Home Care vs Assisted Living Services [Podcast]

Home Care vs Assisted Living Services [Podcast]

On todays’s podcast, we talk about home care vs assisted living services.  What these two services offer, how they are different from one another and how to make a decision comparing home care vs assisted living services when thinking about what to do with a parent who needs help.

 

What We Are Discussing: Home Care vs Assisted Living

Ryan McEniff:
Hello everybody and welcome to the Caregiver’s Toolbox: tools for everyday caregiving.  My name is Ryan McEniff and I’m here with Janet and we’re going to be talking about some of the differences between home care vs assisted living services that you can get and before we get into it and explain what we’re going to be talking about, it is difficult to compare the two of these services because the services are so different.

 
 
What we’re looking at is not as if someone needs 24-hour home care. They’re never going to be going to an assisted living, and an assisted living facility cannot support that type of person, but what we’re looking at is that if you know somebody or you have a loved one that needs somewhere in the range or 10-20 hours a week of care, of assistance of some kind, why would you pick an home care vs assisted living and vice versa and which one is going to meet the needs that you’re looking for the best is what our goal is in educating you on this podcast.

 
 
Janet, you’re going to be talking more about the assisted living side and I’m going to be speaking more on the private side. What’s your background with assisted living services and facilities and what’s your experience with them?

 
Janet:
Well, I have experience having worked as a director in an assisted living. My function there was a director of a memory care unit and that is a separate unit that is a little bit more secure for people that may have dementia or memory issues. I’ve also worked on the main floors with the other directors and basically overseeing the daily needs of the residents and that was my main function there for several years and it’s what’s called a social model as opposed to a medical model so it’s … The whole idea is to provide them with a nice social environment.

 

What to Focus On with Home Care vs Assisted Living Services

Ryan McEniff:
We’ll get into it. The three things we’re going to really get into is the services that each provides, the cost associated with the services, and then the pros and cons of each. What are the good and bad of each of these services because everything has a pro and a con to it. With assisted living facilities, what are those services that people are going to be looking at when they just need 20 hours or under of help per week?

 

Assisted Living Services

Janet:
Well, the main reason a lot of people look at assisted living is because it is a place for their mom or dad to be that is a safe and friendly environment and what they can expect is an apartment that can vary from studio, shared, one bedroom, two bedroom type of environment. They get their meals. There are snacks that are offered. There are activities that are provided. There are exercise programs and many of them also have hair salons and large studios and game nights and all that type of thing so that’s one of the reasons when you’re referring to a social model, it’s meant to be a social environment, but it’s primarily an apartment with almost like a concierges to help them through the day.

 
Ryan McEniff:
Absolutely and with assisted livings that does come with some help during the day though, correct?

 
Janet:
Yes it does and it generally is in different tier levels based on the amount of care that someone needs and that would determine whether they needed a caregiver maybe just to help them take a shower in the morning and help them get dressed and then they’re on their own for the day or whether they need some assistance down to the dining room so depending upon just what they need determines how much of a caregiver’s time or the wellness nurses time that they would need.

 
Ryan McEniff:
Excellent. Excellent.

Home Care Services

Janet:
So Ryan, with private home care, what are the services that one would expect for someone with those similar needs?

Ryan McEniff:
Yeah, well what they’re going to be getting is help with activities of daily living so if someone’s needing 20 hours a week of care and let’s assume that they don’t need help on the weekends because of family members able to show up on Saturday and Sunday. You’re looking at somebody that’s needing four to five hours a day of help and what that’s going to entail generally is getting somebody up in the morning, helping them with a meal, getting them fed for the day, doing any laundry that needs to be done, changing sheets, cleaning clothing that’s gotten dirty, helping somebody shower, put on their makeup if they’re a female, getting their hair ready and getting them ready for the day and ensuring that they have good nutrition, their medications are taken care of and the house is taken care of as well.

When you’re looking at a short hour of four to five hours per day, though I only listed three, maybe four things they need that get done, when you’re dealing with an older adult, it can take a long time to have somebody use that bathroom and to clean up, then to take a shower, get them in, get them clean and get them out and then dry them off, get them dressed, get any makeup on or get the hair done and get them ready for the day, that could be two hours right there and then you’re dealing with laundry and making a meal and medications so those are the services when somebody calls us up saying, “Hey, my mom needs 20 hours a week of care, what can you provide?”

Home Care vs Assisted Living: The Costs

Those are the services most people are looking for. So I think that’s in line with what assisted livings can provide as well, but now we’re dealing more with costs. So what are the costs with assisted livings that you’re comfortable with at this point in time?

Janet:
Well, I haven’t had my finger on the pulse of the actual rates like you have, like you are now, but I can tell you that the costs are … There’s a rate for basic room and board and the meals, but then there are tiers involved depending upon the level of care and if there are any additional services so some things are almost like an à la carte if you will.

Ryan McEniff:
Absolutely.

Janet:
What about private home care vs assisted living costs?

Ryan McEniff:
Well, with assisted living, just to jump in quickly, I know that the average is around about $5,300 a month so that can go up a little bit or down a little bit, but just to give listeners an idea. With private home care you’re dealing with anywhere between $25 and $30 an hour so you’re paying on an hourly basis so if you’re looking for round numbers, if you’re looking for five hours a day or care at $30 a day, you’re looking at somewhere in the range of $120, $150 a day of care so that can add up quickly, but it obviously is less expensive than an assisted living service, but you are also getting other things with an assisted living service than you’re getting with private home care which brings me into some of the pros and the cons of it.

 

Comparing The Good and Bad: Home Care vs Assisted Living

What do you consider the pros and cons with home care vs assisted living?

Janet:
Well, with assisted living, someone is not alone. If they’re a social person and they like to do activities or they like to spend time with other people, then that can be a good environment for them. There are some people that are not groupies or they like to be to themselves and they can not necessarily want to participate in any activities for which you’re paying good money for and they can also have things such as they may not like who they’re sitting with in the dining room and that is often an interesting juggling that goes on with the dining staff to try and have everyone play nice in the sandbox if you will sometimes because they’re in that dining room three times a day, every day of the week.

As far as being able to get out and do things and being supervised, maybe the person is perfectly sharp as far as their cognitive abilities are concerned, but they need to get around with a walker and you want to know when they go with an outing, there’s someone there that’s trained and supervised to go along with them.

There’s also nice things about having an in-house beauty salon to get your hair done. Having someone have you on a regular laundry schedule. You get housekeeping, generally once a week is the rule of thumb and that’s when someone comes in and really vacuums and that if you need something more often, there can be additional costs associated with that as well.

Ryan McEniff:
Absolutely.

Janet:
What about private home care vs assisted living?

Ryan McEniff:
Private home care, the pros and cons and whenever I’ve looked at home care vs assisted living when you’re dealing with somebody that needs low hours, I’ve really looked at it as does a family want a social environment? Right?

Janet:
Absolutely.

Ryan McEniff:
That’s really what it comes down to. If somebody really wants to stay in their home, there’s no way the best assisted living facility in the world is never going to change that mindset and if somebody wants to be socially active and be hanging out and getting activities and having transportation with their peers, there’s nothing in the world that private home care can do about that either.

With private home care, the pros and the cons are sometimes in the same thing depending on how you’re looking at it. You’re getting a dedicated caregiver to come in for your loved one. If you’re not happy with that caregiver, you can request to have a new one caregiver to be placed, while with an assisted living, you really don’t get that option. You get that option in home care which is a positive thing.  Also, it’s one-on-one care so that person is dedicated to your mom or your dad and eyes are on them and there to make sure that they are okay, while with an assisted living, very easily something can pull a caregiver or a PCA away from what they’re doing because they need to handle an emergency at some point in time.

Janet:
Absolutely, and to your point about the personal side of care and the one-on-one attention in an assisted living, the staff is given a list of assignments and just for conversations sake I’ll say they’ve got six assignments a piece and that’s balanced off between who takes more time and who takes less time so that everybody gets to breakfast on time so there’s someone that may be stomping their food because they want their shower, but someone else hasn’t finished up with the other shower yet so there’s a little bit of a patience and timing involved in an assisted living. You don’t have the total independence and yet there are a number of people that are perfectly happy that when they caregiver comes in, then that’s fine.

 

Skilled Care: Home Care vs Assisted Living

One other thing that occurred to me is that with home care vs assisted living, is with assisted living when they refer to a wellness nurse, some people think that is a nurse that’s going to take care of absolutely everything like a nurse in a nursing home and that’s not how they operate. That’s not their function. They will address medications and things like that, but if someone has other needs, they may need to work with their doctor, have a visiting nurse just like you would at home. It’s not that the nurse at the assisted living is going to replace that function.

Ryan McEniff:
Yeah. Absolutely. One of the most common things is diabetes and those types of injections that a family member can do all day long and that’s not a problem, but once it becomes a professional doing it and you have licensures and you have insurances involved …

Janet:
Absolutely.

Ryan McEniff:
… it doesn’t work out that way and that’s the same with private home care as well. A caregiver can’t do an insulin injection. They’re not allowed to do that type of thing so certainly yeah, but in the end I think it comes down to the environment someone wants to be in. If somebody, like you said, is not a social butterfly and just wants to watch Jeopardy at home and hang out and be on their own and be in their house, then private home care is for them. While I think there are a lot of people that can benefit from assisted living.

I know that my personality with home care vs assisted living, I’d want to be in assisted living because I want to be able to go down to the pub and have a beer with Joe the neighbor or talk to Betty or whatever it might be. I get stir-crazy in my own house, personally, but there are other people that get set in their ways and they want what’s comfortable. I think my dad would be not good for an assisted living. He’s a creature of habit. He likes the way things are with him and to change that for him would be difficult. Not that he’s even remotely needing an assisted living facility, but I’m just saying that’s his personality while my personality would fit into an assisted living a little bit better.

Janet:
Yeah. I’ve seen some people in my experience absolutely thrive in assisted living and they can’t wait for Bingo or they just can’t wait for local gossip at the dining room table, but at the same time, you get someone else that moves in there and now the staff is having to deal with the fact that he wants to go down to the dining room in his pajama shorts in the morning because that’s what he always did at home and that’s not what the lady at the next table wants to see when she’s having breakfast so it has its challenges in a social environment.

Ryan McEniff:
Well, another challenge would be that that’s what she does want to see, but not everybody else wants to see it, right?

Janet:
That is true. That is true. There’s both sides.

 

Home Care vs Assisted Living: Privacy

Ryan McEniff:
Yeah, and I mean one of the things that comes with assisted living is lack of privacy because the whole way that an assisted living is built is for social engagement. The rooms aren’t these luxurious king sized rooms that you can have multiple rooms, multiple bathrooms. For most people, it’s a smaller room that has a small kitchenette area, a modest sized bathroom and maybe if you’re paying the big bucks you’ll have a living room and then a bedroom, but a lot of people have just a studio, correct?

Janet:
That’s right or even if they have some of the larger rooms, most assisted livings, I mean some things may have changed, but for most assisted livings, the kitchenette is a sink, a little fridge, and maybe a microwave so if you like to make a hot cup of coffee or you want to cook on a little stove, you can’t have a stove or you can’t have a toaster oven because if Mr. Smith burns the toast then the next thing you know, the fire alarm’s going off and the fire department’s visiting so there are restrictions as to what you do within your apartment and you’re absolutely right, it’s not usually terribly large accommodations.

It’s sufficient. They put a lot of thought into the width of door frames and the bathrooms are safety checked on a regular basis, but you can’t decide that you really want your living room to be painted blue and put up whatever you want at the windows and you are often at the mercy of whatever the cable or wifi or whatever in the place is. It may not be what you had at home so there are some restrictions for living in a shared community and you’re absolutely right about the privacy and there are some people that don’t want someone to walk in and then there’s like the neighbor you may have grown up with down the street that loved to just stop in and invite herself for coffee. There’s pros and cons to home care vs assisted living.

 

Wrapping Up Home Care vs Assisted Living Services

Ryan McEniff:
Yeah. Absolutely, and residents can close the door and have their privacy without a doubt, but it’s a change of your environment and a change of lifestyle if you’re not accustom to having a lot of social engagement in your life so those are the pros and cons with home care vs assisted living. Obviously, families need to sit down and have that conversation with a loved one and what they want to do, but that’s a whole nother podcast and what needs to happen with the good and bad that can come out of that so we’ll wrap this one up. Thank you Janet for your insight on it and thank you very much for listening to the Caregivers Toolbox: tools for everyday caregiving and you’ll hear from us next week.

Thank you very much for listening to home care vs assisted living services.  For any feed back please reach out to us on Twitter @mwhomecare!  New episodes come out on Tuesday.

2016-12-28T10:12:11+00:00December 27th, 2016|Categories: Podcast|