If people need care and full-time supervision, there is no cost comparison between assisted living and home health. Here’s a real life example.

A friend recently asked for some advice (true story) about her 85-year old mother who was hospitalized, then went to a rehab facility, and then had the decision between moving back home or to an assisted living community. I think the family was inclined to assisted living, but mom wanted to go home, of course.

The assisted living community in Connecticut, operated by a well-respected regional chain, offered $4,300 per month for a one-bedroom unit, but after the assessment admitted that she may be bumped up a care level or two. Given the times, the $5,000 community fee would be waived.

The home health agency said they could provide a full-time live-in “aid” who would be on duty from 8 am to 8 pm seven days a week. That cost was just under $10,000 per month, or double the cost of assisted living, but excludes the costs of food and maintaining the house. The aid, however, had no license, such as being an RN or LPN.

This elderly mother is mentally “okay,” but uses a walker and can’t use stairs. Since she could not be in a house alone overnight, or even during the day, in what universe do people think home health is cheaper than any sort of institutional care? As I have said, if all you need is an aid or nurse to drop in a couple of times a day, by all means, home health may be for you. But then you have the lack of socialization with peers that you get in assisted living, and even a nursing home. 

The kicker in this situation is that the mother has a long-term care policy that only covers home health. That kicks in about $6,000 per month, so net-net, the out-of-pocket cost was similar to assisted living. But then you have all those additional housing costs, and the cost of loneliness. Priceless.