There are, generally, two large choices when a senior and their loved ones are working to decide where the next step in care will take them: aging in place or a more institutionalized community of care such as an assisted living facility.
Aging in place means living at home or with loved ones, and it is the expressed preference of most seniors. Assisted living facilities provide more medical expertise and staff training, and they provide easy access to emergency facilities and care if necessary. Both solutions have pros and cons, without doubt, and the decision is a deeply personal one. Yet one factor may overrule all other considerations when it comes time to make this decision: cost.
It seems to be common wisdom that aging in place is cheaper than aging in an assisted living facility. The costs associated with assisted living are high. Yet there are sometimes hidden costs to aging in place, ones that do not always come up in studies and research concerning this important decision. Here we will examine the average costs of both options; we will also look at a few of these "hidden" factors.
The Average Cost of Assisted Living
According to Argentum, the average cost of a month in an assisted living facility is over $3,000. According to the 2014 Cost of Care Survey by Genworth Financial, Inc., the average is more like $3,500 per month. This is for a one-bedroom unit, so it assumes that a pair of spouses would either share a bedroom or be housed in separate units. These costs are also usually tiered based on what level of care the resident needs, so they would increase or decrease depending on how much care a senior requires while living in the facility.
Average Cost of Aging in Place
Generally, a senior who is retired will either live with a relative or live in a home they own. This usually means that rent or mortgage payments are zero extra dollars, although property taxes must be accounted for. If this is not the case, and a senior rents an apartment, we will use Florida (a popular retirement spot for many older Americans) as a basis for the numbers. In Orlando, Florida, there are high-quality one-bedroom apartments available for around $900 per month in rent. This does not include utilities, which could be another $200 per month depending on energy usage (air conditioning primarily). Add on top of that the cost of food, and a senior may be looking at paying around $1300 a month, conservatively, for basic living expenses. This does not include incidentals, a car payment or car insurance, or other healthcare costs not covered by insurance or Medicare.
Another consideration in aging in place is the need for professional care. After a surgical procedure, or even regularly, a senior may require the care of a registered nurse or home health aide. This may be a cost covered by insurance or Medicare, or it may be only covered in part. In some cases it may not be covered at all. In an assisted living facility, the cost of regular care by a nurse or doctor is covered in monthly payments.
Other Cost Considerations: Moving, Unpaid Labor
Adding to the cost of both options is moving a senior from one home to another. Unless a senior is aging in place at home with important safety features and does not need to move to a more senior-friendly home or apartment, they will need to move. We would define a senior-friendly and safe living situation as being fall-proofed, wheelchair-friendly, and equipped with safety bars in the shower, at minimum. What is more, some seniors will need to move closer to relatives in order to age in place successfully.
The cost of hiring movers in Florida can be as low at $200 or as high as $500, depending on whether a senior is moving from another state, has a large home, or has large, delicate objects (such as a piano or a safe) that must be moved with certain equipment.
Moving costs must take into account a deposit on an apartment or house for rent, as well. This requires seniors to have a substantial amount of cash at their disposal.
A non-professional caregiver will often spend personal time...
Unpaid labor is a cost related to aging in place, especially with non-professional caregivers. While this cannot be measured in dollars, it is an important cost that must be noted. A non-professional caregiver will often spend personal time, money, and energy doing things like cooking, cleaning, shopping, transporting, and caring for a senior who is aging in place. If this is not a practical solution (say, for example, the family caregiver is an adult child with young children of his or her own, or the adult child or his or her spouse has a job that involves frequent travel, then this cost cannot be borne by the relative.
As always, the best way to prepare for aging is to plan for it and to consider all possible needs and outcomes. For some seniors, aging in place is very practical for many years, but it may become impossible with severe health complications, which become more likely with age. Negotiating all of these factors is best done over time and with the senior's best interests in mind, allowing for flexibility and change as the life cycles of all involved march on.
Apartment Guide. Orlando, FL. 1 Bedroom Apartments. Available at http://www.apartmentguide.com/apartments/Florida/Orlando/1-beds-1z141xt/. Retrieved April 12, 2016.
Argentum. Cost of Assisted Living. Available at http://www.alfa.org/alfa/Assessing_Cost.asp. Retrieved April 12, 2016.
Expedient Movers. Take Advantage of One of Our Limited-Time Specials. Available at http://www.expedient-movers.com/orlando-movers/moving-specials.php?gclid=COzk4ZP8icwCFdgWgQodu20PdQ. Retrieved April 12, 2016.
Genworth 2014 Cost of Care Survey (March 25, 2014). Genworth Financial, Inc. Richmond, Virginia. Available at https://www.genworth.com/dam/Americas/US/PDFs/Consumer/corporate/130568_032514_CostofCare_FINAL_nonsecure.pdf. Retrieved April 13, 2016.
Stinson, Sonya. 5 ways to cover assisted living expenses. Bankrate.com. Available at http://www.bankrate.com/finance/insurance/paying-for-assisted-living-1.aspx. Retrieved April 12, 2016.