requires a
"buy-in" purchase package but entitles you to
move from one level of care to another as you
need it. Even if the level of care you need is
closed to admission because it is at capacity,
you are guaranteed a space when you need it. The
range of independence is from apartments to
assisted living to skilled nursing. If a spouse
needs short term convalescent recovery after
surgery or illness, they can be in the skilled
nursing facility until they are able to return
to independent living. These communities also
offer respite services for those living in any
of the residential levels.
Congregate housing is
a living situation where meals, common areas and
activities are shared with other residents, but
residents have their own rooms.
Low Income Senior Housing
follows the congregate living model. There
may be separate independent apartments. Because
Senior Housing receives Federal financing, to be
eligible you must be considered low income and
meet the financial criteria.
One of the new housing solutions
is modular housing. Modular
housing is a barrier free portable manufactured
unit that is placed on the lot of a family
member, usually close to the home that is there.
This enables the senior to be within steps of
the house and close by to family caregivers and
at the same time maintain their independence in
separate quarters. Many towns and cities are
revising zoning ordinances to allow these units
to be placed on family property as long as they
are needed. When the senior no longer needs the
unit, it is returned to the supplier because it
can be moved to another location.
Assisted Living Facilities
(ALF) provide separate apartment units
(studio, one and two bedrooms) in a facility
where meals, activities and lounge areas are
shared in common. Services such as housekeeping,
laundry, meal and medication reminders,
assistance with grooming and hygiene or limited
nursing needs are provided as part of the basic
fee. Additional services can be provided for an
extra cost.
Some ALF and some skilled
nursing facilities now have specialized
Dementia units with safe environments
and staff trained to provide the specialized
care to persons with confusion and memory loss.
One creative model that has
evolved is Shared housing where
the senior recruits other seniors to share their
home. They share the costs of renovating the
home to be handicapped accessible and they share
the costs of maintaining the home. This provides
social support and a way to share the burden of
caring for one’s self and the costs and effort
of managing and maintaining a home.
Average Costs of Long Term Care
Future planning is critical.
Unless you know what the costs of long term care
are, you cannot possibly plan how you will pay
for it. Here are some examples of the costs of
long term care options.
Home Health Care: In
2008, the New Hampshire average rate for
a Home Health Aide was $26.00 per hour. If
assistance is needed 5 days per week, 5 hours
per day, home health care costs calculate out to
about $33,800 per year. (Met Life 2008) A case
manager may be helpful in helping a family
negotiate a rate.
Adult Day Care: Costs
for adult day care can range from $54-$62 per
day. This is $270 -$310 per week, or
$14,040-$16,120 annually.
Nursing Home Costs:
In New Hampshire, the cost findings in the Met
Life Long Term Care study for 2008 was $249 per
day (semi-private room) which is or $7,574 per
month or $90,885 per year.
Specialized Dementia Care
Costs: The costs of specialized dementia
care are considerably higher because of the
higher level of staffing and special
programming. Monthly rates in New Hampshire can
range from $5.252 to $9,625 for a shared room.
Assisted Living Facility:
The average monthly fee for assisted living is
$3,838 per month (Manchester) to $3,516 per
month in the rest of New Hampshire. Pricing in
Assisted living facilities varies widely and
consumers are encouraged to make sure that they
understand exactly what services are provided in
the monthly rate. A Case Manager can be helpful
in sorting out the various rate structures.
Continuing Care Retirement
Community: Four facilities have been
selected for this example. Costs quoted are
based on an average of the facilities surveyed.
There is an application fee close to $1,000.
Entrance fees are based on unit size. For a
studio (one person) the entrance fee averages
$42,667 or $84,850 for a couple. There are
monthly charges once the person has become a
resident. They average from $1,353 for an
individual and $2,403 for a couple using 2009
rates
Funding Options
Paying for the cost of long term
care is the responsibility of the individual.
Medicare does not pay for housing. Medicaid is
the funding mechanism of last resort and is an
option only after people have "spent down" their
assets. If meet the financial requirements to
qualify for Medicaid, you may have to give up
choice in selecting where you want to live. Many
states, including New Hampshire, are developing
stricter criteria for admission to state funded
beds.
Consult with representatives who
sell Long Term Care Insurance to discuss various
insurance products that pay for Long Term Care.
Local representatives can be contacted through
these links:
www.longevityplanning.com and
www.bradleyltc.com . For assistance in
selecting the right Long Term Care insurance
product you can find a Long-Term Care Insurance
Planner at
www.weissratings.com . A very helpful
"Shoppers Guide to Long-Term Care Insurance is
available fro the National Association of
Insurance Commissioners through the website:
www.naic.org
For people who own their own
homes, reverse mortgages are an option. Reverse
mortgages provide the needed resources to assist
elders who plan to stay in their own home but
need to purchase support services and home care.
The reverse loan is an alternative to pay for
home modifications for barrier free
accessibility. For more information regarding
reverse mortgages, contact Merl Littlewood of
Carteret Mortgage, who is a reverse mortgage
specialist at (603) 358-1002 or
