Most folks would tell you they want to be at home and not go to “one of those places” to receive care when it’s needed. It sounds like a reasonable request. But when the care gets really complicated and a licensed nurse is needed to maintain the aging parent at home, the cost of care is extremely high.
A Real Life Example
Sadness in caring for his wife
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Older gentleman, (OG) has been married for many years. His wife developed a breathing problem, for which there is no good solution with medication or surgery. The adult children have no answers. They want to support what Mom and Dad decide. OG has promised to allow his wife (OW) to return home after her hospitalization and nursing home stay. She needs a ventilator. Moving her back home took a team of people, an ambulance and paramedics. We at AgingParents.com, advising OG, suggested that he hire a geriatric care manager. He did so. She is responsible for coordinating 24/7 care with workers and the schedule for the independently hired Registered Nurse. OG depends on her and appreciates the help.
Medicare would have paid for a short time of rehabilitation at home after OW’s hospitalization. But rehab is only covered when the person is making progress from physical therapy, speech therapy or occupational therapy. OW is not improving. Her conditions is stable though quite complex. Her breathing must be supported with the ventilator at all times. Managing that takes skilled training. The nurse oversees it. She also needs help with all her daily activities while on the ventilator. OG must pay for 100% of all this.
The Cost
Essentially, OG is providing the equivalent of hospital or nursing home care at home, and paying out of pocket for everything his wife must have. He is a wealthy man, but for the first time, he is looking at how he will sustain this level of care at the price he pays this year: one million dollars. He believes he can manage it for the foreseeable future at least, but he now must also anticipate what he will leave his adult children after he is gone. This consideration never occurred to him before in his adult life. He felt more than secure financially. A million dollars a year for care at home was never in the plan. He simply will not put his wife in a nursing home, so now spending a million dollars a year for care is the plan.
The Emotional Impact
OG is getting emotional support from his psychologist to help him cope with this situation. He is fearful of losing his wife, expressing that he would not know how to live his life without her. For anyone with a successful marriage, this fear is universal. OS is also tying to cope with her condition and all the people coming in every day, around the clock, to help sustain her. She is fully conscious and able to talk about what it is like for her. The same psychologist comes to their home and provides emotional help for both of them individually. Neither OG nor OS wants to give up and stop the care.
The Takeaways
For those of means, care at home can include much of what would be offered in a nursing home or hospital as long as one can pay for it. Without question, 24/7 care at home is likely to be safer than care would be in any nursing home. The private attention the care recipient gets can be of the highest quality available. By contrast, most care facilities experience staffing shortages, high turnover rates, particularly in nursing aides, and a level of risk to safety as a result.
If your aging parent or other loved one wants to remain at home for the last part of life, be prepared to provide what they want in complex care only if you have substantial assets. If that is not the case, you can also oversee good care in a licensed facility with your own privately hired aide to supplement what the facility cannot give: constant supervision. When you can do that, and visit daily or as often as possible yourself, you give your loved one the best chance for safety and quality of life.
