NEW YORK (MainStreet) — A new report shows that the cost of long-term care continues to rise at a rate that outpaces inflation. During the past five years, the cost of a private room at a nursing home rose 4.19% annually, making the 2014 median annual cost for nursing home care $87,600. Prices are about double the median in places such as New York and Hawaii.

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Nursing homes rate hikes outpaced that of in-home aide care, which rose 1.32% annually during the same time period to $19.75 per hour, according to the Genworth Financial analysis.

But what do you get for your money, and do you need it all?

"Nursing home care is a 24/7 proposition that includes a room, meals, medical care, social work, activities, transportation, and more," says Larry Minnix, CEO of LeadingAge, an association of not-for-profit providers of aging services. "The total number seems daunting, and it is, but when broken down by the day or hour, costs are similar to what people pay just for sleeping accommodations in a fine hotel."

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However, that number for in-home care is essentially cut in half if two elderly people live in the home, and some people in the field argue many elderly adults don't need 24-hour care.

"[I]n a nursing home, patients are paying for around-the-clock support whether or not they need it," says Lesley Chang, a spokesperson for Nurse Next Door Home Care Services. She points out that paying for the hotel-like services is avoided when opting for homecare.

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"It's not apples to apples, but more like apples to tomatoes trying to provide an accurate comparison of in-home care and costs compared to care and cost of a nursing home," says Barbara McCann, chief industry officer at Interim HealthCare.

"Seniors who need assistance with activities of daily living – like bathing, dressing and cooking but not necessarily around the clock access to nursing care – can benefit from a home health aide which costs about $19 per hour or $29,600 annually for about four hours a day of care," says McCann.

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McCann further points out people "have that critical element of 100% access to a caregiver in the home, not waiting for a response to [a] pullcord – that makes all difference in a person's life and health."

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In addition, to being familiar and comfortable to the elderly, homecare has been shown at least in some cases to be more cost-effective than acute care services in terms of fewer hospitalizations.

As Mainstreet previously reported, nursing homes can be dangerous places for the elderly. Further, "[t]hey unfortunately cut corners in staffing, and it is important to remember that they usually only staff one C.N.A. to every 12 to 14 residents, so not only is an individual paying more in a nursing home, they are sharing the C.N.A. with 10-plus other people," says Julie Northcutt, who heads up Caregiverlist.

However, it should be pointed out that nursing homes do provide medical care, and although private nurses can be brought into the house, they do cost more than home health aides.

Consumers can look up costs of care at Caregiverlist.

--Written for MainStreet by S.Z. Berg, author of The Other Side of the Window, a medical mystery about the failure of the medical community