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Financial Planning for November, 2020

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A Realistic Picture: Will You Be Able to Afford In-Home Elder Care?

By the end of September, the nation had recorded over a quarter-million cases of COVID-19 and nearly 60,000 deaths in nursing homes that were attributed to the disease. The recent pandemic offers yet another reason why more than 90 percent of seniors say they want to grow old in their homes rather than move into a senior housing facility.

But just how feasible is that goal, from a financial perspective? Much depends on how independently you can live for the rest of your life. That is something we cannot plan. Even elderly people with an excellent gene pool and no known health conditions can experience a fall or other accident that could render them helpless. And the older you get, the higher the risk of cognitive decline, which can make it unsafe to live alone.

However, you might still be able to live out your golden years in your own home if you can afford to pay for in-home care. Each year, Genworth Financial publishes a Cost of Care Survey that examines the cost of various types of long-term care. However, when you break down the assumptions, you might find the survey’s cost estimations are lower than what many people actually pay.

For example, the average fee for homemaker services (household chores, prepare meals, run errands, accompany to appointments) is $22.50 an hour. For a home health aide (help with bathing, dressing, toileting and simple first aid) the average hourly wage is $23. Depending on your location, you could pay more for a company that employs home workers or pay less for independent caregivers. Be aware that if you choose the independent route, you’ll have to vet abilities, trustworthiness and schedule your own back-up resources if they don’t show up for some reason.

However, according to the Genworth report, the average daily rate for a homemaker is only $141, or $4,290 a month. That breaks down to about six hours a day. What happens when you reach a point where it’s unsafe for you to mill about the house by yourself because you might leave the stove on, or you might fall and there’s no one to help. If you pay a caregiver to stay with you 16 waking hours a day, that would cost you $360 per diem, or about $11,000 a month.

If you don’t sleep well and tend to have to use the restroom at night, you might need to pay for a night shift caregiver just to make sure you get around OK. That means 24-hour care will run you more than $16,000 a month, or $195,000 a year – and that’s in today’s dollars.

If you’re planning on in-home care 10 to 15 years from now, those rates will probably be higher.

There are a couple of other issues to note. First, you don’t need to be completely incapacitated to require 24-hour care. It could be as simple as mild but gradual progressive dementia; a mobility issue; or fear of living alone after a spouse dies. Also, if a couple is living comfortably at home with 24-hour care, that expense probably won’t go away if one spouse dies – but household income will probably decrease.

There are alternative ways you might consider that would allow you to stay home throughout your elder years, and the earlier you plan for them the better they will work out. First of all, be nice to your grown children. Not only might you prefer to move in with them or they move in with you, but if things don’t work out, they will likely be the ones to determine where you live out your golden years.

Second, consider your housing situation and if you can negotiate room and board to one or more caregivers in exchange for their help. You might also consider cohabitating with an elderly friend or family member to help share caregiver fees, and perhaps eliminate the need for excess hours a day. Better yet, consider moving in together with several friends to help spread out the costs and improve your chances that some seniors will be less informed than others.

Since 2010, on average more than 10,000 Baby Boomers turned age 65 per day and by the year 2030, all Baby Boomers will be 65 or older. Among them, 52 percent will require long-term care in their lifetime. If you want to remain at home but worry about the cost of caregiving, you’ll have plenty of housemates from which to choose.

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