Hidden Costs in Senior Care

There are many ways to refer to an elderly care community. Some call them “nursing homes,” “assisted living facilities,” and even a “rest home.” Most people don’t realize that there are many levels of care and titles when it comes to senior living communities. These details can be confusing and often times misunderstanding.

It’s no secret that living in an elderly care community can be expensive. According to a market survey of long-term costs conducted by the Metropolitan Life Insurance Company, “the national average for assisted living base rates was $3,550 per month in 2012. Genworth Financial conducted a cost of care survey that showed residents of assisted living communities can typically expect a 4.29% annual increase in their base rate” (Shelton).

But there are more factors to consider in addition to the “BASE” cost of living. Additional charges may apply according to the residents’ level of care. This means if a resident needs assistance with organizing medications or needs transportation to doctor appointments, there will be charges added to the base cost. A common term used for this is “activities of daily living” or “ADL’s.” ADL’s may include medication management, bathing, dressing, toileting, transferring, eating, or meal preparation. For instance, if an elderly resident is recovering from knee surgery and needs additional help with bathing for a few weeks, they will be charged additional fees by the facility in which they live.

A licensed nurse is usually required to do an assessment on prospective residents prior to admission to care communities. The nurse is qualified to assess whether the resident may need additional help (or assistance) upon admission. During the assessment, the nurse may find that the resident needs help with medication management or help transferring from a wheelchair to bed. This additional help results in additional costs. These additional costs can range from $150 to $700 or more per month.

Another hidden fee that most do not consider is the deposit fee. This non-refundable fee can range from $1,000 to $5,000 and covers administrative expenses and covers renovations between residents.

In some cases, it makes more sense for the elderly to stay in their own home and pay for in-home care. For instance, if an 85 year old couple can pay for a registered nurse to come once per week and set up medications, take vital signs, and complete a physical assessment, the monthly charge would be $180. If the couple added 5 visits weekly by a caretaker to prepare daily meals, this would only add $900 monthly. This adds up to 20 caretaker visits and 4 RN visits per month for only $1,080 and it includes meals prepared, vital signs taken, medication management and frequent check-ins. This is less than one quarter of the average cost to enter an elder care facility and it allows the elderly to remain in their own home and maintain independence. Moving can be especially stressful for the elderly. According to Judith E. Hertz, “For older adults who may have limited coping resourses, a move to a new home might be especially stressful. Whatever the reason, the decision to move requires careful consideration.” So, keeping the elderly in their own home may even be better for their health in some situations.

While exploring options for assistance, ask questions. Ask for details regarding additional services and hidden fees. Then make a written list of pros and cons and costs associated with each. This can help you make a more objective decision.

Shelton, Sara. “Assisted Living Costs: Facts & Figures. Senior Homes.com. n.p. 2014. February 20, 2015< http://www.seniorhomes.com

Source: Lisa Fields, “6 Ways Pets Can Improve Your Health”, WebMD site, Reviewed by Michael W. Smith, MD on 24 October, 2013


Jessica, RN

Jessica Schaben Owner/Director Advanced Home Health and Nursing

Call today for Skilled Nursing or Senior Care Costs in the Omaha, Metro


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