VOL. 128 | NO. 172 | Wednesday, September 4, 2013
By Michael Waddell
The cost of caring for family members and loved ones as they age can become overwhelming if not planned for properly.
Herbie Krisle, left, executive director of Page Robbins Adult Day Care Center in Collierville, checks on the center’s garden with clients. The center provides low-cost, adult day care alternatives for families.
(Daily News File/Lance Murphey)
Stellar Home Care and Page Robbins Adult Day Care Center are offering families less-expensive alternatives that allow them to keep their loved ones in their homes longer.
Home care costs in Tennessee range from $38,000 to nearly $40,000 based on 44 hours of care per week for a year, according to the 2013 Genworth Financial cost of care survey. And nearly 10 million adult children older than 50 care for an aging parent, according to 2011 MetLife estimates.
Assisted living facilities in the Mid-South cost an average of $140 per day (or $51,100 per year). Skilled nursing facilities can top $200 per day (or $73,000 per year), while in-home care can cost as much as $18 per hour.
“We want to help our clients stay in their homes for as long as they can versus having to move into a facility,” said Carter Kirk, president of Stellar Home Care, which provides personal assistance for activities for daily living (ADLs) for 320 clients in West Tennessee. “It’s much more cost-effective for us to come in compared to going into an assisted-living facility that could cost three times as much.”
Stellar assists with ADLs such as bathing, grooming, light housework and preparing hot meals.
“Statistics show that people are in better health mentally and physically if they can stay in the environment they are accustomed to,” Kirk said.
Stellar’s rate is a flat $14.75 per hour, with no hourly minimums, no set contractual obligation for clients, and no up charges for weekends or holidays. The company’s business is based on a TennCare reimbursement rate set at $14.75, and Kirk feels comfortable that Stellar can remain competitive at that mark.
“The Choices program through the Tennessee Medicare program TennCare allows clients to stay in their home longer, and we go to the home one to three times per week to help with ADLs for up to four or five hours per day,” said Kirk, who pointed out that Stellar provides non-skilled care and does not administer injections or help with feeding tubes.
Red Door Wealth Management handles long-term care planning for the elderly, helping its clients understand the cost of keeping their loved ones at home versus other alternatives.
“There’s a wide range of options today, and the sooner you can get out in front of planning for them the better,” said Fred Hiatt, Red Door chief operating officer. “At some point, one of caregiver spouses might have to quit work, and taking one income off the table can be a huge hit to their own financial planning and personal retirement.”
He suggests taking an inventory of the loved one’s assets, income and expenses, as well as being aware of the tax breaks and deductions that are available. For instance, if a family needs to install a wheelchair ramp to their home and a doctor recommends it, the expense is deductible.
“You should also designate one person in the house who will be responsible for hiring the professionals that will be involved, and that person also needs to be the bookkeeper,” said Hiatt, who is also a board member for the Page Robbins Adult Day Care Center in Collierville.
He also suggested considering long-term care insurance when planning for the future, as it lessens the burden on young adult children so they will not have to pay out of pocket.
“It pays for a period of five to eight years of care in specified facilities,” Hiatt said. “This type of insurance is usually wisely considered or purchased between 55 and 65 years of age.”
Adult day programs are designed to provide engagement primarily for individuals with memory impairment caused by Alzheimer’s disease, strokes, vascular dementia, Parkinson’s disease and many other disorders.
“We are doing something a little different by opting to also accept clients with little to no memory impairment who are frail and should not be staying at home alone because there could be risk of a fall and they could be stuck on the floor for eight hours before someone came back to the house,” said Herbie Krisle, Page Robbins executive director. “Or they might be at risk for severe depression and loneliness because they are fully cognitive but they can’t do much on their own because of their physical condition.”
The average cost for a day’s care at Page Robbins is $50 to $54 (or $13,000 per year).
“It’s our hope to postpone nursing home or long-term care placement,” Krisle said. “Most premature nursing home placement happens because the caregiver is exhausted, not because the individual with dementia truly needs to be placed in a residential facility. So if we can provide that caregiver with a break, then they generally can maintain their loved one in the home with our assistance often for 18 to 24 months.”
Adult-day programs are generally open 12 hours per day, 6 a.m. to 6 p.m., Monday through Friday, and most serve two meals and a snack.
“We provide some form of art, music, exercise and reminiscing every day in order to keep our participants as engaged and active as they could possibly be, both cognitively and physically,” Krisle said. “It’s important for them to stay engaged socially.”
Page Robbins currently has 63 clients, with an average of 40 to 45 attending each day.
“It means that 40 to 45 families are experiencing a respite where they are not required to have a full day’s care,” Krisle said.