​​What Seniors Need to Know about Elder Care

Did you know that by 2030, all of the baby boomers will be over the age of 65? As America’s population rapidly ages, it’s more important than ever to understand the options for elder care.

Elder care refers to the wide range of services that help older adults live as safely and independently as possible. Whether planning for your own future or caring for an aging parent, navigating the world of elder care can feel overwhelming.

Be sure to start learning about elder care before a health crisis strikes. Stay informed and take control of your options as you age.

Types of Elder Care

Choosing the correct type of elderly solution is crucial to ensuring your loved one receives the support and services they need as they age. Each type of elder care offers unique services tailored to varying health, independence, and daily living needs. We’ll examine a few of these options to help you make an informed decision.

Custodial vs. Skilled Care

• Custodial care: This includes assistance with activities of daily living (ADLs) like bathing, dressing, eating, and toileting. It also provides help with instrumental activities of daily living (IADLs, such as meal preparation, household chores, transportation services, and medication management. Custodial care is provided by caregivers who are not necessarily licensed medical professionals.
• Skilled care: This refers to medical services that must be performed by trained health professionals such as registered nurses or physical therapists. Examples include wound care, intravenous (IV) therapy, injections, catheter care, and vital signs or medical equipment monitoring. Skilled care is often necessary after a hospitalization or for chronic conditions.

In-Home Care Options

77% of adults 50 and older want to “age in place” or stay in their home long-term and receive care in the comfort of their own home for as long as possible. In-home elder care can take a few different forms:

• Home care: (Also known as personal care or companion care) Provides custodial care and assistance with ADLs and IADLs. Home care aides can also provide companionship and socialization. No medical training is required.
• Home health care: Involves skilled nursing or therapy services delivered at home, usually under a doctor’s order. Medicare may cover home health care if certain criteria are met. 

Some benefits of in-home care, or elder sitting, include one-on-one attention, a familiar environment, and maintaining existing routines and social connections. However, in-home care can be costly over time and may not be suitable for seniors who require 24/7 supervision or need a safe living environment.

Senior Living Communities

Moving to a senior living community that provides care and housing may be the next step when remaining at home is no longer feasible or desired. Some common options are:  

• Assisted Living Facilities (ALFs): Assisted living facilities (ALFs) offer services, including custodial care, meals, housekeeping, transportation, and recreational activities. Residents live in private apartments but benefit from 24-hour staff support, making ALF ideal for seniors who need daily assistance without requiring skilled nursing care.
• Memory Care Units: Memory care units specialize in providing care for seniors with Alzheimer’s, dementia, and other memory impairments. They offer round-the-clock supervision, security measures to prevent wandering, and activities designed to reduce agitation. Staff members receive specialized training in dementia care and communication strategies to better support residents.
• Skilled Nursing Facility (SNFs): A skilled nursing facility (SNF) provides round-the-clock nursing care and rehabilitation services for seniors with more complex medical needs. SNFs can be used for short-term stays after hospitalization or surgery or long-term care when constant medical attention is required.

Adult Day Care

Adult daycare centers provide a safe, supervised environment for older adults to socialize, participate in activities, and receive needed care and support during daytime hours. Some elder care centers focus more on social interaction, while others cater to seniors with greater medical or cognitive needs. 

Adult daycare can be a cost-effective form of respite for family caregivers who work or need a break from caregiving responsibilities. It also allows isolated seniors to connect with peers and stay engaged.

Signs Your Loved One May Need Elder Care

It’s not always easy to know when an aging parent or relative needs more help. Changes in abilities and health can happen gradually, and many older adults are reluctant to ask for assistance. Here are some common signs that additional care may be needed:

• Cognitive red flags: Signs of cognitive decline include frequently forgetting important dates, names, or events and confusion about time, place, or people. Difficulty following conversations, poor judgment, and impulsive actions—like leaving the stove on or wandering—are also concerning. Personality changes such as increased irritability or aggression may indicate early dementia. If these symptoms persist, consult a doctor to determine if they are normal age-related issues or signs of more serious conditions.
• Physical decline: Physical decline in seniors may be evident through an unsteady gait, frequent falls, or trouble rising from a seated position. Unexplained bruising, noticeable weight changes, and neglect of personal care or household chores are red flags. Managing medications and appointments may become challenging, indicating a need for help with daily tasks. Chronic conditions like arthritis or heart disease can further complicate these issues.
• Emotional and social changes: Emotional and social changes in seniors might include withdrawing from activities, expressing loneliness or sadness, and showing a lack of motivation for self-care. Mood swings, irritability, and increased alcohol use or medication misuse are also concerning. These signs can indicate social isolation or depression, highlighting the need for increased companionship and support.
• Caregiver stress: Caregiver stress can manifest as feeling overwhelmed, exhausted, or resentful, with neglect of personal health and increased tension with the loved one. Difficulty concentrating at work or daily life can also be a sign of burnout. Recognizing these signs is crucial for seeking elder support and managing caregiver responsibilities effectively.

Caregiving is rewarding but also incredibly demanding. It’s okay to admit when you need backup. Arranging for respite care or extra support can allow you to recharge and ultimately be a better caregiver.

Paying for Elder Care

Elder care costs can increase quickly, especially if your loved one requires full-time or specialized care. Here are some of the main ways to pay for long-term care:

• Medicare: Health Insurance programs like Medicare cover short-term skilled nursing care and rehabilitation following a qualifying hospital stay but do not cover custodial care or long-term nursing home stays. It may cover limited home health care if specific criteria are met.
• Medicaid: Medicaid covers nursing home care and some in-home care for low-income seniors who meet eligibility requirements. Medicaid pays for roughly 50% of all long-term care services in the U.S. Elder care benefits and eligibility and services vary by state, and seniors may need to “spend down” assets to qualify. However, not all providers accept Medicaid, which can limit care options.
• Veterans Benefits: VA Health Care offers long-term care services for eligible veterans. Qualifying veterans and surviving spouses may also receive additional monthly payments, such as Aid & Attendance (A&A) benefits and the Housebound allowance, to help cover care costs.
• Long-Term Care Insurance: Long-term care insurance policies can cover various care services. Premiums are determined by age, health, and benefit preferences and can be expensive if bought later in life. Policies often have elimination periods before coverage starts, and coverage limits or exclusions may apply.
• Out-of-Pocket Costs: Many families pay for elder care with personal savings, retirement accounts, or by selling assets. The average costs of long-term care (as of 2021):
  • $4,500/month for assisted living
  • $7,900/month for nursing home (semi-private room)
  • $27/hour for home health aide    

Planning ahead and researching all your options is crucial for making informed decisions about paying for long-term care.

Elder Care Planning Checklist

Don’t wait for a health crisis to start planning for elder care needs. Taking proactive steps now can help ensure your or your loved one’s wishes are honored and make transitions easier for everyone involved. 

• Start the Conversation Early: Discuss preferences for care settings and end-of-life treatment with loved ones early on. Consider cultural, religious, or personal values that influence care decisions and ensure all family members are aligned to prevent conflicts later on.
• Assess Care Needs and Research Options: Evaluate both current and future care needs, including activities of daily living (ADLs), medical care, and supervision. Tour local senior living facilities, interview home care agencies, and compare the costs of different care options with available funding sources.
• Get Legal Affairs in Order: Create or update essential legal documents such as a durable power of attorney for finances, advance health care directives (living will and health care proxy), and a will or trust. Organize these documents and share their locations, passwords, and contact information with trusted family members.
• Tackle Financial Planning: Consult with an elder law attorney or financial planner specializing in long-term care. Explore eligibility for government benefits and community resources, consider long-term care insurance if suitable, and plan for managing retirement accounts, Social Security benefits, and other assets.
• Make Home Modifications for Safety: Enhance home safety by installing grab bars, ramps, and other accessibility features. Remove tripping hazards, improve lighting, and add contrast striping on stairs. Consider incorporating technology such as medical alert systems or remote monitoring devices to ensure safety further.

Taking the First Step

Navigating the complexities of elderly care is rarely straightforward, but knowing your options for elderly solutions and planning can make a world of difference. Whether you’re just starting to think about your own future needs or actively caring for an aging loved one, remember that you’re not alone. Approximately 70% of people turning 65 can expect to use some form of long-term care. You’re already on the right track by educating yourself about elderly care solutions and seeking support from family, friends, and community resources. Keep lines of communication open, and don’t hesitate to reach out for help when needed.

You can visit the U.S. Administration on Aging’s Eldercare Locator and AARP’s Family Caregiving Guides for more information and resources on elder care planning. These resources provide valuable insights to assist with elder care decisions and planning.

No matter the challenges, a solid plan, and a strong support network can help you face the future more clearly and confidently.