Jim Zientara: Breaking down costs, details of adult day care

In my last writing, I discussed the concepts of adult social health care and adult health day care.

Adult social day care provides social activities, meals, recreation and some health-related services.

Adult health day care offers intensive health, therapeutic and social services for individuals with serious medical conditions and those at risk of requiring nursing-home care.

Although the term adult health day care is not as widely recognized, it will become the dominant form of adult day care as our population continues to age.

Let’s investigate the costs and details of using both adult day care versions.

First, make sure any worker or facility is bonded and insured – elder abuse must not be tolerated. You can have caregivers come to your residence starting at about $10 per hour. The minimum time is usually four hours for non-skilled workers at your home.

For our purposes, let’s assume there are 21 business days in the month. At home, if it’s $10 per hour for eight hours for 21 days, that’s $1,680 per month. If more extensive adult health day care is required at home, the cost increases.

At the least, consider a 24-hour emergency signaling and vital sign monitoring system or a GPS locator for wandering care recipients.

Often, the home must be remodeled to allow for grab bars, wheel chair access, chair lifts and others, and that can prove costly. Also, consider downsizing and removing clutter.

There are free and paid consultants to guide you through the challenges. They can assess your situation, provide recommendations and connect you with needed resources.

Outside of the home, there are many centers to choose from. Some adult social care centers provide services at no cost because they may be a 501(c) (3) non-profit, or accept donations to pay for expenses on both sides.

At some centers, you pay for part or all of the adult social day care costs, which might be similar to at-home costs. If you need a center that has adult health day care with skilled nurses, aides and physical therapy specialists, expect to pay more.

At some point, both the caregiver and the adult might reach the decision that in-home or out-of-home care isn’t working and a new arrangement is required. Indeed, deciding to leave the home and move into a retirement home is an emotional one.

There are many retirement facilities offering independent living, assisted living, memory care and full-skilled nursing. They vary in amenities depending on how much you need and how much you can pay.

To estimate these expenses, go to longtermcare.gov. In Florida, assisted living, memory care and skilled nursing facilities range from about $3,500-$7,500 per month.

At the National Care Planning Council and the Manatee County Aging Network, there are many forms and checklists available. They include home modification, a continuing care questionnaire, a caregivers log and many more.

Without your finances in order, your needs, wants, wishes and team members might not properly work together. Your financial planner could be the starting point to getting a team organized to help.

It’s recommended that you have specialists available, such as your attorney, elder law attorney, tax adviser, guardian, hospice and a funeral director. Moreover, heirs should have an understanding of what’s going on. Be sure to have updated legal documents, such as a will, living trust, power of attorney and living will.

I recommend a final gift to your heirs in the form of a detailed written account of financial affairs and personal wishes, and perhaps a video about your end-of-life preferences and planning. This is both a guide and a physical record of your last wishes. Why leave it up to someone else to guess what you wanted?

Nobody knows when or how they will die. It’s best to have affairs in order regardless of age.

This story was originally published October 24, 2016 at 11:20 AM with the headline "Jim Zientara: Breaking down costs, details of adult day care."