Compare National Healthcare Costs

Compare Senior Care Costs

Care Type	National Average Daily Cost	National Average Monthly Cost	Five Year Increase
Adult day care weekdays only	$61	$1,322	1.67% 1 year increase
Assisted living	$110	$3,300	5.71%
Home care 44 hours per week	$162	$3,432	1.09%
Nursing Home double occupancy room for one person	$200	$6,083	4.50%
Nursing Home single occupancy room for one person	$222	$6,753	4.28%

Adult Day Care helps Dementia patients and Caregivers

Regularly using adult day care services for a family member with dementia may help reduce stress for caregivers, a new study suggests.

"Caring for someone with dementia often involves high levels of daily stress," Steven H. Zarit said. "This amount of stress exerts wear-and-tear on the body."

Zarit led the new study at The Pennsylvania State University in University Park.

Some researchers have thought that adult day care may actually increase stress, because of the extra effort of getting the person ready to go in the morning and transitioning back in the evening. But based on this and a previous study, that doesn't seem to be true, Zarit said.

"What we found is that each day a caregiver uses adult day care interrupts a part of the body's stress response, and leads to a more normal level of a key stress hormone, DHEA-S," he said.

DHEA-S, short for dehydroepiandrosterone-sulfate, is produced by the adrenal glands. Some studies have shown that high levels of this hormone can help protect the body against the damaging effects of stress.

But prolonged exposure to stress can deplete DHEA-S levels, the authors write in The American Journal of Geriatric Psychiatry.

Their study included 151 people caring for a family member with dementia who used an adult day care service at least twice a week. The caregivers were an average of 62 years old, and their family members with dementia were an average of 82.

For eight days, caregivers reported their stressors and mood levels by phone once daily and collected their own saliva samples to be tested for DHEA-S five times per day.

The researchers found that caregiver DHEA-S levels were higher on the day following an adult day care day, suggesting that a break from caring for their family member allowed their body to restore this hormone level.

Caregivers who used the day care service more often tended to have higher average mood scores for the eight days than those who used it less frequently. Their mood levels tended to mirror their DHEA-S hormone levels, with better mood on days with higher DHEA-S scores, but there was no connection to symptoms of depression.

"For years researchers have amassed a large literature on the emotional stress and strain of caregiving," Susan T. Charles, who was not involved in the new study, told Reuters Health in an email.

Charles studies emotional processes across the adult life span at the University of California, Irvine.

This study offers a solution on how to lessen the effects of stress, she said.

"Given the rise in the number of people caregiving for a family member with dementia as our population ages, this issue is becoming more central to our public health," Charles said.

"Stress related to managing a relative's challenging behaviors, helping a relative complete daily tasks or assisting them with their medications can lead to stress that spills over to other parts of a caregiver's life such as family conflict and disruption, lost wages due to fluctuations in employment and difficulty in maintaining important friendships outside of the caregiving situation," said Joseph E. Gaugler. He researches community-based services for caregiving families at the University of Minnesota School of Nursing in Minneapolis and was not involved in the new research.

"This accumulation of care-related and life-related stress can then lead to negative mental or physical health outcomes on the part of family caregivers, including depression, impaired health or immune system response or even mortality," Gaugler said.

Many family caregivers either do not know of adult day care services, or think that the services are only "babysitting" and do not take advantage of them, he said. But a good program includes therapeutic activities that can help people with chronic illnesses like Alzheimer's disease maintain function at a higher level, Zarit said.

"Activities such as exercise, cognitive stimulation and social programs can be very helpful for maintaining functioning, and can be carried out in a respectful way," he said.

Area Agencies on Aging can be found throughout the country and maintain a list of community resources. That would be a good place for caregivers to start looking for information on adult day care programs, Zarit said.

Gaugler recommends the National Adult Day Services Association homepage (nadsa.org), which has a "find a center new you" search tool, and the eldercare locator at eldercare.gov.

How Adult Day Care Helps the Aging to Live in Place

Adult day services act as an alternative or supplement to home care and an alternative to moving to assisted living or a nursing home to receive care. The centers enable continued community-based living for individuals with physical and cognitive limitations and provide respite for their caregivers.

In recent years, adult day services centers have played and increasing role in providing long-term care services, as evidenced by the rapid growth in programs from 2,000 in 1989 to over 4,600 in 2009.

While this increase is partially due to the aging of our society, much of this growth can beattributed to the benefits offered through adult day services. First, adult day services centers allow individuals toremain in their home settings rather than an institutional setting, which is what the majority of caregivers and care recipients desire.

Adult day services are also far less expensive than nursing home care. The national average daily rate for ADS was estimated at $67 compared to $198 for a semi-private room in a nursing home. (Note: the average daily rate for adult day services among respondents in this study was under $62). Finally, new evidence from case-controlled study suggests ADS can improve health-related quality of life for participants. In addition, ADSare effective in improving caregiver well-being and reducing burden, role overload, worry, anger, and depression

Grants for Starting an Adult Day Care Center

Construction and Renovation Grants

Federal grants are available for financing the construction and renovation of adult day care facilities in urban and rural areas. The U.S. Department of Housing and Urban Development funds the Community Development Block Grant program. These grants fund the construction and rehabilitation of adult day care and other health care and community facilities in cities and counties with more than 50,000 and 200,000 residents, respectively. The U.S. Department of Agriculture, sponsors the Community Facilities Grant Program. Grants are awarded to counties, towns and districts with less than 20,000 residents to build senior day care centers and equipment necessary to run the operations.

Food Services Grants

Senior day care operators can apply for grants to help with providing healthy meals. The Special Programs for the Aging, funded by the Department of Health and Human Services awards grants covering the expenses of purchasing and providing nutritious meals to the elderly in day care and other congregate settings. The USDA also sponsors a grant program called the Child and Adult Care Food Program, which provides healthy meals and snacks to adults while they’re in day care.

Nonprofit Grants

National and regional grants are also available from nonprofit organizations to start senior day care center businesses. The Kresge Foundation awards grants over $300,000 on for major capital projects such as facility construction and renovation and equipment purchases. These are challenge grants, which means applicants are required to raise capital from other sources to match the foundation. In North Carolina, the The Kate B. Reynolds Charitable Trust organization provides grants funding capital projects and equipment purchases for non-profit senior day care centers in rural areas throughout the state.

Health Equipment Grants

Grants from regional and national programs are available to owners of senior day care centers for the purchasing of medical equipment for their facilities. For example, the George S. and Dolores Doré Eccles Foundation awards grants to senior day care centers and other health care-related facilities in Utah to purchase equipment for their operations. The National Emergency Medical Association awards grants on a national scale for the purchase of health care equipment.

Alzheimer's Blood Test

Researchers have developed a new blood test that can predict with 90% accuracy whether a healthy person will develop Alzheimer's or cognitive decline within 3 years. They report how they identified and validated the 10 biomarkers that form the basis of the test in a study published in Nature Medicine.

Study leader Howard J. Federoff, a professor of neurology at Georgetown University Medical Center in Washington, DC, says:

"Our novel blood test offers the potential to identify people at risk for progressive cognitive decline and can change how patients, their families and treating physicians plan for and manage the disorder."

Rates of Alzheimer's disease - a condition that gradually clogs up and kills brain cells and leads to memory loss and mental decline - are rising rapidly around the globe. The disease mostly affects older people, although there are rare forms that can start earlier in life.

In 2010, there were 35 million people with Alzheimer's disease worldwide. The World Health Organization (WHO) predicts this number will double every 20 years, rising to 115 million by 2050.

Assisted Living Finance

Financial Assistance for Assisted Living and Senior Living Care

Several government subsidies are available to fund senior housing. However, the reality is that these amounts are limited and will impose restrictions on what care you receive and where you receive it.

§                         Medicare: Neither Medicare Parts A nor B offer coverage for comprehensive ongoing long-term care. Medicare A (hospital insurance) may cover costs for a semiprivate room, meals, nursing and rehab services, medications, and medical supplies in a skilled nursing facility for the first 100 days after being released from hospitalization for an acute illness or injury. The first 20 days are covered at 80 percent, with the rest of that time period covered at decreasing rates. It never covers a private room nor services in an assisted living residence. Medicare B only offers reimbursement for covered services you receive from a doctor. 

Ask Medicare is designed to support and assist caregivers. Ask Medicareoffers a wide range of helpful information for the nearly 66 million Americans who provide help to an aging, seriously ill, or disabled family member or friend. Ask Medicare offers tools that helps caregivers and those they care for make informed health decisions. 

§                         Medicaid: Medicaid, which provides federal health-care assistance to low-income Americans, is the biggest payer for room, board, nursing care, and social activities in nursing homes. Many, but not all, states now cover some assisted living services under their Medicaid programs; however, these fluctuate widely in terms of eligibility requirements, and dollar amounts of coverage. The Senior Assisted Housing Waiver provides eligible low-income adults a choice of receiving senior living care services in a community-based setting rather than in a nursing facility. Bear in mind that faced with budget deficits for years to come, states are more likely to cut, rather than expand, these programs. 

§                         Housing and Veterans Subsidies: Seniors with annual incomes under $12,000 may qualify for U.S. Department of Housing and Urban Development 202 and Section 8 senior housing, which provide rent subsidies that can help pay for the room-and-board portion of both independent living and assisted living environments. The Department of Veterans Affairs also provides some skilled and intermediate-level care to veterans in its own residences, depending on space availability. 
 

§                         For more information on benefits, visit Federal Benefits for Veterans and Dependents or check out the VA's benefits fact sheets. 

§                         Life Care Funding Group (LCFG) assists people in need of funds to cover the costs of senior housing and long term care. LCFG specializes in converting the death benefit of an in-force life insurance policy into a long term care benefit to cover the costs of skilled nursing home care, assisted living, home health care, and hospice.

  Additional Resources and Advice for Financing Senior Living:

§                         Center for Long-Term Care Financing

§                         AARP

§                         National Association of Insurance Commissioners

§                         America's Health Insurance Plans

Senior Living Care Insurance

Long-term care insurance is perhaps the best way to ensure you can afford to pay privately to receive the most choice in housing environment possible from your provider of choice, whether it's independent living, assisted living, or another housing option. Experts suggest consumers should be looking at long-term care insurance at 40 and own it by age 50. When choosing an insurance provider, consider the following tips:

§                         As with any insurance, read the fine print on the policy and ask questions.

§                         Compare at least three different insurers.

§                         Verify each company's financial strength through independent rating systems such as AM Best.

§                         Review the company's rate history for stability.

§                         Check to see if the policy is tax-qualified, in which case premiums may be deducted under medical expenses if you itemize your deductions.

§                         Select an inflation-protected policy to ensure sufficient coverage when you file your first claim years from now.

Technology for Memory Care

Playing brain-training video games may help reverse the natural decline in cognitive abilities among older people, according to scientists.
They found that 60-year-olds who played a custom-designed video game for 12 hours over the course of a month improved their multitasking abilities to levels better than those achieved by 20-year-olds playing the game for the first time. The subjects retained those improvements six months later.
"Through challenging your brain, you can drive plasticity and improve its function," said Adam Gazzaley of the University of California, San Francisco. His team's findings suggest the ageing brain is more "plastic" than previously thought, meaning it retains a greater ability to reshape itself in response to the environment and could therefore be improved with properly designed games.
In their experiment, published on Wednesday in Nature, Gazzaley's team asked participants to play a game the researchers had designed called "NeuroRacer" which involved driving a car along a hilly, winding road. At the same time, they had to press a button whenever they noticed a target sign – a green circle, say – appear at the top of the screen. Another version of the game involved just pressing buttons when the signs turned up on screen, without having to drive the car.
The researchers measured the "multitasking cost" for the participants as the change in accuracy from doing the sign task by itself, to doing the sign task and driving the car at the same time. A -50% cost, for example, meant the participant had a 50% reduction in their accuracy as a result of having to multitask.
Gazzaley first assessed groups of healthy people at different ages and found, unsurprisingly, that multitasking abilities declined with each extra decade of life from the age of 20 to 80: 20-year-olds had an average multitasking cost of around -25%, 30-year-olds had an average cost of around -40% and 70-year-olds had a multitasking cost of more than -65%.
The subjects, aged 60 and 85, played the game for an hour three times a week over the course of a month. As a result, the team found their average multitasking cost dropped dramatically.
"They went from a 65% cost to a 16% cost," said Gazzaley. "These games exceeded both that of an active control group as well as the non-contact control and they also exceeded levels attained by 20-year-olds who only played the game a single time." The improvement was still there six months later.
Cognitive tests carried out by the researchers before and after the sessions with NeuroRacer also revealed improvements in their attention and working memory, areas of cognition that were not directly targeted by the video game.
Peter Etchells, a psychologist at Bath Spa University who studies the effects of computer games on the brain, said that Gazzaley's work was "a great example of how video games tailored to specific populations can be used to improve mental health. We hear a lot about how video games might be bad for us, but it's not really a simple, black-and-white story."
Robert Howard of the Institute of Psychiatry at Kings College London said that reports of ways to deal with cognitive decline tended to generate a great deal of interest in older people and those who worry that they might be in the early stages of disorders such as Alzheimer's disease. But he added: "We are still a very long way from being able to recommend cognitive training as a preventative or treatment measure."

Gazzaley said his findings were not directly comparable to existing commercial video games and he was keen for people not to overinterpret the results.
"One thing I'm cautious about is that it's not blown out of proportion in that the conclusion from this is that video games are a panacea for all that ails us," he said. "The devil's in the details and this was a very carefully constructed game that was targeted to a known neural deficit and a population."
But he said that the results could be extrapolated to other situations. It was a reasonable hypothesis, he said, to speculate that training with video games might help people of all ages keep up their cognitive reserves and that it might even be useful for people with the many neurological and psychiatric conditions that also affect cognitive function.
Tom Kirkwood, director of the Institute for Ageing and Health at Newcastle University, said training with video games is known to result in improved cognitive performance. "It would be surprising indeed if this was not underpinned by measurable changes in neural activity," he said.
"It would also be surprising if training effects did not persist for a while. Just think of all those music teachers who would be out of jobs if this were not the case. In this connection, it is a bit surprising that the authors did not compare the benefits and persistence of training effects in different age groups. It would have been especially interesting to know whether older adults were significantly less trainable than younger adults, or if the results were relatively comparable."
Kirkwood added that, in experiments of this kind, it was tough to control for the benefit that came from reinforcement of self-belief when engaging with a new challenge. "Those in the 'multi-tasking' group will inevitably have been aware that they were doing something quite demanding which might have generated wider psychological and cognitive benefits."