 Existing your final years in a Nursing Home has never had a good aura about it. In this blog post, I will share:
Before we begin, please watch this video... Now, Let's begin... My Personal Experiences When I was 14 years old, my first job was working in a nursing home in the kitchen. I would deliver food from the kitchen to the various areas of the facility. During my deliveries, I would hear elder residents who were alive, but they weren't living. They were existing in a cubical, but that was basically how they would live out the rest of their lives - in an enclosed adult cubicle. Not desirable in my opinion. Nursing Home Alternatives in the USA In the USA and other parts of the Western world, there are Nursing Home Alternatives. See Nursing Home Alternatives available in the USA in the graphic below.  Nursing Home Alternatives Summary We have identified 5 viable options to nursing home placement. Each option is explored in greater detail further down this page. 1) Assisted Living - a group residence where residents live in private apartments, share meals, participate in activities and day trips and receive personal care assistance, medication reminders and have 24 hour on call assistance. Though still a group living environment, assisted living is vastly different from nursing home care with consideration to the quality of life of the resident. 2) Medicare PACE Programs - for Medicare beneficiaries, PACE (Program of All-Inclusive Care for the Elderly) programs offer a combination of services to individuals who would otherwise require nursing home care. This allows them to remain living in their homes or in the homes of family members. 3) Medicaid HCBS Waivers - for Medicaid beneficiaries, HCBS (Home and Community Based Services) Waivers provide a variety of care services and non-medical support for the elderly and their caregivers. These services are specifically intended to prevent nursing home placement and allow seniors to live at home or in the homes of their caregivers. 4) Adult Foster Care - is offered in private residences, usually family homes, where 1 - 3 seniors live and receive personal care, share meals and assistance with their activities of daily living. Compared with nursing home care, adult foster care offers a family-oriented living experience. 5) Eden Alternative - Not as much an alternative to a nursing home as a philosophy for significantly improving the nursing home experience for residents. Program Details and Average Cost of Nursing Homes (2018 numbers) Assisted Living These group residences accommodate between 25 - 100 seniors. Residents live in private or shared apartments, enjoy optional group dining, participate in activities and day trips, and receive personal care assistance, medication reminders, and have 24 hour on call assistance. The level of care available varies with needs from no care to almost nursing home level care. Many residences have "Memory Care" divisions with increased supervision for persons with Alzheimer's or dementia who would otherwise require nursing home care. The cost and financial assistance available for care vary significantly by state. Between $3,500 - $15,000 / month should be expected. Alzheimer's units typically charge an additional $2,000 / month. While this may seem high, it is significantly less expensive than nursing home care. Some individuals who could thrive in assisted living end up in nursing homes because Medicaid is more likely to cover that cost. Medicaid hopes to prevent this and is increasingly helping with the cost of assisted living, both to save money and to improve the quality of life for residents. Other financial assistance comes from Supplemental Security Income (SSI), state specific programs, and the Department of Veterans Affairs (VA). Private pay still makes up the majority of assisted living costs. Medicare PACE Programs For Medicare beneficiaries, PACE programs offer a combination of services to individuals who would otherwise require nursing home care. Thereby enabling them to remain living in their homes or in the homes of family members. While medical care and some personal care are provided, family members are expected to provide caregiving as well. These programs do not pay for 24/7 personal care and supervision. However, their great benefit is helping the elderly remain in an environment with which they are familiar and comfortable. Some drawbacks associated with PACE Programs (also called LIFE Programs in some states), include the fact that care services come from a limited number of providers and the program participants have very little, if any, choice of who provides them with assistance. Another factor limiting participation is the geographic availability of PACE Programs. They are not available in every state nor in every county of those states in which they are available. Participants may have to travel great distances to receive care. There is no additional cost for PACE beyond the normal Medicare costs. Participants elect to receive all their care services from a limited group of providers and Medicare pays for those services. Therefore financial assistance is not available, nor is it really relevant. Medicaid HCBS Waivers For Medicaid beneficiaries, HCBS (Home and Community Based Services) Waivers provide a variety of care services and non-medical support for the elderly and their caregivers specifically intended to prevent nursing home placement and allow seniors to live at home or in the homes of their caregivers. Typical services provided under a waiver include adult day care, personal care at home, chore assistance, personal emergency response services (PERS) and often times support for home modifications that increase independence or safety. Some of these services can be "participant directed" meaning the care recipient chooses their care providers. In some states, family members can be hired as care providers. Drawbacks associated with these Medicaid waivers include limited enrollment. Waivers have a defined number of "slots" and frequently there are waiting lists. Medicaid (and therefore HCBS Waivers) are intended for low income seniors with limited financial assets, so unfortunately many seniors who cannot afford their cost of care still are not financially eligible for Medicaid waivers. There are no costs associated with participation in a HCBS Waiver above and beyond normal Medicaid co-payments or spend-down. They are a form of financial assistance which helps families care for loved ones at home instead of in a Medicaid funded nursing home. Adult Foster Care Personal care, supervision and meals are provided in a family home. Some homes care for just a single senior and others may care for 4 or 5 seniors. Compared to nursing home care, adult foster care offers a family oriented living experience. Some seniors prefer this while others prefer the greater social interactions available in assisted living. Assistance with medications, toileting and bathing are provided, but medical care is not. Adult foster care providers are regulated by their states or counties and one is usually introduced through working with a state agency. Adult foster care is significantly less expensive than nursing home care or assisted living. Nationwide costs range from $3,500 - $10,500 / month. Payments options include assistance from state programs, Medicaid and SSI. Some states run structured Adult Foster Care Programs and others leave residents to find and manage their own arrangements. Eden Alternative The Eden Alternative (and the closely related Green House Project) are not as much alternatives to nursing homes as an alternative approach or philosophy to creating a nursing home environment. If one has determined a nursing home is essential for their loved one, they would be well advised to find a nursing home that adheres to the Eden Alternative approach. In summary, the Eden Alternative works to create an environment in which the care recipient is the decision maker, both in their care services and in their lifestyle choices. This results in aging environments where seniors are much more engaged, valued, respected, and frankly, happier. Physically, Eden Alternative homes tend to be spacious, with gardens, animals, and even playgrounds for visiting children. Residents are engaged with their care, as well as their living community and each other. There are no additional consumer costs for nursing homes that adhere to the Eden Alternative philosophy. Funding comes from the same sources that pay for traditional nursing homes, largely Medicaid and private pay.  What I believe is a Better Nursing Home Alternative (Similar to the Eden Project but Less Expensive & more Benefits) Imagine:
In 2006, I SOLD Everything in the USA and moved to the Philippines. I discovered a beautiful, gentle, tranquil island with fresh air, beautiful landscapes, and wonderful people. While I was setting up my own home, I realized what this place could be for seniors - a Better Nursing Home Alternative. Since living here, I have shared this idea with friends, and nearly 90% of them have followed me and set up residence in the Philippines as well. What could someone expect if they transitioned to this Lifestyle? Let me answer this by sharing what Caregiver Professionals in the Philippines are doing for the people they care for. In Home CareWhile caring for your loved ones can be a rewarding experience, it’s often simply not possible given the pressures of work and family or distance. More so, it can be quite overwhelming considering their medical needs. This is why a qualified home care professional is needed. Caregivers are trained to assist your loved ones with their hygienic needs, personal care and medical requirements. If you’re like most relatives, and want nothing but the best for your family’s aging members, then you must consider the benefits of having home care. As you or your loved ones experience the results of aging, you want to make sure that you receive the highest quality of personal care in the comfort of your home. Caregivers understand the emotional aspect of loved ones being sent to a nursing home. Filipino caregivers take pride in our outstanding personal care, letting our clients feel that they have an enjoyable and worthwhile experience. Filipino caregivers are capable of providing for your medical needs while keeping you company. With our compassionate, dedicated and committed staff, that take our services to heart and make sure that you get the best care possible, both personal and emotional. Daily routines can be hard. This is especially true for those who are recovering from illnesses, surgeries or are going through age-related sickness. This is why caregivers in the Philippines offer the following services:
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