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The term “senior living” usually conjures images of older adults leaving their homes to live in a skilled nursing facility, assisted living or memory care facility. In reality, most over 65 live in their own homes or with family.

There are many reasons for this:

  •           Greater independence
  •           Established relationships
  •           Avoid the cost of moving
  •           Familiar surroundings and routines
  •           Lower living expense

So, even though we expect to need more help as we age, most want to stay in our home or with family. Another term for this is “aging in place.”

However, before deciding to go this route, there are essential questions to ask.


Who Will Provide Care?

Most of the time, family members serve as caregivers. Two reasons for this are that family members feel obligated and it saves money. Nevertheless, this can be a stressful role that often falls to female caregivers who may already be juggling job and family responsibilities. Usually, these family caregivers are unpaid and untrained. This can result in unnecessary risks like injury from moving a limited-mobility person incorrectly.

Another option for aging in place is to hire healthcare professionals. Many businesses provide trained staff to deliver healthcare in the home.


What Care is Needed?

The overall goal of caregiving is to help older adults stay healthy, safe, and independent. This may involve the following types of care:

  •           Helping with everyday activities like toileting, getting dressed and bathing
  •           Preventing falls by helping a limited mobility adult move from place to place
  •           Helping with meals, laundry and appointments
  •           Overseeing an older adult with dementia-related afflictions


Sometimes the level of care needs to be more intense. In these cases, private nursing for more acute medical conditions is required. A licensed and certified caregiver may need to deliver these services:

  •           Giving medications
  •           Monitoring vitals like blood pressure
  •           Care of medical devices like catheters or feeding tubes
  •           Delivering therapy like physical, speech or occupational


In-Home Healthcare Costs

One might logically expect that in-home healthcare costs less than a senior living facility. However, if paid caregivers are required, the cost depends on the number of daily services and the hours needed to provide such assistance.

For example, the cost for assisted living in the U.S. averages around $4,300 per month. If a person needs help for only an hour or two per day at an average of $24/hour, then in-home healthcare could be affordable. However, if such assistance was required 24 hours per day, the monthly cost would exceed $17,000.

For more intensive services, on average, the monthly cost of a skilled nursing facility is $7,513 for a double-occupancy room and $8,517 for a single-occupancy room. Again, in-Home health care would be more affordable if 11 hours per day or fewer were required.


Covering the Costs

Paying for In-Home Healthcare can come from various sources.


Private Pay

The most common way people pay for in-home care is out of their own pockets. According to a report from BMC Health Services Research, over 60% of payments to in-home caregivers were private pay.



While Medicare will pay hospital, doctor and medication costs, most long-term healthcare is not covered. Medicare will cover personal care services only if they are delivered with prescribed medical services. Some Medicare Advantage policies cover types of personal care, but since each policy provider is different, it’s important to review and understand the details.



Medicaid will pay for in-home care for seniors who qualify on both financial and medical grounds. In some states, personal care is covered, but other states only cover care delivered by licensed professionals. Check your state’s Medicaid rules to understand what is covered.

Many state Medicaid programs offer “cash and counseling” options under which family caregivers can be paid. In-home services must be set up to meet the requirements of an authorized Medicaid care plan so the state will pay benefits.


Long-term Care Insurance

Long-term care insurance often covers in-home care. However, some policies, especially older ones, lack this type of coverage. Be sure to check the specific in-home care provisions for your policy.


Veterans Aid and Attendance Benefit

VA Aid and Attendance benefits may be available to fund in-home care. Qualifying veterans must meet eligibility requirements be receiving a VA pension. Some veterans may also require a doctor’s letter to confirm a disability to receive Aid and Attendance.


Reverse Mortgage Loans

Reverse mortgages allow homeowners to make use the equity of their homes to access non-taxable cash. Older adults can then access then access the funds for in-home healthcare without needing to sell their homes. Of course, there are many crucial considerations when taking out a reverse mortgage. Still, it can be an exceptional way to afford in-home healthcare.


About the Author

Peter Keers is a writer and video blogger focusing on topics for the over-55 audience. Defining himself as a curious seeker, Peter’s interests range across both the art and the science of living an authentic and fulfilling life in the 21st century. See Peter’s recent posts at He can be contacted at [email protected].