Cost of Home Health Care vs. Other LTC Options

When it comes to long-term care, which type of care is cheaper? A common misperception among the media and the public is that receiving care at home is less expensive than receiving care at an assisted living facility or a nursing home. In reality, however, which type of care is the cheapest depends on the amount of care needed. When only a little care is needed, home care is the most cost effective, but if continuous care is needed, home care may actually be the most expensive option.

 As I reported in my December newsletter, the average cost of a private nursing home room in Northern Virginia is $91,615 a year, and the average cost of home health care in Northern Virginia is $19 per hour.1 For an Assisted Living Facility in Northern Virginia, the average base cost is $49,416 per year, which does not include extra charges for personal care and dementia care.2

The following chart breaks down the differences in expenses, depending on the type of care the elder requires.

 Costs of Care (Annual)

  Home Health Care Assisted Living Nursing Home
Intermittent Care
(20 hrs/wk)
$19,760 plus household expense $49,416 $91,615
Daily Care
(40 hrs/wk)
$39,520 plus household expenses $69,1763 $91,615
Continuous Care (24hrs x 7days/wk) $165,984 plus household expenses $195,6404 $91,615

The reason assisted living can be more expensive than home care or nursing home care is that most assisted living facilities do not provide personal care as part of the basic fee; instead, most require residents to purchase such care from the facility or an outside provider at an extra charge.

Home care is even more expensive than indicated in the chart above if the cost of maintaining one’s home is factored in. Of course, money is only one consideration in choosing where to receive care. Most seniors prefer to stay home if at all possible. Other factors include the ability to access quality care, proximity to family members, the regimentation and socialization at an institution, and even the quality of food provided.

1Source: MetLife 2006 Market Survey of Nursing Home and Home Care Costs
2Source: MetLife 2006 Market Survey of Assisted Living Costs
3
Most assisted living facilities do not provide personal care as part of the basic fee, so this cost assumes 20 hours/week of personal care (@$19/hr) in addition to the base fee.
4
Most assisted living facilities do not provide personal care as part of the basic fee, so this cost assumes 148 hours/week of personal care (@$19/hr) in addition to the base fee.

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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