Monday, March 14, 2016

Comparative Aging in Place at Home Costs (Private Pay)

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Work on my residential care spreadsheet (Maintaining a Safe Cognitive Impaired Environment) stopped when my health failed to the point that I could no longer take care of my wife at home. It is now over two months later since we moved to Provision Living at Columbia (MO). Just a three mile free move. One day of packing; two hours loading; two hours unloading; and another couple of hours and all the packing stuff was out of the apartment. The time to move had come and there was no waiting list for the new apartment
The original emphasis in the spreadsheet (2014) was on independent living (IL). During 2015 that turned to assisted living and to memory care. Now we are concerned about what follows assisted living/memory care and finances. Our original instructions were, “I want a phone number”, to a person who actually knows you and Gma and a plan of what to do next. We owe this to our kids.
The spreadsheet works well with money, square feet of space, and the time and number of meals. However it can easily give false impressions. Nothing is simple as everything can have many related parts and timing (and billing). Our move is a good example: one person stayed with the process from start to finish to see that all did go well, including taking care of us for the day.
So, I am breaking the spreadsheet summary dated, 22 December 2015, into four parts. The first three have us living together, as we have, and the last one has us living in separate spaces; something we cannot do financially.
  • Aging in place at home.
  • Independent living (IL).
  • Assisted living (AL).
  • Memory care (MC). 

This first step has been a good learning experience; for less than we were paying for Medicare insurance (dropped from over $11,000/yr to zero; BlueCross/BlueShield to Essence Boone County MO HMO). A 3-hour service period, from Home Instead Senior Care, seems to be the optimum for memory care. We selected three days a week after I was in the hospital emergency room, twice, and later admitted twice. Boone County Hospital provided food and a bed for my wife each time.
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We learned a lot about memory care. Well-matched (bonding) caregivers made residential care facility visits possible. We learned that the “new family” we would be a part of is different at each facility. We ended up grouping the facilities “health oriented”, “both” and “fun retirement”. This grouping ranked the cost of joining; from higher to lower priced independent living (IL) entry costs (Chart 8).

In-home care for just a 3 hr/day matched the cost of IL when charged by the level of care. At this level you are just paying for room and board. Day care can be added at Mill Creek. Tiger Place and Provision Living include assisted living (AL).

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