When it comes to long-term care, there are a number of complexities.
Custodial Vs. Skilled Care
One concerns the difference between “custodial care,” which helps a person perform various activities of daily living (see further down), and “skilled care,” which is medical care a person receives from doctors, nurses, therapists, and other skilled practitioners.
For more on this distinction, see the following video.
Care Environments
Further issues arise when you go to select your care environment.
The basic question is: Where do you want to be cared for?
For an introduction to some of the relevant concerns, see:
The two most fundamental places are (1) at home, and (2) in an institution.
“At home” might mean in your own private residence, someone else’s private residence, or in an apartment/independent-living facility.
Institutions vary depending on whether they provide Assisted Living or Skilled-Nursing Care.
Some institutions – like adult daycare, hospice, and respite care – are available to assist caretakers who provide mainly at-home services.
Others – chiefly assisted-living facilities and nursing homes – are designed for more intensive care.
What Are Institutional Costs Made up of?
When you think of costs, there are really three categories of cost that can contribute to a bill.
Residential Costs
This is basically room and board as well as meal-preparation services (if any).
Custodial Costs
These costs are associated with any help that a resident may receive with the six, so-called “Activities of Daily Living” (or ADLs). These include bathing yourself, feeding yourself, dressing yourself, remaining continent, toileting by yourself, and transferring in and out of bed by yourself.
Skilled-Nursing Costs
These costs are those that attend the reception of various medical interventions. This may include the administration of pharmaceuticals, physical and speech therapies, wound dressing, and so on.
How Much Do Assisted-Living Facilities and Nursing Homes Cost?
In the Greater St.-Louis area,[1] the costs vary widely, depending upon the amenities, location, and services of the facility in question.
However, for assisted living, we’re a talking about around $1,600 a month on the low end to about $4,000 or $5,000 a month on the higher end.
Nursing homes, which (in theory) provide an even high level of attention and care, cost anywhere from approximately $6,000 to $8,000 a month on the low end. Some nursing homes can run more than $10,000 every single month.
| Facility Name | Assisted Living | Nursing Home | Medicaid | Low-End Cost Per Day | Low-End Cost Per Month | Low-End Cost Per Year | High-End Cost Per Day | High-End Cost Per Month | High-End Cost Per Year |
| Breeze Park | Yes | Yes (I) | $278 | $8,340 | $100,080 | $343 | $10,290 | $123,480 | |
| Delmar Gardens (O’Fallon) | Yes | Yes | $268 | $8,040 | $96,480 | $291 | $8,730 | $104,760 | |
| Garden View Care Center | Yes | Yes (W) | $244 | $7,320 | $87,840 | $291 | $8,730 | $104,760 | |
| Mount Carmel | Yes | Yes | Yes | $244 | $7,320 | $87,840 | $261 | $7,830 | $93,960 |
| Garden View (Dougherty Ferry) | Yes | Yes (I) | $240 | $7,200 | $86,400 | $255 | $7,650 | $91,800 | |
| Glenfield Memory Care | No | Yes | No | $233 | $6,990 | $83,880 | $233 | $6,990 | $83,880 |
| Boulevard St. Charles | Yes | No | $209.83 | $6,295 | $75,540 | $217 | $6,495 | $77,940 | |
| Cedarhurst | Yes | No | No | $208.33 | $6,250 | $74,999 | $208 | $6,250 | $74,999 |
| Gray Consulting | Yes | Yes | $163.33 | $4,900 | $58,799 | $247 | $7,400 | $88,798 | |
| Villages (St. Peters) | Yes | Yes | Yes | $126 | $3,780 | $45,360 | $236 | $7,080 | $84,960 |
| Lake Saint Charles | Yes | No | No | $54.16 | $1,625 | $19,498 | $125 | $3,750 | $45,000 |
(I) – “Internal” Medicaid availability only. This means that the facility accepts Medicaid-eligible persons who began their time as private-paying individuals in the facility.
(W) – “Waiting List.” Many facilities probably have a waiting list. But I do not presently have data from all of them.
St. Louis Area Slightly Less Than National Averages
Nationwide, assisted-living costs have hovered around $4,000 per month, while nursing homes have been about $7,000-$8,000 a month – depending on whether the resident has a semi-private room (i.e., one shared with another person) or a private room.[2]
Still, $4,000 a month is $48,000 a year.
And $8,000 a month is $96,000 a year.
These are not small numbers.
The average nursing-home stay is about 2.3 years, or 835 days.
So, if you’re paying about $251 per day to a nursing home, that comes to $209,585.[3]
What to Do?
There are really only three (3) ways to pay for long-term-care expenses. (1) You pay out of your own pocket; (2) you “spend down” your assets and qualify for the government’s Medicaid-assistance program; (3) or you use proceeds from a long-term-care-insurance policy.
For a bit more on these, see this:
In another installment, I’ll get more in depth in terms of payment options.
For a no-cost, no-obligation review of your own situation, call
(636)447-1169.
[1] Including portions of Franklin, Jefferson, Lincoln, Montgomery, Pike, St. Charles, St. Louis, and Warren counties, as well as St. Louis City. In terms of municipalities, we’re talking about Arnold, Ballwin, Barnhart, Bel-Nor, Bel-Ridge, Bella Villa, Bellefontaine Neighbors, Bellerive, Berkeley, Beverly Hills, Black Jack, Bowling Green, Breckenridge Hills, Brentwood, Bridgeton, Calverton Park, Champ, Charlack, Chesterfield, Clarkson Valley, Clayton, Cool Valley, Country Club Hills, Country Life Acres, Crestwood, Creve Coeur, Crystal Lake Park, Dellwood, Des Peres, Edmundson, Ellisville, Eureka, Fenton, Fenton, Ferguson, Flordell Hills, Florissant, Foristell, Frontenac, Glen Echo Park, Glendale, Grantwood Village, Green Park, Greendale, Hanley Hills, Hawk Point, Hazelwood, Hillsdale, Huntleigh, Imperial, Jennings, Kinloch, Kirkwood, Ladue, Lake Saint Louis, Lakeshire, Mackenzie, Manchester, Maplewood, Marlborough, Maryland Heights, Mehlville, Moline Acres, Moscow Mills, Normandy, Northwoods, Norwood Court, Oakland, Oakville, Olivette, Overland, O’Fallon, Pacific, Pagedale, Pasadena Hills, Pasadena Park (Village of), Pine Lawn, Richmond Heights, Riverview, Rock Hill, Shrewsbury, Silex, St. Ann, St. John, Sunset Hills, Sycamore Hills, Town & Country, Troy, Twin Oaks, University City, Uplands Park, Valley Park, Velda City, Velda Village Hills, Vinita Terrace (Village of ), Warrenton, Warson Woods, Webster Groves, Wellston, Wentzville, Westwood, Wilbur Park, Wildwood, Winchester, Woodson Terrace, and Wright City.
[2] Sometimes “private” bedrooms still share bathrooms with other residents.
[3] That is, $251/day * 835 days.