P.A. MacLean
RedwoodAge.com

Barring a catastrophic injury or illness, our parents are unlikely to go from being self-sufficient to needing a nursing home.  But the gradual loss of physical and mental acuity creates a need for levels of care that ramp up with age.

Placing a parent in the hands of strangers in nursing home settings frightens many of the adult children of seniors, and the costs are staggering.  The just-released study of cost trends by Genworth Financial shows the average annual rate for a private nursing home room was $78,460 in 2008, up more than $10,000 from costs five years ago.

But lets step back and look at less severe, and less expensive options as reported in the survey by Genworth,, which provides long-term insurance.

Knowing the kind of care available is as important as how much it costs, in order to find the level of care best suited to a parent or relative’s needs. Consulting a nonprofit or public senior-care specialist in your area will probably save you a lot of time and trouble. 

At the least intrusive end of the scale, a homemaker service provides help with cooking and running errands but not medical care or monitoring.  The provider is referred to as “personal care assistant” or companion and the national the average hourly rate was $18.

These rates have remained the most constant in recent years, most likely due to competition among non-Medicare certified agencies and the availability of unskilled labor.

Home health aides do not provide medical care but give extra help in the home such as bathing, dressing and transferring in and out of bed.  Again, this rate is, on average nationally, about $19 per hour, just a 3 percent increase over 2007, according to Genworth.

The rate jumps when the home health aide is from a Medicare-certified agency, one that accepts Medicare reimbursements.  Those rates hover around $38 per hour on average. This showed a sharp increase over 2007 – up 18 percent.

If a parent lives with you, both of you can benefit from community support service in the form of adult day health care, which is similar to daycare for kids. Daycare can provide a much-needed break to caregivers at a national average of $59 a day. Daycare may provide supervised therapy, exercise and social activities.

Different Strokes
Overall, service styles generally break down into four types: those that provide social activities, meals and recreation; facilities that add in some living support such as dressing and cooking; medical models for those in need of medical monitoring of participants; and a third type that offers both social and medical care.

This brings us to live-in facilities.  For the truly independent seniors able to manage most parts of their lives but still in need of some recreation and help with errands, there are independent living facilities that are little more than apartment buildings for elders. Help is there, if you need it.

For seniors able to manage some life tasks but still in need of regular help, such as medication management, and help with bathing or dressing, there are assisted living facilities.

These are also known as residential care arrangements, they are not an alternative to nursing home care, but provide more independent living as an intermediate step for the frail elder who does not need nursing supervision.

A private one-bedroom averages $3,008 per month nationally and that is a whopping 11percent increase over 2007, Genworth found.

The highest level of care, skilled nursing facilities, are for those in need of personal care, medication help, possibly therapy and rehabilitation, if they have had a stroke or a fall that required surgery.

A shared room, or semi-private as they are dubbed, averages $187 per day, a 4 percent increase over 2007.  While a private room costs $209 a day, on average across the country, that is just 2 percent higher than last year.

The average rates vary greatly from state to state and detailed study shows rates for each category broken down by state and even separates out major cities.