Haims: Aging in place or assisted living? It’s a complex choice
The decision process of choosing between aging at home and moving to an assisted living facility is complex and emotional. I speak from both personal experience and acquired experience over almost a decade and a half. This is what I have learned — the decision is personal and unique for everyone.
My mother had Parkinson’s. She passed away in 2019 just before the COVID pandemic. At that time, her long-term care insurance paid about $6,500 a month for 24-hour home care, and she paid out of pocket about an additional $7,500 per month. Although this $14,000 a month is a lot of money, it only covered her personal care — it did not include living expenses nor the cost of running her home. That was all extra.
Her care did not start like that. Rather, it gradually evolved. When her need for in-home care began, she only needed a few days a week. Over about seven years, her needs evolved and ultimately became round-the-clock. As it did, at least once a year, she “asked” — which I use as a euphemism — that my brothers and I come to her home and discuss the issue “as a family.” These were tough visits.
Discussing her mortality and personal finances with her sons must have been hard for her. For me and my brothers, it was emotionally heavy, saddening, appreciated and evoked guilt and fear. Few adjectives can nearly convey the conflict of emotions. However, at the end of the day, we were all united in the planning process. This was a gift that she may not have fully known. I’m so thankful for it.
As we age, one of the most significant decisions many of us may face is whether to “age in place,” or relocate to an independent or an assisted living facility. All options involve financial implications and emotions that are very personal. Further, the choice may also depend on various factors like personal health, the availability of either family, spouse or friends, housing market trends, and social needs.
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Aging in place can be an appealing option for many seniors. Staying in one’s own home allows for independence and familiarity. However, this choice isn’t without its challenges, especially when it comes to caregiving.
For those who require assistance with daily activities such as bathing, dressing, transportation, meal preparation or medication management, hiring home health aides may become an option. The cost of in-home care can vary widely depending on the level of care needed.
Per the 2023 Genworth Cost of Care Survey, the median hourly cost for an in-home care provider is $42 an hour ($45-65 an hour in the Western Slope mountain towns) Thus, for the average person starting care at five hours a day at four days a week (20 hours), the cost may range from about $43,000 to $67,000 a year. While many home care companies offer monthly, prepaid and annual discounts, at rack rate, 24-hour care can be extremely expensive.
Referring back to the 2023 Genworth Cost of Care Survey, the median cost of an assisted living facility in Colorado is about $6,000 a month ($72,000/year), though this can vary depending on location, facility amenities and the level of care required. However, these costs can increase as one’s health deteriorates or if they require more personalized care, such as memory care for those with Alzheimer’s or other forms of dementia. For higher levels of care, including memory care units, the cost can climb well above $12,000 a month ($144,000/year).
Both are expensive. Deciding between aging at home and moving to a facility involves significant financial considerations. Aging at home may initially appear more cost-effective, particularly if the individual owns their home and requires only minimal in-home care. However, expenses can quickly escalate with the need for home modifications, part-time or full-time caregivers, medical equipment and ongoing health care services.
Conversely, independent living and assisted living facilities often come with a predictable monthly cost that includes housing, meals, social activities and on-site medical support, which can offer more financial clarity. Families must assess current and projected health care needs, long-term affordability, and available insurance or government support options before making a decision.
Emotionally, the choice is deeply personal and often complex. Many seniors have a strong attachment to their homes, where they’ve built memories and feel a sense of independence and identity. Leaving this behind can trigger feelings of loss or anxiety. On the other hand, assisted living facilities can offer a renewed sense of community, safety and relief from daily burdens, potentially improving overall quality of life and reducing isolation.
Together, families must navigate these emotional dynamics with empathy, considering both the aging loved one’s preferences and well-being. Open, ongoing conversations are key to ensuring that the final decision aligns with both the elder’s emotional needs and practical care requirements.
If this topic is germane, please read next week’s column, where I will share some suggestions and items that may need to be considered when making decisions about aging in place versus a facility.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and is available to answer questions. Connect with him at jhaims@visitingangels.com.
