For many families, assisted living feels like a very expensive elephant in the room. No one wants to think about it and dreads what will happen when the time comes. And yet, assisted living care is a multi-billion dollar branch of the American healthcare system that provides vital care, community, and support for over 800,000 elderly Americans.
The Pros and Cons of Assisted Living
According to Consumer Affairs, 7 out of 10 elderly Americans will require assisted care in their lifetime. Assisted living facilities provide many seniors with a vital bridge between fully independent living and 24/7 nursing home care. With private lodging, built-in community, amenities, and medical care on call, assisted living facilities can provide essential relief and support for certain families.
It’s probably not surprising, however, that these services can be expensive. In 2022, American assisted living facilities cost an average of $4,300 per month. This expense can quickly deplete hard-earned retirement savings and place heavy financial strains on adult children. For many Americans, this option is simply not feasible.
Thankfully, a range of other options exists that serve a variety of needs, budgets, and family dynamics. This article will explore the pros and cons of six common assisted living alternatives to help you take the right steps for your loved ones.
- Medical alert systems
- Family caregiving
- In-home care
- Respite care
- Adult daycare
- Adult family care
Option 1: Medical Alert Systems
For aging parents able to live on their own, the most affordable and least intrusive option to help ensure their health and safety is a medical alert system. These services vary in cost depending on the features you require, but a very basic in-home medical alert system can cost as low as $25 per month — though more advanced features such as fall detection, 4G mobile coverage, and GPS location can add cost. Most buyers can expect to pay around $50 for a fully-loaded, reputable service, which will get your loved one a wearable monitor that automatically detects falls, calls emergency services with the push of a button, and offers 24/7 customer support—all from the comfort of their own home.
Certain services, such as Connected Caregiver, take this a step further, allowing you to supplement safety monitoring with remote health monitoring. This allows family caregivers to remotely monitor your loved one’s vitals, such as blood pressure, heart rate, blood sugar, and more without requiring an on-call nurse to take and record the measurements. The family caregiver can receive instant alerts if readings are too high or too low, or if any readings are missed. In addition, a digital health record is created that can easily be shared with the loved one’s doctors or others involved in caregiving.
Pros:
- Low monthly cost
- Minimal disruption to daily life
- Allows your loved one to remain in their home
Cons:
- Limited in-person supervision
- Must be healthy enough to live independently
- Potential stigma associated with wearing the device
Option 2: Family Caregiving
When an aging parent or loved one requires additional care, many families look for options to keep that responsibility within the family. This includes a range of scenarios from basic logistical support to significant changes in living arrangements.
Logistical support includes activities like cooking, cleaning, bathing, administering medications, and supervising medical care (including medical alert systems and remote health monitoring). Or your scenario may require shifts in lifestyle such as spending several nights a week in your loved one’s home or inviting them to move into your own home.
Family caregiving provides aging parents and their adult children with more time together and can often be preferable to assisted living care. While it’s less expensive than assisted living care, family caregiving can still be costly. According to AARP, the average family caregiver spends $6,954 in out-of-pocket expenses per year. Additionally, there can be real challenges as caregivers experience disruptions to their regular routines, work schedules, and pre-existing family responsibilities. Regardless, family caregiving can be worth the cost for the extra time it affords you with your loved one—for as long as you can provide the appropriate level of care.
Pros:
- Keeps care responsibilities within the family
- Can provide significant quality time with loved ones
- Allows for aging in a familiar place
Cons:
- Annual expense for caregiver (and the opportunity cost of working less to provide care)
- Can be disruptive to work, routines, responsibilities, and family dynamics
- Limited capacity to provide expert care
Option 3: In-Home Care
For older parents who wish to age in place, in-home care offers professional medical care and services in the comfort of your loved one’s own home. For an average cost of $25 per hour, your loved one can receive regular visits from a nurse to check vitals, administer medications, and even provide non-medical care such as chores, cooking, running errands, and more.
While considerably less costly than assisted living, in-home care can still be expensive at around $2,000–2,500 per month. This form of help is typically only available during daytime hours, which leaves your loved one alone overnight. While you can mitigate this risk with safety monitoring services, in-home care requires that your loved one can safely manage on their own for a portion of each day.
Pros:
- Professional care at home
- Help with household needs
- More cost effective than 24-hour care/assisted living
Cons:
- Still expensive
- No overnight support
Option 4: Respite Care
Respite care is a service designed to address a major gap in family caregiving and in-home care: caregiver burnout. It doesn’t matter if you are an adult child of an elderly parent or a professional in-home health specialist, caregiving is hard but rewarding work that can impact your physical and emotional health. Everyone needs time to rest.
Respite care provides short-term relief to caregivers so that they can focus on their own health and responsibilities. This service can range from a few hours to a few weeks. It is offered in the home or even through short-term accommodations in an assisted care facility.
Pros:
- Allows loved ones to remain at home
- Provides vital rest to caregivers
Cons:
- Short-term solution
- May require temporary relocation to an unfamiliar facility
Option 5: Adult Day Care
Adult day care is an increasingly popular option that combines the social and caregiving benefits of assisted living with the comfort of spending evenings in the family home. As the name implies, these facilities allow your loved one to spend their days in a caregiving facility. There are now more than 7,500 adult day care facilities in the United States, and the service costs an average of $70 per day, depending on your location.
While that can’t be considered low-cost for most families, adult day care provides elderly parents with vital care and companionship while allowing caregivers to maintain their regular duties, such as a jobs, chores, or parental responsibilities.
Pros:
- Professional caregiving in a safe setting
- Provides social connection and activities
- Helps family caregivers maintain routines
Cons:
- Costs an average of $1,500 per month for Monday–Friday care
- Can create logistical issues with drop-off and pickup
Option 6: Adult Family Care
Also known as adult foster care, adult family care is a service in which elderly residents live in a group home with 5 to 10 other residents. Loved ones receive professional medical and social care similar to what’s provided in assisted living, but in a more intimate environment. This is ideal when it is no longer possible to age in place or in a family caregiver’s home.
Adult family care offers unique benefits. Due to its smaller scale, it offers up to 50% in savings over fully assisted living. Adult family care can also provide specialization in a specific medical condition, preferred language, or even religious affiliation.
Pros:
- Professional 24-hour care
- Intimate, home-like environment
- Specialized care
Cons:
- Fewer amenities and services than assisted living
- Less affordable than other options
- Fewer location options than assisted living
If you are looking for a caregiving solution for an aging parent or loved one, you have many options available. Assisted living is a valuable and even life-changing service for certain elderly Americans, but it’s not always the best option. If you have questions about which caregiving solution is right for your loved one, we recommend you speak with their doctor, a social worker at your local hospital, or an aging life care expert. These professionals will help you consider the level of care required, budget, and even availability of Medicare programs to offset the cost.