Home care is significantly less costly than nursing home care. And, most Americans would far prefer to age in place, in their homes, and receive home care than move to a care facility. But, the latest Urban Institute research by Richard Johnson and Claire Wang shows that nearly half of older adults will not be able to afford care in their home when they need it.
Researchers looked at the cohort of older adults with severe need for long-term services and supports (LTSS), assistance with bathing, feeding, cooking and the like. They found that nearly half could not afford two years of paid home care on their own even if they sold all their assets. Overall, about two in three adults over 65 not on Medicaid can afford two years of paid home care if they rely on income and other savings that can easily be turned into cash.
The researchers found that three in four older adults could afford home care for two years if they sold less easily liquidated assets, including their cars and businesses, but not their homes. And, four in ten older adults could afford home care as long as needed based on their income alone. Half as many with severe LTSS needs, two in ten, could afford indefinite home care based on their income alone.
But, most older adults end up relying on unpaid family caregivers and not paying for home care. In the 14 years between 1998 and 2012, fewer than one in five adults 55 and older needing help with four out of five activities of daily living–bathing, feeding, toileting, transferring and dressing–received it.
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