Health Care Options for the Aging

Nursing homes probably won't be your first choice; here are some other things to consider.
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There's a good chance that at some point in your life you will need to investigate assisted living options, whether it's for yourself or a loved one.

Nursing homes, while inescapable in some situations, likely won't be your first choice of care. There are other options and, as the elderly ranks swell and more families are unable to care for their parents on their own, those options should grow. Here are the main ones to consider now:

Continuing Care Retirement Communities

CCRCs, also known as Life Care Communities, offer residences for all levels of need. So if your needs change as you age, you can shift to an assisted living area of the same community. There's usually a wide range in what they offer, from residences for fully independent seniors to facilities offering round-the-clock care.

But CCRCs don't come cheap. You will know ahead of time what each facility will cost so you can plan accordingly. The costs usually includes a one-time entrance fee, ranging anywhere from $20,000 to $400,000, in addition to monthly payments. You can check out the Commission on Accreditation of Rehabilitation Facilities'

Web site for a list of accredited facilities and the standards met to obtain accreditation.

Assisted Living Facilities

In assisted living facilities you can still be relatively independent, but the worry and stress of performing certain daily tasks can be mostly removed. These facilities have all kinds of names, such as residential care, adult living facilities, community-based retirement facilities and retirement residences to name a few.

The housing could be in a high rise or single story. They may have one- or two-bedroom units or double occupancy rooms. Naturally, the cost range will vary depending upon the amenities, the room size and the geographic location.

Typically, the services they give you include assistance with meals, medications, bathing, dressing, laundry, shopping and transportation. They are not intended for around-the-clock nursing. Instead, they cater to seniors who are more or less independent and just need occasional assistance with certain tasks. If your health deteriorates beyond the abilities of the facility, you will need to find care elsewhere.

For more information, visit the American Health Care Association and National Center for Assisted Living's

Web site. You can also check out the American Association of Homes and Services for the Aging's

Web site.

Home Health Care

Many of us would prefer to remain in our home or the home of a family member, rather than move into a new place with strangers. Home health care includes a wide array of services, including medical, nursing, social and therapeutic sessions. These are provided by a variety of businesses and organizations, including home health agencies, homemaker aide-agencies, staffing and private duty agencies, durable equipment and supply dealers, and hospice services.

The agencies usually make care available 24 hours a day, 7 days a week either individually or as a team. Some may charge by the hour or day depending on your needs. Some may give you mostly one-stop shopping -- offering a variety of different services, including assistance with meals, bathing, dressing and housekeeping. Some may be more specialized, offering just one or two of these services.

According to the Metlife Mature Market Institute, the national average hourly rate for home health care is $19, or $152 for eight hours of care. If you need a registered nurse, the cost will be higher.

Adult Senior Centers

There's probably no better way to reduce the cost of long-term care than by living with your family, but what happens if they work and you can't stay at home alone? Programs known as senior centers, adult day care centers or day services, which are often run by the local community, offer structured, comprehensive day programs.

They provide a variety of health, social and other support services at a reasonable cost. By spending the day at one of these centers, your family members can go to work and take care of their business, helping to at least partially reduce the burden on them.

According to the

National Adult Day Services Association, there are about 3,500 adult day centers in the United States. Average cost is approximately $56 a day.

The more research you can do upfront -- before you or your parents need the care -- the easier the transition will be if the issue arises.

Donna O'Rourke joined Weiss Ratings, now Ratings, Inc., in 1999, and is the senior analyst responsible for assigning financial safety ratings to health insurers and supporting other health care-related consumer products including Medicare supplement insurance, long-term care insurance and elder care information. She conducts industry analysis in these areas. She has more than 10 years experience in credit risk management and analyses. Previously she served as an assistant vice president at the Union Bank of Switzerland, where she analyzed hedge funds, insurance companies and structured products in support of the derivatives and foreign exchange businesses. She holds a bachelor of science in management from Binghamton University and a master's of science in health systems administration from the Rochester Institute of Technology.

While O'Rourke cannot provide investment advice or recommendations, she appreciates your feedback;

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