Nancy McBell was so busy taking care of her husband in the last year of his life that she struggled to keep up with routine chores like grocery shopping or cleaning. The couple, married more than 40 years, had always lived on a modest income that supported four children, but their budget rarely left anything extra. So Nancy assumed she couldn't afford nursing assistance for her husband. Like many seniors and their families, Nancy was so focused on meeting her daily challenges that she didn't seek out free or low-cost care options right in her own community.
Nancy's situation isn't uncommon, assures Jill Martinelli, Senior Care Advisor at Care.com. Families often miss out on rich resources in their own backyard because they either don't know about programs, or assume they won't qualify. Even finding free resources can be daunting, if you don't know where to look. But care options exist for every financial situation, no matter how complex.
Martinelli and her colleagues are most often asked to advise families in one of three situations:
- Families with limited or no financial resources for senior care
- Seniors with some financial resources, and potential access to care benefits such as long term care insurance and veterans benefits
- Families with ample financial and care resources who don't know what type of care they need
Senior Concern #1: Mom Has No Financial Resources for Senior Care
Nancy, 71, is independent in many ways but she and her children can forsee a need for more help as she grows older. Her own health is stable, but Nancy needs assistance with daily chores, especially housekeeping. She has very few financial resources, lives on Social Security and receives fuel assistance for her heating needs. She owns the family home, which is worth roughly $120,000.
Three of Nancy's children live nearby, while the other lives several states away. Together, the children would struggle to afford in-home care for Nancy. She is also resistant to the idea of someone coming into her home to help out with personal care or housekeeping.
- Consult a counseling program through the local Area Agency on Aging about free or subsidized services she might be qualified to receive. Programs include friendly visitor programs for companionship, transportation, errands and help around the house.
- Seek out free or low-cost religious-based senior services, to include regular visits, light chores or meal programs. Many religious organizations offer free senior care services such as visitor programs or adult day programs.
- Use a private caregiver for a few hours per week of light housekeeping, meal preparation or other basic tasks the family needs assistance with. Private caregivers are often less expensive than home care agencies because they don't have the overhead cost.
Senior Concern #2: Daily care and transportation are needed for an elderly couple
Will and Martha met and married shortly after World War II while he was a young soldier. After successful careers in public service, the couple retired to the country where they live in a beautiful rural setting. Recently, Will's health concerns led his doctor to recommend he stop driving. Martha always relied on Will to get them to the grocery store, take them to church and visit friends' homes. Now the couple, who have no children, relies on friends and some paid helpers to take them on errands and to regular doctors' appointments.
They have begun making preparations to sell their home in the near future, recognizing that living several miles from the center of town isn't ideal for their health or safety.
Both Will and Martha are in reasonable health and provide their own personal care. They're considering their options for assisted living, and want to take advantage of any programs that will extend their resources as long as possible.
- Continue to pay for in-home help and personal care when the need arises, possibly with Aid and Attendance Veteran's benefits, if qualified.
- Sell their home and move into an assisted living facility as private payers, then go through Medicaid spend-down once funds are depleted. The spend-down often requires the assistance of an elder law attorney.
Martinelli sees many people who are unaware that they qualify for veteran benefits for themselves or a surviving spouse. The Aid and Attendance Benefit can provide a monthly stipend and additional funds specifically to help pay for care for assistance with their activities of daily living. "Completing the paperwork can be challenging and it takes about nine months at this point for the benefit to kick in, but it is retroactive," says Martinelli.
Services like Veteran's Financial can help assist with the application process and determining if a senior is eligible to receive the benefit. Some nursing care facilities are specifically designed for veterans. The Veteran's Administration also offers benefits that can help pay for senior care.
Senior Concern #3: Mom wants to downsize her living space, but doesn't want to move more than once
After her husband passed away three years ago, Bridget, 80 was intent on staying in her home in the area where she grew up. Her three children are dispersed several states away. Bridget has strong ties to her community, but her home is starting to feel too large to live in and maintain. She is considering ways to downsize in a way that will also leave resources for future care needs. Moving to be near her children is one option, but she doesn't want to move multiple times. Plus, Bridget is comfortable and happy in the area she calls home.
In addition to a more manageable living space, Bridget is interested in staying very social. She and her daughter have investigated a variety of senior care communities to weigh various buy-in levels and spectrums of care options. Because of some inheritance, a quality long-term care insurance, and financial planning, Bridget has the resources needed to choose her home and care options based on what appeals most to her. She does worry that her finances need to hold out for the years ahead.
- Sell her home and move to a smaller house, Over 55 community or apartment with fewer maintenance demands.
- Invest in a Continuing Care Retirement Community (CCRC). These communities offer various levels of care so as care needs increase they can remain in the same community. Buying into these communities early can allow the person to socialize and really feel a part of the community rather than entering in when they are already dealing with challenges of not being able to care for themselves.
- Stay in her home until her care needs change, then consider moving into an Assisted Living community.
Planning for the cost of care is a crucial part of family discussions about senior care options. While finances can steer families on their journey to choose appropriate and sustainable care solutions, sometimes the picture is cloudy or less than ideal. With the help of services like Care.com and local Agencies on Aging, families can uncover hidden resources that exist specifically for their circumstances, no matter how unique.