Aging in place, the concept of growing old within the comforts of home instead of in a retirement community or with the aid of an assisted living facility, sounds ideal to many individuals. I mean, who wouldn't rather be comfortable, independent, and able to keep up his or her routines? But while the emotional advantages may be obvious, the financial and logistical implications are more complicated. The issue isn't only whether you'd like to age in place, but whether you can afford to.
1. The High Cost of Staying at Home
Your home may seem like the least expensive setting rather than paying for expensive senior living facilities when rolled up at first. But aging in place poses its own costs that can accumulate quickly. Among the greatest contributors are home modifications. As mobility wanes, households sometimes require investments like the installation of wheelchair ramps, grab bars in bathrooms, stairlift or wholesale conversions of first-floor bedrooms. Renovations to get the kitchen to keep pace with the rest of the house cost anywhere from a few thousand dollars to tens of thousands, depending on the scope of what the work is going to entail.
By the way, in addition to physical changes consideration will need to be given to the cost of maintenance. The older homeowners get, the less able they may be to do things like yard work, shoveling the snow or home repair in general, all of which require a paid service. You might also need to hire some one to clean, shop for groceries or assist with transportation, which can contribute to monthly costs. Also, property taxes, insurance and utilities continue to increase, which can stress fixed income budgets, particularly for retirees on Social Security or a draw on savings.
2. Costs of Medical Care and Home Care
Among the most daunting financial issues of aging in place is health care. Medicare pays for most medical services but not for long-term custodial care — assistance with everyday activities, including bathing, dressing and preparing meals. If elderly residents need help, they would have to pay for in-home care, which could cost $25 to $40 an hour. Costs can spiral to in excess of $8,000 a month for 24-hour assistance, in league with assisted living facilities.
Medical emergencies can create unforeseen costs even with part-time help. If there are no close family members on hand, seniors may require assistance from medical alert systems or emergency response services, which come with monthly fees. In addition, aging in place is simply managing chronic conditions independently, which can contribute to more out-of-pocket expenses for medication, medical supplies and frequent doctor visits.
3. The Emotions and Social Factors
There are also the emotional and social implications of aging in place, in addition to financial ones. Isolation is a significant risk for older adults who live on their own, especially if they cannot drive or have limited mobility. Loneliness is associated with higher risks of depression and cognitive decline, and also with poor physical health. Technology can help fill in the gap with video calls and social media, but it is no substitute for being together in person.
Families also have to decide whether their loved one's home is actually the safest place. Hopping on the subway and navigating a tenement building with a thousand families would be treacherous, to say nothing of living in a wooden apartment house with steep stairs, in a rural area hours from the nearest medical help. Even when retrofitted, there are homes that just aren't friendly to aging bodies, and it can be difficult to live independently for long.
We can age in place, but that will only happen if we face up to our money reality now and get ready. It's natural to want to live in one's home, but the costs, financial and emotional, may outweigh the benefits over other options, such as senior living communities, with services and social opportunities built right in. In the end, it depends on the health, money and family help each of us has. By looking ahead, seniors and their children can make the right decisions about what combination of independence, safety and affordability is right for them, thus ensuring that living in place doesn't have to be only a fantasy, but can be a matter of life-long reality.
