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You Can't Go Home Again? That Depends...

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“You Can’t Go Home Again.” Or can you?

When Thomas Wolfe wrote his novel, it is unlikely he contemplated that someday the title of his work would hold meaning for boomers trying to figure out what the next step is for parents or elderly relatives who have been hospitalized.

But, according to financial advisors who work with boomers, the question does hold meaning and is one that is beginning to be asked with more frequency.

Planners will see more of these situations, and as boomers face this issue, it is even possible that a whole new area of financial planning could develop, says Karen Eddy, a certified financial planner with Eddy Financial Planning, San Diego.

For instance, Eddy says she sees clients who have relatives with deteriorating mental abilities who are considering hiring help or have placed a relative in a facility without understanding “the financial implications of a long-lived Alzheimer’s relative.” In one case, she says, a man opted for home care for a mother who showed signs of deteriorating. Eddy says a 6-9 month watching period was established to observe the mother’s abilities and see if this was the right healthcare choice.

Cost of care, advisors say, is as much a factor when determining what to do as the amount and quality of care needed.

Going home after a stay in a hospital or a rehabilitation clinic is a possibility, says Kevin Gahagan, a certified financial planner with Mosaic Financial Partners Inc., San Francisco, but that can be quite expensive.

The decision is a mix of quality of life and cost, says Sharon Luker, a certified financial planner and holder of C-LTC and certified senior advisor designations.

One client specifically wanted her mother at home–even though home care was costing $220 a day–because she believed her mother would receive better care than if she were in a nursing home facility.

There are many sources for comparing costs of the different venues for care.

The New York Insurance Department website estimates that in 2004, nursing home care averaged about $238 per day in upstate New York and $316 per day downstate, or between $86,000 and $115,000 per year. The average stay, according to the New York website, is 2.5 years.

Home health care, according to the New York department, was, on average, $20 per hour upstate and $15 per hour downstate in 2004. Average annual costs for home health care in 2004 ranged from $15,000 to $21,000 a year, the department says. (See ).

The cost of care in a nursing home, an assisted living facility and at home is described in a March 2006 Genworth Financial study, ’2006 Cost of Care Survey.’

The survey found that for a private nursing home, the average national cost was $194.28 a day, or $70,912 per year.

Alaska had the highest annual cost at $191,140, followed by New York City at $140,708. Louisiana and Missouri had the lowest annual costs for a private room with a respective $42,304 and $43,249.

The cost of private nursing home care is 17% greater in urban than non-urban areas; in New York City, the cost is 68% greater than non-urban N.Y. areas; and in San Francisco, it is 45% greater than in non-urban California areas.

The average annual cost for a semi-private, double-occupancy room in a nursing home, according to the survey by Genworth Financial, Richmond, Va., is $171 a day, or $62,532 per year.

And, the survey continues, nationally, one bedroom assisted living facilities have average annual costs of $32,294. These rates exclude a one-time community or entrance fees, the survey says.

The highest annual ALF costs, the survey finds, were found in Bridgeport, Conn., where the cost was $57,566, and in New Jersey (excluding Newark and Edison), where the cost was $51,314. Costs excluded community fees.

The lowest average annual ALF costs were in North Dakota, with $20,714, and Arkansas, with $20,937.

For home care as measured by all home care provider types–Medicare certified home care providers, non-certified but licensed home care providers, and non-certified and non-licensed home care providers–the average hourly rate for home health aides is listed as $25.32 in 2006, according to Genworth Financial. Home health aides provide personal care but not medical care, as defined by the survey. As an example, the survey states that a home health aide “typically helps with bathing, dressing, transferring and toileting, but not with catheters or injections.”

For homemakers, the average hourly rate is listed at $17.09 per hour. The survey describes homemakers as those helpers that “generally do not provide hands-on care; their services usually include help with shopping, finances, cooking, running errands, transportation and/or providing companionship.”