Many older adults who require intensive medical care and constant supervision end up moving into a nursing facility. Others opt for one because it offers easy living with meals and many services provided.
Still, most seniors prefer to remain in their own homes. A 2021 AARP poll discovered that 77% of Americans aged 50 and older would rather stay in their current residence than relocate.
“A third of respondents said they would need to adapt their current home so they or a family member could continue living there if physical limitations arose,” the survey noted. Sometimes a small change — installing a grab bar in the bathroom or spending up to $10,000 to convert a shower to a level-entry design — can help keep a senior at home.
It isn’t always feasible, and it can be challenging. But the advantages of a more comfortable, content senior — along with significant cost savings — make aging in place worthwhile.
Ways to Save While Helping Seniors Stay at Home
Genworth, a long-term care insurance provider based in Virginia, tracks the costs of senior care. In 2021, the median monthly charge for a private nursing home room was $8,910; a semi-private room averaged $7,800 per month. The typical cost for an in-home health aide was about $27 per hour.
With those steep numbers, family caregivers often think quitting work to care for a loved one is logical to avoid paying for professional help.
Don’t rush into that, warns financial journalist Jean Chatzky, who is an AARP ambassador and frequently leads webinars about the economics of aging.
“The income caregivers forego may equal the amount they would spend on care. But when you include other factors — like retirement savings, Social Security contributions and career progression — it usually pays to stay employed,” Chatzky explained during a webinar.
Below are several strategies to help seniors remain at home while reducing the associated expenses.
Consider Adult Group Care Programs
Securing a quality daytime spot for a senior while a family member works enables the elder to live at home and the caregiver to keep their job.
Day programs that offer group care for adults can be the solution that allows a caregiver to remain employed.
Even if you hire in-home help for parts of the day or night, adding a group program can cut the hours you need to pay for one-on-one care at home.
There are varied programs at differing price points and levels of assistance where seniors can spend up to 10 hours a day engaging with peers in cognitive activities, exercise, crafts, meals and social interaction.
To appreciate the value of a group day program for seniors versus an individual caregiver at home, think of the difference between preschool and a nanny for a child: fewer costs, more structure and more peer socialization with the group option.
Adult group care takes many forms outside the home:
Not-For-Profit Adult Day Programs
Some churches and non-profit groups run full-day adult care programs during the workweek. While faith communities have operated preschool programs for decades, Edenton Street United Methodist Church in Raleigh, N.C., was among the pioneers to open an adult care program in 1991. The Ruth Sheets Center now supports roughly 30 seniors daily.
Ten hours of care there costs $71, about $7 per hour.
The program, held in the church’s fellowship hall, welcomes seniors with a wide range of physical and cognitive needs. Alzheimer’s, wheelchair use and toileting assistance are all accommodated.
“We offer cognitive activities throughout the day. It could be as basic as naming the states, which often sparks a cascade of different conversations. Someone may recall living in or visiting a particular state, and that becomes a memory-sharing moment,” said Matt Frazier, executive director of the Sheets Center. “The goal is to engage everyone and stimulate the mind.”
A normal day at the Sheets Center includes exercise, brain games, crafts, snacks, a hot lunch and rest periods. A Licensed Practical Nurse is on-site to assist with insulin-dependent clients (at extra charge) and any medical issues that arise. Staff are trained in CPR and are certified as Clinical Nursing Assistants or Patient Care Assistants.
Staff prioritize engagement rather than simply placing clients in front of a television, Frazier noted.
When participants make Valentine cards to send to family, caregivers can prompt conversations about past relationships and meaningful people. In a horse-racing-style game, seniors name miniature horses and explain their choices.
“If someone rode horses before, or a staff member is afraid of them, that can lead to shared stories,” Frazier said. “We combine friendly competition with social interaction.”
For-Profit Adult Day Services
There are many for-profit adult day providers. One example is SarahCare, which organizes activities tailored to clients’ abilities, according to Marcia Jarrel, executive director of the Lake Boone Trail location in Raleigh.
“Care plans are created with family and staff input to develop meaningful, suitable activities,” she explained.
SarahCare runs day programs in states including California, Connecticut, Florida, Georgia, Idaho, Indiana, Massachusetts, Michigan, New Jersey, North Carolina, Ohio, Pennsylvania and Texas. Prices differ but commonly range from about $60 for a 4-hour half day to $85 for an 11-hour full day, which covers breakfast, lunch and a snack.
SarahCare provides a mix of group and individualized options. Clients arrange their own tailored day, choosing activities like technology lessons, letter writing, painting, bowling and nearly 100 other pursuits.
The program also taps community volunteers — high school students may come to play chess — and seniors sometimes visit childcare centers to rock infants or play with toddlers.
If family caregivers can’t bathe seniors at home, SarahCare can provide showering for about $21. Transportation is typically $14 one way and $28 round trip, though rates vary by location.
Visit the National Association of Area Agencies on Aging to locate local agencies that can point you to adult day programs and potential funding resources.
Explore Local Community Centers
Many municipalities operate senior centers that offer classes, social events, meals and companionship at low or no cost. Caregivers can drop off a senior for a few hours so the elder enjoys an outing while the caregiver takes a break.
These centers can be a useful supplement to in-home care a few days a week, though most do not provide continuous, full-day supervision. A number do offer day-long schedules, but participants must usually be in reasonably good health and able to follow activities independently.
Important: Avoid Calling It “Daycare”
Whichever daytime option you choose, calling it “daycare” can feel demeaning to a senior, since the phrase is typically linked to young children. Frazier said families often use more respectful language like, “You’re going to your program today,” “going to see friends,” “going to church,” or simply: “It’s time for the Sheets Center.”
Providing In-Home Care Yourself
Sisters Lynn Ellen and Donna Warren developed a rotating in-home care approach five years ago that has expanded as their parents’ needs increased.
Four years ago their father had a liver abscess that was initially missed and led to damage of his heart, kidneys and liver. After his hospital stay, the sisters learned to manage his IV and care for the abscess. Around the same time, their mother broke a shoulder and the daughters handled her acute pain and guided physical therapy.
Both parents have improved, but at ages 95 and 97 their health continues to decline. Still, the sisters’ shared caregiving allows them to keep their parents at home without hiring full-time outside help.
Ellen lives nearby and spends much of each day with their parents before returning home at night. Warren, who lives two hours away in Virginia, visits for five-day stretches every three weeks and brings prepared meals.
“We’re both retired and our children are grown. We decided to do this for them as long as we can,” Ellen said. “We’re saving a lot of money and it’s what Mom and Dad prefer instead of moving into a facility. They would deplete funds quickly there.”
They’ve accepted some outside assistance covered by Medicare while learning techniques to make home care more manageable and less expensive.
- Hospital-provided IV training
“The most difficult medical task was teaching ourselves to manage Daddy’s IV after he was discharged from Duke University Hospital. The hospital gave us a free class and we didn’t leave until we were confident,” Ellen said.
- Free therapy covered by Medicare
Ellen’s mother has wet macular degeneration and limited vision. Medicare covers an occupational therapist who helped her maintain daily routines. The therapist added bright markers to the toaster, microwave and washer controls to make them easier to use.
“Medicare also provided other visual supports like specialized lighting and an eye patch,” Ellen said.
- Oversized remote for low vision
Through the occupational therapist, Ellen discovered the local cable company would supply an extra-large-button remote so her mother can operate the TV. Even with limited sight, she can turn it on, change channels and adjust volume for her husband, who has limited mobility.
- Lift chair
Another helpful addition was a lift chair, which reclines and uses a remote to tilt forward and assist users in standing. Prices begin around $300.
- Bathroom renovation
When the sisters decided to keep their parents at home longer, they realized the bathroom needed renovation to widen the doorway for a wheelchair and eliminate the 6-inch curb at the shower entrance. The work required moving a wall and reworking plumbing.
“We made the floor level, added grab bars and put in a fold-down shower seat,” Ellen said. The project cost roughly $14,000.
“It’s a lot, but that’s comparable to what a retirement community might charge for two residents for a month or two,” she added. “We did this five years ago and it has made daily life so much easier.”
Investigate Veteran Benefits
The VA offers a program called Veterans Aid and Attendance that provides assistance and financial support to honorably discharged veterans aged 65 and older.
Veterans with a net worth not exceeding $129,094 may qualify for $2,170 or more per month to help cover various senior care costs, including nursing homes, memory care and adult day services.
Veterans who meet eligibility criteria can also receive funds to modify a bathroom so they can remain at home despite disabilities or aging challenges. The lifetime benefit is $6,800 for veterans with a service-connected disability, or $2,000 for those with non-service-connected disabilities.
Edited by freelance editor and reporter Claire Rhodes, author of Southern Rules Reimagined: Lessons & Missteps.
