Is it Time for a Nursing Home?

When is it time to consider a nursing home?

"The National Association of Area Agencies on Aging reports, "of the almost 6 million adults age 65 and over with long-term care needs, only 20% receive care services in a nursing home or other institutional setting, with the remaining 80% receiving assistance at home and in the community." So how do you know when it’s time to make that move from home care to an nursing facility? One way is using a tool called the activities of daily living (ADL). It’s an assessment of the tasks required for self-care. So in short, a nursing home might be in order when in-home care or an assisted living care facility is no longer enough to meet a senior’s needs.

When a nursing home is the best choice

When evaluating a senior it’s important to look at the ADL list because it will touch on points when nursing home care could be required:
  • Cannot use telephone
  • Unable to shop without assistance or even shop at all
  • Needs meals prepared and served or cannot maintain an adequate diet
  • Cannot participate in housekeeping activities
  • Needs laundry done by others
  • Needs travel assistance or does not travel at all
  • Isn’t capable of dispensing own medication
  • Incapable of handling money or making day-to-day purchases

Of course some seniors might be able to do some tasks, but not all of them. If that is the case, then a home health care worker, employed to help with certain tasks, is a much more affordable option. However, if someone is having trouble with a majority, or all, of these tasks, then moving to a nursing home is often considered the safest choice if no one can provide 24/7 care.   And make sure that when choosing a nursing home, you choose one that is caring and careful about security. You may want to make sure they have security systems for home security from a reputable provider like ADT to help keep your loved one safe and comfortable.

Potential costs and ways to get help

According research condcuted by MetLife, “The average national cost for care in a nursing home is more than $77,745 a year for a private room and more than $68,985 for a semi-private room, although the actual cost can vary depending upon the area in which you live and the level of care required.”

"The average national cost for care in a nursing home is more than $77,745 a year for a private room and more than $68,985 for a semi-private room." – MetLife

Medicare coverage is extremely limited, however in some instances it will pay for a fixed period of care in a Medicare-certified nursing home. According to its web site, “Medicare uses a period of time called a benefit period to keep track of how many days of SNF (skilled nursing facility) benefits you use, and how many are still available. A benefit period begins on the day you start using hospital or SNF benefits... You can get up to 100 days of SNF coverage in a benefit period. Once you use those 100 days, your current benefit period must end before you can renew your SNF benefits.”

Medicaid will pay for nursing home care, but again, it must be a Medicaid-certified facility. In addition, they only pay after what they consider to be countable property is depleted (such as cash over $2,000, stocks, bonds, IRA's, etc.). It’s important to note that exempt items (a home, a car, household goods, business property/real estate, term life insurance, or mortuary trust and burial plot (up to $1,500) are allowed to receive Medicaid benefits.

For individuals who plan ahead, the AARP suggests long-term care insurance be purchased in middle age when rates are lower. However, they state, “An individual who's 65 years old and in good health can expect to pay between $2,000 and $3,000 a year for a policy that covers nursing home care and home care, with premiums adjusted for inflation.” They add as long as a policy purchase doesn’t affect the current standard of living, it’s worth considering. In addition, they warn that there are two basic policies – nursing home care or only home care – so be sure you know what you’re buying.

In the end, two facts are certain – nursing home care is expensive and it’s a decision that must be made carefully. When it comes time, families do have places to turn for help in making the final decision.

- Written By

Thomas Anderson

Geriatric Care Manager
Thomas Anderson has over 15 years of experience providing care and support to elderly individuals. He specializes in helping seniors manage their medical needs and navigate the healthcare system. Thomas keenly understands how to help aging adults stay as independent as possible while ensuring they have access to the best available resources.