Archive for October, 2009

Comparing Costs For In-Home Care, Nursing Homes, RCFE Assisted Living And Adult Day Care

Saturday, October 31st, 2009

Comparing Costs For In-Home Care, Nursing Homes, RCFE Assisted Living And Adult Day Care

There is an ever increasing demand for elder care. As the number of older American continues to grow, so does the need for services to assist those aging individuals. Research shows, that as baby boomers will reach the age of 65 years old in 2011. By, 2030 they will comprise roughly 20% of the population. Those that live to age 65 years old can expect to utilize some sort of assistance as they age. These services can range from in-home care, assisted living or a nursing home environment.

Adult Day Care, assisted living, finance, nursing home, in-home care

A 2008 long term care study done by Prudential insurance has some surprising information regarding the costs of care for services needed as we age. This is information is important to assist in making plans for the “golden years”.

The study shows that the average cost of a nursing home can exceed $70,000 a year for a semi private room. A break down of the daily charges is $194 per day.  A private room can exceed $79,000 a year or $217 a day. These costs will, of course depend on the area of the country you live in. Some areas will be more and some less. It was also noted that there has been a 7% increase in the cost of living in a nursing home over the past 2 years. Nursing home costs have had an increase of over 30% in the past 5 years.

Assisted living facilities have seen the greatest increase in costs over the past 2 years. The average for living in an assisted living facility rose to nearly $39,000 per year. This is an average daily charge of just over $100 per day.

There was an average of a 15% increase in rates for the assisted living facility that provide care for Alzheimer’s and dementia patients.

In -home care has had the smallest increase rate of all the service providers. The rate of in-home care has had an increase of 5% over the past two years and only 17% over the past 7 years.

The average cost for a certified nursing assistant providing in-home care is $21 per hour. The services provided by a certified nursing assistant are bathing, dressing and care provided under the supervision of a register nurse. These services are ordered by a physician and generally covered by insurance. These services are only provided intermittently and for a limited amount of time.

The 2008 Genworth Financial study of cost of care also covers the non skilled in home care. This is a growing segment of the in-home care services, as many individuals want to remain in their homes as long as possible.

The average cost for homemaker services is $18 an hour. The rate of these services has increased by 4% over the last year. A homemaker provides companionship, light housekeeping duties, assistance with cooking and running small errands.

In- home care also provides home health aides. These individuals are able to provide basic assistance with personal care, but are not permitted to perform and medical tasks.

The average rate of a home health aide is $19 an hour. This is an increase of 3% over the past year.

In-home care services surveyed provide training for care of Alzheimer’s dementia patient, and almost all surveyed do not charge an additional fee for their trained staff.

The Met Life Market survey of 2008 on adult day services states the average cost for adult day care services is $64 per day.  There has been an increase of 5% in these services in the past year. There is growing trend in the utilization of adult day care services, as it is a cost effective way maintain an aging loved one at home. More than half of the adult day care programs surveyed provide transportation back and forth to the program. If transportation is provided, the average cost one way was a little over $7.

As a community based service, adult day care provides care for those individuals that require some supervision or socialization during the day, but do not require round the clock care. Many adult day care services offer therapeutic support services, health services and recreational activities.

For many caregivers, adult day care services gives them an opportunity to continue to work or have time to get out and do important activities while their aging senior is cared for in a safe and secure environment.

Costs of elder care services will continue to rise. Surveys show that the trends will continue. The largest increases will be in the assisted living and nursing home areas of elder care services.

Over the past five years there has been an increase in assisted living rates by 41%. Nursing homes have had an increase in rates of over 30% in the past 5 years. More than half of all facilities surveyed expect to increase their rates over the next year. Only one in four providers of in-home services plan to increase their rates this year.

Becoming aware of the cost of elder care can assist you in preparing for the future. It is important to educate yourself in the different options available and how you may need to utilize those services in the future. Proper planning can prevent you from relying on family, friends or Medicaid to provide the services you need. If you want to be in control of your future and health care needs, it is important to be proactive and investigate avenues to pay for your future health care needs.


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Evaluating An RCFE Assisted Living Facility

Friday, October 30th, 2009

Evaluating An RCFE  Assisted Living Facility – A Check List
Amenities and Personal Care
RCFE Assisted living communities provide more personal care services than an independent living retirement community.
They offer a less-expensive, residential approach to delivering many of the same services available in skilled nursing, either by employing personal care staff or contracting with home health agencies and other outside

Amenities in assisted living typically include:
Three meals a day served in a common dining area
Housekeeping services
24-hour security
Exercise and wellness programs
Personal laundry services
Social and recreational activities
Personal care in assisted living typically includes:
Staff available to respond to both scheduled and unscheduled needs
Assistance with eating, bathing, dressing, toileting, and walking
Access to health and medical services, such as physical therapy and hospice
Emergency call systems for each resident’s apartment
Medication management
Care for residents with cognitive impairments
Consumer Checklist
Do the residents seem to be appropriate housemates for you or your loved one?
Are staff members appropriately dressed, personable, and outgoing?
Do the staff members treat each other in a
professional manner?
Are the staff members that you pass during your tour friendly to you?
Are visits with the resident welcome at any time?
Physical Features
Is the community well-designed for your needs?
Is the floor plan easy to follow?
Are doorways, hallways, and rooms accommodating to wheelchairs and walkers?
Are elevators available for those unable to use stairways?
Are handrails available to aid in walking?
Are cupboards and shelves easy to reach?
Are floors of a non-skid material and carpets firm to ease walking?
Does the community have good natural and artificial lighting?
Is the community clean, free of odors, and appropriately heated/cooled?
Does the community have sprinklers, smoke detectors, and clearly marked exits?
Does the community have a means of security if aresident wanders?
Needs Assessments, Residency Agreements, Costs and; Finances
Is a residency agreement available that discloses personal care and supportive services, all fees, as
well as move-in and move-out provisions?
What are the policies for refunds and transfers?
Is there a written plan of care for each resident?
How frequently is it reviewed and updated?
Does the community have a process for assessing a resident’s need for services, and are those needs
addressed periodically?
Does this periodic assessment process include the resident, his or her family, and community staff,
along with the resident’s physician?
Are there any government, private, or corporate programs available to help cover the cost of services
to the resident?
Are additional services available if the resident’s needs change?
Are there different costs for various levels or categories of personal care?
Do billing, payment, and credit policies seem fair and reasonable?
Are residents required to purchase renters’ insurance for personal property in their units?
Is there an appeals process for dissatisfied residents?
Medication and; Health Care
Does the community have specific policies regarding storage of medication, assistance with
medications, training and supervision of staff, and
record keeping?
Is self-administration of medication allowed?
Is there a staff person to coordinate home healthcare visits from a nurse, physical therapist,
occupational therapist, etc., if needed?
Does the community have a clearly stated procedure for responding to a resident’s medical
To what extent are ancillary services available, and how are these services provided? Ask if there is an
additional charge for any of these services.
Services and; Amenities
Can the community provide a list of personal care services available?
Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed? ADLs
include dressing, eating, mobility, hygiene and
grooming, bathing, and toileting.
Does the community provide housekeeping services in personal living spaces?
Can residents arrange for transportation on fairly short notice?
Are barber/beautician services offered on-site?
Consumer Checklist
Does the community provide scheduled transportation to doctors’ offices, the hairdresser, shopping,
and other activities desired by residents?
Individual Apartment Features
Are different sizes and types of apartments available?
Are apartments for single and double occupancy
Do residents have their own lockable doors?
Is a 24-hour emergency response system accessible from the apartment?
Are bathrooms private and designed to accommodate wheelchairs and walkers?
Are residents able to bring their own furnishings for their apartment? What may they bring? What is
Do all apartments have a telephone, cable or satellite TV, and internet access?
How is billing handled?
Is a kitchen area provided with a refrigerator, sink,
and cooking element?
May residents keep food in their apartments?
May residents smoke in their apartments? In public spaces?
May residents decorate their own apartments?
Social and; Recreational Activities
Is there evidence of organized activities, such as aposted daily schedule, events in progress, reading
materials, visitors, etc.?
Do residents participate in activities outside of the community in the neighboring community?
Does the community have its own pets?
Are residents’ pets allowed in the community? Who
is responsible for their care?
Do volunteers, including family members, come
into the community to help with or to conduct
Does the community create a sense of inclusion by encouraging residents to participate in activities?
Food Service
Do dining room menus vary from day to day and meal to meal?
Does the community provide three nutritionally balanced meals a day, seven days a week?
Are snacks available?
May a resident request special foods, and can the community accommodate special dietary needs?
Are common dining areas available?
May residents eat meals in their apartment or suite?
May meals be provided at a time a resident would like, or are there set times for meals?
Additional Questions
Does the community conduct criminal background checks on employees?
Does the community train staff on elder abuse and neglect? Is there a policy for reporting suspected
Does the community have a special wing or floor for residents with cognitive impairments such as
Alzheimer’s disease? If so, is it secured?
Does the community allow hospice to come in and care for residents?
Does the community accept long-term care insurance?
Does the community allow a loved one, such as a grandchild, to spend the night? Is there a charge?
Does the community participate in the Veterans’ Administration Aide and Attendance Program? Will
the community help complete the paperwork?
Does the community accept Medicaid?
What are the most common reasons why a resident may be asked to move out of the community?

Click her to download the PDF Guide to Choosing an RCFE  Assisted Living Community from ALFA

What is an RCFE?

Thursday, October 29th, 2009

What is an RCFE?

RCFE stands for Residential Care Facility for the Elderly.

An RCFE is sometimes called “assisted living” or “board and care” facilities, they are non-medical communities  that provide a level of care that includes assistance with activities of daily living.  They are often small homes that can have 2 to 6 bedrooms or more.  This creates a comfortable  intimate setting “at home”  environment for the resident.  The RCFE community can specialize in particular resident needs because of their small size. These RCFE communities  are concerned in the quality of life for their residents.

RCFE’s serve persons 60 and older, providing room, board, housekeeping, supervision and personal care assistance
with basic activities like personal hygiene, dressing, eating and walking.

These Communities usually store and distribute medications for residents to self-administer.

The care and supervision found in these communities are for people unable to live alone, but who do not
need 24-hour nursing care.
RCFE Caregivers

RCFE’s  and are NOT  required to have nurses, certified nursing assistants or doctors on staff, although some do have licensed medical professionals on staff.

A  RCFE caregiver can  provide  basic housekeeping,  laundry services, and can  assist as needed with the personal care  and activities of daily living like dressing, bathing, toileting, Incontinence, and feeding.

Care level charges may be determined after an assessment of the resident’s needs.

The RCFE community provides staff to  prepare nutritious meals, following dietary guidelines that are recommended  by the resident’s physician.

The RCFE Community often provide transportation to and from medical appointments, shopping and activities.

In California RCFE  caregiving staff  are required to pass medical and basic criminal background screenings, and be certified in  administering basic first aid.

Who licenses RCFEs?

Thursday, October 29th, 2009

Who licenses RCFEs?
The State of California Department of Social Services licenses and inspects RCFEs to
ensure they meet care and safety standards.

What types of City Permits are required for an RCFE?
The City’s ability to regulate and restrict RCFEs is limited and pre-empted by state and
federal law. These laws specifically prohibit a city from exercising zoning authority that
treats RCFEs with six or fewer persons any differently than typical single family homes.
“No conditional use permit, zoning variance or other zoning clearance shall be required
of a residential care facility for the elderly which serves six or fewer persons which is not
required of a family dwelling of the same type in the same zone,” Health and Safety
Code section 1569.85. In other words, the City Planning Division cannot require special
permits for RCFEs with six or fewer residents.

The City does review RCFEs for safety issues through a fire permit process. This permit
ensures that proper access and fire safety concerns are met. The State of California
requires City fire department review and approval for any plans for an RCFE.

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Grandma’s on Facebook

Tuesday, October 20th, 2009

Grandma on Facebook

Grandma’s on Facebook: New UAB Study Examines Benefit of Internet Access, Social Media Networking on Seniors’ Health
BIRMINGHAM, Ala. – Many elderly adults are increasingly isolated and grapple with depression, loneliness and declines in physical health. The UAB Department of Sociology and Social Work will use a five-year, $1.9 million National Institute on Aging (NIA) grant to study the ability of computer use and social media networking to enhance the quality of life of elderly adults through online social connections and easier access to health information.

In the study, UAB sociologist and principal investigator Shelia Cotten, Ph.D., will examine the extent to which access to the Internet and the use of social networking sites by seniors in assisted living facilities enhances their personal interactions and relationships.

“With increasing numbers of older adults living in long-term care facilities and declines in quality of life as people age, we need innovative ways to lessen these negative impacts and to enhance quality of life,” Cotten said.

UAB graduate students will train 300 senior adults at 15 Alabama assisted-living facilities to use the Internet, e-mail, Facebook and other social media networking sites. The residents also will learn about blogging, online groups and ways to evaluate online health information.

Cotten says a primary benefit of the study is that it will help decrease inequalities in access to health information due to age-related declines in mobility. An increasing amount of health information is available electronically, says Cotten. “Once older adults cross the digital divide, they can access health information much more easily using the Internet than they can go to the library or visit a health-care professional,” she said.

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