Five ways to ensure you have access to home care later in life

One critical step in retirement planning is to consider how your mobility and independence will change with age. Will you be able to perform the yard work or house repairs that you take care of now? What about your yearly spring cleaning efforts? Unfortunately, many older adults require help with even more basic tasks. The onset of chronic disease or disability can require one to need assistance with activities of daily living such as showering or eating. In the past, older adults requiring such care were often transitioned to an assisted care facility or nursing home. Today, however, there are more services than ever before to enable older adults to stay in their own home.

This is great news as most Americans have a strong preference to stay in their own homes for as long as possible. Receiving medical or supportive care in the home can be one way to help realize this common preference. Maximizing your chance of staying in your own home into late life does require planning. Here are a few factors that will help you in you to think ahead:

1) Save for contingencies

Retirement savings aren’t just about protecting a constant, low-cost lifestyle. The strategies you take to save money at age 70 may not be sustainable at age 85. Budget for a few years of needing help with almost everything. The first category of support might include tasks like maintaining your home, common cleaning chores, and meal preparation. If you have family that lives nearby, they may be able to help with some of these activities, but this is not an option for everyone.

You might also require a second category of support if you were ever hit with the onset of a disability or if you were to have an extended recovery period from a medical procedure. It is not uncommon for older adults to require help with basic daily tasks like bathing, getting dressed, and toileting for months or years at a time. Although professional support of this kind (often referred to as ‘custodial care’) was once delivered in a nursing home or assisted care facility, for those individuals who can afford it, more professional services are being delivered in the home.

This is a positive trend for those wishing to stay in their homes as long as possible, but because this type of support is usually required daily, the cost of professional care in this second category can add up quickly. The cost of a home health aid is typically $125 or more per day. Unfortunately, neither Medicare, Medicaid, nor private health insurance plans will normally  cover the costs of custodial care delivered in your home.

If you have Family that lives in your area it is possible that they would be able to provide some of this critical daily support. Beware, however, that asking a loved one to deliver this type of care could become taxing for them. Burnout among family caregivers is common. Furthermore, you may want to free up family members to focus on especially important support tasks like overseeing your finances or coordinating care across providers. For these reasons, you will want to have savings that will pay for professional custodial care if you wish to maximize time in your own home later in life. As custodial care costs on average $45,760 a year when delivered in a home setting, not every family can pay this outright using their retirement nest egg. Consider some of the insurance products discussed below, such as long-term care insurance, that could help you to stay in your home longer.

2) Plan with your family

Start the conversation with your children or other loved ones early on. As you approach or begin retirement, begin by talking with them about the frailty and lifestyle changes that can come with advancing age.

If you have a strong preference to move closer to your children later in life, you may need to begin the conversation years or a decade in advance. Finding shared or proximal dwelling may require considerable coordination. For example, in order to live closer to your children both parties may need to resolve dependencies or compromise around issues of employment, housing expenses, and cost of living.  Be aware of the trend towards more urban lifestyles, especially for young people.

Beyond where you hope to live as you get older, talk to your loved ones about the frailty that can often come in late life. Be frank with them and yourself about the possible outcomes of your future care needs.

3) Ensure that your home is well-equipped and accessible

Many individuals will re-evaluate their living arrangements when approaching or starting retirement. Downsizing is one common decision. This can help to lower housing costs and also reduce the burdens of home cleaning and maintenance. If making the move to a new home, consider if you’d like to be closer to a town or city square that is adjacent to a grocery store or other amenities. This could be helpful later on if you want to reduce your dependency on driving.

Similarly, ask yourself about the characteristics of a home that you could stay in for as long as possible. Is it primarily on the ground floor? Is the entrance or walkway easily accessible? If you would consider an apartment in a multi-unit building, does it have an elevator that is cramped or spacious? These questions may not feel especially relevant to someone who has their full mobility, but physical capabilities could easily change as you get older.

As you think about future housing costs,  budget for injury preventative installations like extra handrails, shower handles, etc. These simple adjustments to your home may help maintain your independence longer and make your daily routines more convenient. Despite the benefits these changes may bring, only 27 percent of adults over the age of 40 have reported modifying their home to make it easier live in as they age. For example, the installation costs of grip bars for the bathroom or other parts of the home may be a few hundred dollars. Having the savings in place to pay for their installation could prevent a debilitating hip fracture or other slip injuries.

4) Research home health agencies

Have a look at home health agencies that serve your area. Knowing about the services and costs available to older adults can help you better imagine some scenarios that you should probably plan for. For example, the site careing.com provides an aggregator to compare companies working in a given region. In some cases, it can be difficult to find an agency that provides high-quality care at an affordable rate and many of such agencies struggle to retain their employees. One recent estimate pegs the employee turnover rate for home health agencies to be in the range of 40% to 67%.

It is hard to predict how these services and their offerings might change over the next 5-20 years. Throughout your retirement, you should check-in to ensure you have the appropriate savings to cover 6 months or more of care that may need to be delivered in your home.

5) Consider long-term care insurance

Among the possible layers of late-life support discussed above, requiring extended custodial care could easily come with the largest price tag. Unlike help with cleaning or yard work, you could require professional help almost every day of the week if you become unable to perform daily tasks like bathing or changing clothes. Compromised mobility or severe illness could strike at any time and could last for multiple years. Many Americans will struggle to ever have the robust savings needed to overcome these costs while trying to stay in their own home. Couple this with the need to possibly pay for long-term care in other settings,

Insurance helps to pool the financial risks associated with adverse medical events or other ups-and-downs in life. About 1 in 10 individuals over the age of 65 will need 2 years or more of long-term care with out-of-pocket expenses over $250K. Why not share the financial risk of paying for this care with other individuals? Long-term care insurance is one mechanism to share this risk and may be a good fit for those individuals who couldn’t pay hefty care bills outright for extended custodial support that is delivered in their own homes or in a care facility.


Older adults often prefer to stay in their own home for good reason. Although it is not right for everyone, staying in your own home may provide many comforts relative to transitioning to an assisted care facility or nursing home later in life. Other benefits could include maintaining the investment of owning a house, maintaining existing community connections, and having the increased autonomy and control over your own environment. If these advantages seem attractive to you, begin planning with your family and financial advisor as early as your late 50s or early 60s. The costs of maintaining home-based independence could be substantial, but worth it to many.

If you are interested in learning more about long-term care insurance and how it can enable home care for older adults, follow Bolster. We are building insurance services and family planning tools that could make your retirement planning easier.



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