For an aging person, the move to a skilled nursing facility is a costly one. Nationwide, the average annual cost of a semi-private room in a skilled nursing facility (nursing home) in 2011 was $78,110, according to the 2011 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs Survey. And the cost is clearly rising!
The majority of the cost of care in a skilled nursing facility is borne by taxpayers through Medicaid. At $78,110 annually, it doesn't take long for even the most financially prepared senior to go through their retirement savings and other assets to qualify for Medicaid.
But the financial burden is not the only "cost" felt by seniors who must move into skilled nursing facilities. Whether they are leaving the home where they raised their families, the community where they looked forward to spending their retirement years, or the assisted living center where they had hoped to live the rest of their lives with a degree of autonomy, the move to a nursing home costs them their freedom and independence.
Certainly, there will always be a place for skilled nursing facilities, because there will always be frail older adults who need the level of care only they can suitably offer. However, there may be just as many "would-be" nursing home residents who could successfully and happily age in place -- whatever place they choose -- at great savings to tax payers, if they had that option.
Fortunately, some agencies are funding (and states are instituting) programs to make it more possible for older adults to age in place at a significant savings of money and personal dignity.
In Georgia, for example, the recent passage of Senate Bill 178 increases the chances that residents of the state's licensed personal care homes will be able to live out their lives in a "homelike" setting by allowing larger homes to provide additional services, including administering medications, that residents often need as they grow older and more frail.
The cost savings of allowing residents to stay in personal care homes rather than moving them to skilled nursing care would be significant. According to the previously mentioned MetLife survey, the average monthly price of a private room in a licensed personal care home in Georgia is $2,818, compared to $6,500 for a semi-private room in a skilled nursing facility.
In Connecticut, Senate Bill 138, Special Act 12-6 established a task force to study how the state can encourage "aging in place." The task force's recommendations, which are generally low-cost ideas (that could improve the ability of Connecticut residents to age in place without needing a budget appropriation) focus on areas such as instituting or increasing tax deductions and tax credits for caregivers and long-term care insurance premiums, improving public transportation options and nutrition services (including aggregate dining and meal delivery) for seniors, engaging in long‐term strategies to meet the demand for direct-care workers and changing zoning regulations to allow for in-law apartments for caregivers in single-family housing.
In addition to state initiatives such as these, many individual communities are instituting their own "age-in-place" initiatives with grants from programs such as The Community Innovations for Aging in Place Initiative (CIAIP), which was authorized by Congress to assist communities in their efforts to enable older adults to sustain their independence and age in place in their own homes.
Some of the programs funded through CIAIP grants include:
• Boston Medical Center's Services to Help At-Risk Elders Age in Place (SHARE) - this is a program that helps older adult who were previously homeless to age in place by providing "comprehensive, individualized, ongoing case management" targeted to the specific needs of these individuals.
• The Rural Elder Assistance for Care and Health (REACH) Care Bank - a network of people and organizations coordinating multiple avenues of mutual support instituted by the City of Montpelier, Vt. REACH Care Bank is a new social enterprise that will foster health, wellness and resiliency for elders, caregivers, people of all abilities and vulnerable populations who need expanded services to build livable communities for elders of all income levels and facilitate aging-in-place by engaging the community at large in the exchange for services and time.
• SOWN: Growing Healthy Lives Together - this is a comprehensive healthy living program for older adults, predominately women, who are aging in place in their homes. The project is targeted to serve a West Philadelphia neighborhood that has a very high percentage of minority, poor older adults living alone, with chronic multiple health conditions.
• Older Adult Outreach and Engagement Project - a project of the Catholic Charities Diocese of Stockton (Calif.) and several other agencies designed to expand the current Older Adult Outreach and Engagement Program by adding new services and strengthening existing ones. The primary goal of the project is to provide a comprehensive, community-coordinated case management system that is responsive and addresses the diverse needs of older adults residing in rural areas, enabling more elderly residents to safely age in place, continue to live independently in their community while retaining the dignity and respect they have earned.
These are just a few of the recent initiatives that are currently being offered to help seniors age in place. But they are just a start! As more baby boomers reach the 65-year mark each day, the need for varied and affordable senior care options will increase. There is no doubt that baby boomers will not be satisfied with the traditional nursing home environment and our society is certainly not able bear the cost.
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