In-Home Dementia Care Costs For Family Members
Dementia generally refers to a class of neurocognitive conditions, the most common of which is Alzheimer’s disease, that typically result in symptoms like memory loss, cognitive impairment, and a reduced ability to function. In the later stages of dementia, patients may have difficulty living on their own without support. At this point, family members and loved ones may want to consider assisted living options. In-home care can be an appealing choice, as it is often helpful for patients to continue their daily living routine without too much disruption.
However, cost can be a significant consideration when assessing care options for a loved one. There is no set cost for in-home dementia care, just as there is no set cost for moving your loved one into a nursing home or memory care facility. Dementia patients frequently have different needs, and depending on your loved one’s unique situation and resources, in-home care could look very different. It can be helpful to better understand what may be required of in-home care in order to calculate the estimated costs. If long-term planning for your loved one is negatively impacting your mental health, consider speaking with a licensed therapist for support.
What does in-home care involve?
In-home care may be broken down into the following broad categories.
Personal care services
These activities likely come to mind for most people when they think about in-home care. Personal care usually encompasses the basic activities of day-to-day living, such as bathing, dressing, eating, exercising, and using the toilet.
Homemaker services
These services typically keep the dementia patient’s home safe and functional. They may include cleaning, housekeeping, yard care, home maintenance, and gardening, as well as food-related tasks like grocery shopping, cooking, and meal planning and preparation.
Companion services
These services can address a dementia patient’s social needs. Companion services normally involve transportation, whether that means driving a patient to a medical appointment or walking with them to the post office down the street. They can also involve recreational activities, like playing games or creating art, and coordinating visits from friends or family members.
Skilled care services
“Skilled care” often encompasses what many people think of as medical care, and it may not be necessary for every dementia patient. For example, if a patient requires regular physical therapy or medications that must be injected, skilled care may be a required component of in-home care.
Employing home health aides for dementia care
If family caregivers are unable or unwilling to provide all of the necessary care services, a home health aide may need to be employed. It can be important to check the credentials of any person hired to provide services to a loved one with dementia and to fully understand what they can and cannot do. Some home health aides may be licensed only to provide personal care or homemaker services, and additional support may be necessary if the patient has in-home medical needs.
Hidden costs of in-home care
When calculating the cost of in-home care, it can be tempting to directly compare the fees associated with nursing homes or memory care communities with those associated with a home health aide or family caregiver (who may not receive compensation at all). However, the cost of in-home care is typically much more complicated than a simple difference in fee rates.
Factoring caregiver salary into costs
If a family caregiver who is currently working for pay is planning to transition into providing full-time care without compensation, the salary they will no longer be earning should generally be factored into the cost analysis. Even if a prospective family caregiver is not currently working for pay (for example, a stay-at-home parent who is transitioning to providing care for an elderly relative after their children leave for college), their cost of living should be included in cost calculations.
Considering home ownership costs
The cost of the home itself may also need to be considered. If the patient owns their home, are they still in the process of paying off the mortgage? If so, those monthly payments need to be considered, along with home insurance and mortgage insurance (if applicable). If the patient doesn’t own the home, what will rental payments look like? What about home maintenance costs?
Renovating for safer living
Another potentially unconsidered cost of in-home care could be renovating the home to make it safer for a dementia patient to reside there.
Additional in-home dementia care costs
These changes may include the following:
- Additional lighting to ensure that all rooms and hallways have good visibility
- Wall straps and anchors to secure large furniture and prevent it from tipping
- Replacing old furniture with chairs with armrests, which a person can push down on to more easily stand up
- Installing a locked cabinet or safe to store potentially dangerous items, like medications, sharp objects, matches, alcohol, tools, vitamins, small appliances like blenders, and cleaning products
- Placing a latch or deadbolt at eye level on all exterior doors so the patient does not have to bend over to lock their door, and removing locks from all interior doors so the patient cannot lock themselves in anywhere
- Replacing a shower or tub with a walk-in version, or placing grab bars around the shower, tub, and toilet
- Installing safety features on certain appliances, such as stove knob covers, a safety lock on the washing machine and dryer, and auto-shutoff on heated objects
- Placing a motion sensor on the garage door
- Replacing stair railings with steadier, sturdier options
- Moving closet shelves to a more accessible height
- Placing textured stickers on slippery surfaces and bright tape on the stairs
Average assisted living and in-home dementia care costs
As mentioned, no two dementia patients may require the same level of care, and there can be more to in-home care costs than initially meets the eye. However, it can be helpful to have a ballpark range for the cost of memory care from a number of different providers.
2023 assisted living and health care cost survey
- In-home care from a family member: $5,720
- In-home care from a home health aide: $6,292
- Care from an assisted living facility: $5,350
- Living in a nursing home in a semi-personal room: $8,669
- Living in a nursing home in a personal room: $9,733
Financial assistance options for dementia and Alzheimer’s patients
These costs may seem prohibitive to many people. Financial assistance may be available from state-run programs or government health programs like Medicare or Medicaid. Eligibility requirements can vary, so be sure to check with your local government agency.
Finding additional health care support for a dementia and Alzheimer’s patient
The financial and emotional stressors associated with taking care of a loved one with dementia can be significant. It may be beneficial to speak to a mental health professional in these situations. However, if you are providing in-home care to a loved one, leaving them home alone so you can attend a therapy appointment may not be feasible. Online therapy can be a more accessible alternative in these situations.
Effectiveness of online therapy
Studies have found that online therapy can be just as effective as traditional in-person therapy in relieving various mental health symptoms, including those associated with caring for a loved one with dementia. One group of researchers examined a group of dementia caregivers who completed a course of online therapy and found that the therapeutic intervention usually helped to relieve symptoms of anxiety and depression. Online therapy could be a means for dementia caregivers to find additional support in navigating a potentially stressful situation.
Takeaway
Frequently asked questions (FAQs)
Below are some of the most frequently asked questions about in-home dementia care.
How much does it cost to care for someone with dementia?
Care expenses for someone with dementia can depend on various factors, including but not limited to the following:
- Whether the individual has disability insurance
- Whether retirement benefits could cover the cost of care
- Whether one needs skilled nursing care, in-home care services, adult day services, or long-term inpatient memory care in a facility
- Whether the individual will require home modifications
- Whether the individual will require transportation services
- Whether the person will received personalized support or basic care
- Whether the individual will need a semi-exclusive room or a exclusive room
The overall cost of care providers can also change, as professional caregivers would charge less than a nurse who provides personal care in a facility. When looking for options for your loved one’s dementia, consider the national median cost and whether there any financial resources in your area, such as financial assistance programs that may help cover caregiver costs.
Is it better to keep a dementia patient at home?
Whether you keep someone home or in an assisted living facility is up to the legal guardian or decision-maker for the person with dementia. You might also consider taking their previous wishes into account. Staying home can be helpful in some cases because it provides familiar surroundings in a difficult time. In addition, home safety modifications can be made to ensure the individual’s familiar environment is safe for them. However, in the case that you require durable medical equipment to care for someone, you might consider long-term care. If you have financial barriers, you might look into Medicaid coverage, Medicare, or talking to a financial advisor about government insurance programs and other ways to cover physical and mental health costs.
How long can someone with dementia live at home?
People can live at home with dementia for the rest of their lives if they are able to receive skilled nursing and caregiving at their personal property. Some support services offer in-home care, which can be helpful for individuals who want to stay home. In the final stages of dementia, medication management and medical equipment may be necessary. You may also consider hiring a hospice nurse to support you in end-of-life care. Caregivers and loved ones may also consider whether having their loved one die at home would be more or less traumatic for them.
What support is available for dementia carers?
Dementia caregivers may be able to receive financial assistance and support for lost pay in the time they provide assistance. The government offers some benefits for caregivers in some states, and family members acting as caregivers may meet the requirements to receive pay from the government for caring full-time for a loved one with dementia. Consider talking to financial planners for professional advice and looking into the laws in your state to understand what you might be able to claim.
When should someone with dementia go into a care home?
Going into a care home is a choice made by the people who care for the person with dementia, often taking into consideration their wants and needs, too. You might consider financial challenges and whether you can qualify for benefits that could cover their care, such as Social Security disability income (SSDI) or an attendance benefit. Supplemental security income may be helpful for families that struggle to afford elder care costs. Still, people often go to homes in the final stages of dementia, when they start to require stricter medication management and medical support. You can also consider personal health insurance to cover costs.
Do dementia patients need 24 hour care?
Dementia patients may eventually require 24-hour care when they are no longer able to care for themselves. Often, people with dementia will wander and become confused, so if they are left alone, they may hurt themselves or get lost. In these cases, people may consider putting their loved ones in an assisted-living facility where they can receive care 24/7.
How much money is spent on dementia?
The amount of money spent on caring for a dementia patient can depend on whether the family has personal health insurance plans, Veterans benefits, retirement funds, personal funds, or financial aid to pay for services. The cost can also depend on the service used. These health plans cover a significant portion of the cost, but they may be costly for the family. You can learn more about the average costs of certain care options on the Alzheimer’s Association website.
Do people with dementia need a caregiver?
People with dementia eventually require caregiving from those they have personal relationships with or caregivers, as dementia is a progressive disease. People will start to be unable to perform self-care, such as personal hygiene. In these cases, loved ones may consider getting caregiver training to provide their loved one the care they require. You can also consider long-term care in a home or at-home caregiving with a caregiver, which may be more financially accessible.
What is the average stay in a care home with dementia patients?
The average length of stay in a care home for dementia is two to three years. Dementia progresses in this time, and the individual will often receive end-of-life care at the facility. Family members may come to visit and offer love and support throughout this time.
Do dementia patients need special care?
Dementia patients may require special care, especially if they develop another illness while in care, such as pneumonia. Lung problems are common in patients with dementia, so end-of-life care is often recommended in the later stages of the disease.
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