By Alan D. Feller, Esq.
We spend so much time dissecting the differences between home care and nursing homes that the merits of assisted living are rarely discussed.
Assisted living facilities offer medication support, in-house physician availability, transportation to medical appointments and all-day nutrition in a hotel-like setting. Residents tend to be mobile, though many will use walkers.
Staff and resident relationships more closely resemble hotel and guest relations rather than medical personnel and patient connections. When loved ones living independently encounter increasing difficulties handling day-to-day responsibilities, then assisted living may be a preferable option.
The two factors that hover over a resident’s assisted living experience are health and cost. Assisted living facilities serve a population that is not quite well enough for independent living, but not unhealthy enough for nursing home care.
There can be an expectation that an assisted living facility is an intermediate step on a continuum leading to nursing home care. That is not necessarily true. Assisted living provides a quality of life with oversight that is sustainable. But decline is a fact of life, and if a resident’s health begins to fail, then assisted living will not be able to support that resident.
Cost is also a reason why many assisted living stays are cut short. With monthly rents between $5,000 and $10,000, assisted living requires significant outlays depending on the type of facility and type of care needed. Residents with ample retirement benefits and pensions may have enough monthly income to cover these costs. Others with sufficient savings and investments coupled with various income sources, including Social Security, dividends and annuities, may also be able to afford this type of care.
Medicaid can also be utilized to pay for assisted living with the Assisted Living Program (ALP) Level Three, which has similar financial eligibility requirements to Medicaid Home Care. ALP residents must pay up to $1,488 of their income to the assisted living facility with Medicaid picking up the rest. Finding facilities with Medicaid ALP beds can be a challenge. New York State has a web database at https://www.health.ny.gov/health_care/medicaid/program/longterm/alps.htm. There are other sites that can be searched as well.
Long-term care insurance will also cover assisted living costs. It is usually obtained many years before care is anticipated, but premiums can be expensive. The flexibility of this type of insurance, even with its complexity and bureaucratic red tape, is a positive, especially in the current environment where Medicaid is targeted for cuts.
Planning for assisted living is a good idea. While nursing home planning grabs more people’s attention, assisted living offers an enhanced quality of life to a loved one, takes some of the burden off of a family caregiver and provides a mix of socialization and medical support. Planning may include annuitizing a pool of resources to augment monthly income to cover assisted living rent. Selling the family home once independent living is no longer viable and using the proceeds to fund assisted living rental payments is also an option.
Keeping assisted living in mind when a loved one ages will benefit a family in many ways.
Alan D. Feller, Esq. is managing partner of Sloan & Feller Attorneys at Law, located at 625 Route 6 in Mahopac. He can be reached at firstname.lastname@example.org.