issues. A good starting point for information about many types of services and programs specific to a state or local area is the Area Agency on Aging. Some of these regional agencies have information available on-line, and others can provide it if you call them.

License and Certification

When looking for health care facilities and in-home caregivers, you'll want to be sure you are working with licensed and certified providers. In many states, licensing is overseen by the Department of Health, and certification by the agencies that administer Medicare and Medicaid. In some states, the oversight agency has a name that includes the words Assurance, Quality or Licensing.

Several state provide lists of licensed facilities, like Licensed and Certified Health Care Facilities from the Minnesota Department of Health, which you will find on the page for Minnesota. Facilities are surveyed as a part of the licensing process. You may be interested in seeing survey results to help you assess the quality of a healthcare facility. Some states, like Massachusetts, have survey results on-line, Nursing Home Information for Consumers from the Massachusetts Division of Health Care Quality. In other states, you'll have to request these from the individual facility or from the state oversight agency. For nursing home surveys, try Nursing Home Compare, a database of nursing home surveys for all licensed facilities in the United States from the Centers for Medicare and Medicaid. You can look up facilities by state and city and see the results of the latest state surveys.

Individual healthcare professionals, such as doctors and nurses, are licensed by a state regulatory agency. You'll have to dig around to find out which agency does that regulation. It could be the Department of Health, or a Department of Regulation. You will want to make sure your healthcare professionals, especially anyone you use for in-home services, meet all state licensing standards.

Each state has a nursing home or long-term care ombudsman program. The ombudsmen visit the facilities regularly and help residents and families register complaints or obtain information. You will find information about ombudsman programs at the sites of the aging services organization.

Eldercare Locator

The Eldercare Locator is a national toll-free directory assistance public service of the U.S. Administration on Aging that helps people locate aging services in every community throughout the United States. The primary goal of the service is to promote awareness of and improve access to state, area agency and local community aging programs and services. Since its inception in 1991, more than 660,000 calls been received from families, friends, caregivers, aging professionals and older persons seeking direction on where to begin to look for aging services and programs.

The Eldercare Locator is absolutely FREE. There is no charge to use the service, and there is no charge for the information. Individuals calling this service or using the website have access to state and local information & referral service providers identified for every ZIP code in the country. Individuals calling the Eldercare Locator can connect to more extensive information sources for a variety of services including:

  • Alzheimer's hotlines
  • Home delivered meals
  • Transportation
  • Legal assistance
  • Housing options
  • Adult day care and respite services
  • Home health services
  • Long term care ombudsman

The Eldercare Locator is administered by the National Association of Area Agencies on Aging (http://www.n4a.org) in cooperation with the National Association of State Units on Aging (http://www.nasua.org)

Contacting the Eldercare Locator — (800) 677-1116

Normal Operations: Call the Eldercare Locator toll free by dialing 1(800) 677-1116. Monday thru Friday 9:00AM to 8:00PM(ET). For calls after normal hours of operation: After hours, a message recorder is available for the caller to leave a name and a telephone number. Calls will be returned the next business day.

More Information

For other information, use the Search link at the top of every page, select the correct state and county and submit the form. This will bring up a list of organizations that serve that area which you can contact for more help. If there are lots of results, you can refine the search by typing in a keyword or phrase to narrow the search.

You'll need to know zip codes for some search engines. If you don't know the zip codes for the city you're researching, you can use the Zip Code/City Association from the U.S. Postal Service. You type in a city and state, and it returns a list of all the zip codes in that city.

The Cost of Elder Care and Senior Caregiving

We can't plan adequately for elder care needs without knowing the costs, so we need to quantify those costs. In searching for statistical information on the costs of aging, I was not able to find everything I was looking for, but I did find a number of interesting statistics which cast some light on what people over age 65 might expect to pay for housing and care-related expenses as they age.

Average life expectancy has increased by about 15 years since the Social Security program was implemented in the 1930s. If the eligibility age for Social Security and Medicare had increased along with the average life expectancy, it would have risen from age 65 to age 80 by this time. If people were retiring at that later age, the funding problems for the Social Security and Medicare programs would be eliminated, but our lives and expectations would be far different!

Life expectancy changes once one reaches age 65, since not everyone will reach that age. If one lives to age 65, they can now expect to live 16-19 more years. By 2050, when the baby boom generation retires, average remaining life expectancy at age 65 is expected to be over 20 years. That 20 year period is what we need to plan to fund.

The population over age 65 are very disproportionate users of healthcare. Although they represent 12% of the total population, they account for 36% of total national healthcare expenditures, 36% of hospital stays (admissions), and nearly 50% of all days in the hospital!

People over age 65 have far higher medical expenses than those under age 65, and the projections are that their costs will rise at a far faster rate than healthcare costs for younger people. By 2005, non-institutionalized people over age 65 may average over $14,000 per year of healthcare expenses, over four times the cost of those under age 65. Because these statistics are for the community-based population, this figure does not include the cost of long term care.

The average cost of medical expenditures for the community-based population over age 65 is primarily for hospital costs, but physician, home health, and prescription medicines also represent significant expenditures. Of particular interest is the projected $1,000 of annual cost for prescription medicines, a cost which is not covered by the standard fee-for-service Medicare program.

Looking at the source of payments for these healthcare costs provides some insight into the need for insurance. Only about half of these costs are covered by Medicare, a fact which many people are unaware of. The remaining half of per capita expected costs, about $7,000 a year in 2005, must be paid for out-of-pocket, or by Medicaid or private insurance.

The out-of-pocket expenditures of all Medicare beneficiaries highlight the gaps in the Medicare program. Although hospital costs made up the largest part of the incurred costs, they are a very small part of the out-of-pocket expenses of the average Medicare beneficiary since hospital care is well covered by Medicare. The biggest out-of-pocket expenses are for long term care, pharmacy, and dental expenses, most of which are not covered by Medicare, and for physician services not covered by Medicare. Some of this out-of-pocket expense is in the form of patient deductibles and co-insurance for covered care, and some for uncovered services.

Most people who have Medicare insurance will need supplemental insurance to cover some of the significant co-insurance and deductibles left by Medicare. This insurance could be provided by a private commercial Medigap policy. Medigap policies were standardized by the federal government into 10 policies, called Plan A through Plan J, so that beneficiaries could more easily compare policies from one insurer to another.

Even with this standardization, premiums vary considerably. In this example, taken from data posted by the Illinois Department of Insurance on their Web site, the cost of Medigap policies in the Chicago area varies from $440/year to $5,600/year, depending on the plan, the insurance carrier, and the age at which it is purchased!

Older people will generally elect Medicare Part B coverage, which requires a premium paid to the federal government. That premium is currently about $45/month. This provides coverage for physician and other charges.

The Part B premium is also required if a beneficiary elects a Medicare HMO as an alternative to standard Medicare. A Medigap policy would not be needed for a beneficiary who elects a Medicare HMO, and the HMO premiums are generally less than Medigap premiums, but there are trade-offs for that lower premium, since the Medicare HMO controls which providers and what services the beneficiary can use. There have also been problems when Medicare HMOs have dropped out of the program, requiring the beneficiaries to find alternatives.

Older people may also want to purchase long term care insurance. The premiums for long term care insurance vary widely based on the age at which it is purchased, the sex of the beneficiary, the amount of coverage elected, the waiting period, and a host of other options.

Just to provide a simple example of the potential gross cost of insurance premiums which would accumulate over the 20 years of retirement, this chart shows that gross, non-inflated, insurance premium costs could be $50,000 to over $100,000 over that time, a significant expense many people fail to plan for.

Complicating the planning for the cost of insurance premiums is the fact that health insurance premiums don't move up steadily with inflation, but instead fluctuate widely. For example, Medigap premiums shot up sharply in 1995 after several years of slow growth.

There are a number of types of healthcare used by older people. They are paid for in very different ways, resulting in the need to plan for how all types of care will be funded. Nursing home care is primary funded by Medicaid, the state-run welfare program for people who have exhausted their assets. This is sometimes because people exhaust their assets paying for the nursing home bills, and sometimes because they anticipate the need for nursing home care and gift or spend their money down to a level where they qualify for services. Contrary to what many people believe, most nursing home care is not covered by Medicare, and even when it is covered, the co-insurance is significant, nearly $100/day after the 20th day. Days of care not covered by Medicare or Medicaid must be paid for by private long term care insurance policies or paid for out-of-pocket.

Medical home health care is well-covered by Medicare. People on Medicaid find home health services are limited, since the states have generally concluded it is more cost-effective to provide care in an institutional setting.

Assisted living is a fairly new level of care. It is appropriate for people who are not able to manage for themselves at home, but who don't require 24 hour a day nursing care or daily therapy. This is a type of care which is highly desirable to consumers, but it cannot be funded by Medicare, and there are few places in the country which are licensed to take Medicaid payments. Consequently, the money for this type of service often has to come from private long term care insurance or out-of-pocket.

Independent living is the lowest level of care. People in independent living are still able to take care of themselves and remain independent, but benefit from socialization, transportation, a dining room, or housekeeping services. On average, people in these types of facilities are about 75. At younger ages, most people would not see the benefit to moving out of the family home.

People don't generally move into assisted living facilities until a later date, and they average 83 years old and stay about two years. Nursing home residents average age 85 and stay there an average of 1-2 years.

One common reason for the need for either assisted living or nursing home care is dementia, most commonly Alzheimers. About 1/3 of assisted living residents and about 1/2 of nursing home residents have dementia problems. Dementia is difficult to handle in a person's home unless a full-time caregiver is available, which is not always the case. Even when a caregiver is available, they may not be able to manage a patient with aggression, nighttime wandering, or other common manifestations as Alzheimers progresses.

Another reason why a person may need to move to assisted living or a nursing home is that they require assistance with the activities of daily living (ADLs). These include needs for assistance in dressing, bathing, eating, toileting, or moving around. When people require help with multiple ADLs, it may be difficult or impossible to provide that help in the person's home. Over 50% of people over age 85 require assistance with ADLs.

Interestingly, only a small percentage of the population over age 65 is institutionalized. Even at age 85 and over, 85% are still living in some non-institutional setting.

One sign of the changing ways we provide care to older people is the decline in the average length of stay in a nursing home. That has dropped from 34 months in 1985 to 28 months in 1995, a six-month reduction!

It's important to understand the real likelihood of the need for nursing home care, and the length of time it might be needed, in order to plan and purchase appropriate levels of insurance. Generally, about 40% of people who spend time in nursing homes stay for less than one year, 30% stay 1-2 years, and 30% stay over 2 years.

These numbers will probably change as patterns of use of long term care changes. Assisted living facilities are drawing many people who would have been in a nursing home in the past, and as they become more widely available and affordable, the use of assisted living will probably impact these statistics.

Costs vary widely from region to region, but these are some statistics which compare the costs of different types of healthcare.

Costs also vary widely depending on the level of services provided in different long term care settings.

Just to get some idea of the gross dollars at stake, this chart shows the non-inflated, accumulated cost of spending different amounts of time in assisted living and nursing home facilities, including potential entrance fees (which may or may not be required, and which also vary widely in amount.) As you can see, the potential cost is several hundred thousand dollars.

The potential costs are significant, easily accumulating to a hundred thousand dollars or more. Yet most people are unaware of these costs and do not plan for them. Appropriate planning can have a real impact on actual costs, by doing things like selecting the right insurance for the right situation, and understanding all the alternatives available in order to choose the most cost-effective solutions to problems.

Paying for Elder Care and Senior Caregiving

There's no exact cost of elder care, as overall pricing will vary amid providers and will heavily depend on the extent of care your loved one needs. Unless provisions in retirement planning for senior care have been previously made, these options may help cover part or all of elder care expenses.

Medicare Coverage

Currently, the Medicare program offers minimal coverage for elder care services. Primarily, it covers four related services:

  • Patients in need of after-hospital/sub-acute care.
  • Medical cost ONLY for seniors in assisted living.
  • Limited part-time in-home nursing care when prescribed by a doctor for confined patients.
  • In-home or facility hospice services for those expected to pass within a 6 month period.

Medicare policies traditionally will not cover any assisted living expenses related to boarding, meals or personal care. Adult day care and specialty services for dementia or Alzheimer's are not covered, as Medicare considers those ‘personal' expenses.

Medicaid Policies

Medicaid is a state-funded program that provides health care options for those with limited financial means. Those who qualify can receive either full or partial assistance to cover expenses related to both in-home and facility-provided elder care. Most facilities accept Medicaid and can also help with applying for such benefits.

Traditional Health Insurance

The majority of senior care facilities and licensed caregivers work with most major insurance policies including HMO's, PPO's, Workers Compensation insurance, managed care plans and others. Thee providers will contact your insurance company to confirm your benefits to pre-authorize patient's admission.

Long-Term Care Insurance

These supplemental policies are a solid investment, and long-term care insurance plans typically pay all or a set portion of expenses associated with elder care. Individuals without substantial savings or who want to spend their retirement on life's pleasures do well under these plans.

Self-Payment

Self-payment is an option with almost all caregiver options. Be sure to inquire about any type of sliding scale plans at facilities in which you and your loved one are interested in. Asking can often save you substantial money.

Where to Find Reputable Elder Care Options and Caregivers

We understand that you want the best for your aging loved ones and don't want to take a risk with their safety, health and happiness. Regardless of their level of independence or preferences for care, you can easily find what you need with a quick search on our user-friendly, no-cost database.

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Since graduating from Harvard with an honors degree in Statistics, Jeff has been creating content in print, online, and on television. Much of his work has been dedicated to informing seniors on how to live better lives. As Editor-in-Chief of the personal… Learn More About Jeff Hoyt

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