In-Home Dementia Care Costs And Financial Considerations 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.

Managing long-term care finances can be stressful

An online therapist can provide 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.

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. 

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.

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?

Another potentially unconsidered cost of in-home care could be renovating the home to make it safer for a dementia patient to reside there. 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 memory 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. 

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.

Managing long-term care finances can be stressful

An online therapist can provide support

Finding additional support for caring for a dementia 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. 

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.