Aging in Place: Count the Cost(s)

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AUTHOR: DrLefty on 6/22/2024

My mother-in-law has Alzheimer’s. It’s very advanced, and over the last year, her husband (my husband’s stepfather) has been unable to keep handling her care on his own. We would help, but they live 400 miles away from us, and we’re still working.

His plan was to move them into a senior living community (just a 55+ community, not a CCRC), remodel the unit, and hire in-home caregivers as needed. He even added an extra bed and bath to their new unit so a caregiver could live in or sleep over.

That was the plan. It didn’t work, for several reasons. First, he only had minimal part-time care, about 15 hours a week. Then he had a medical emergency and had to be hospitalized for three full days, leading to a frantic scramble to get my mother-in-law’s care covered. This was a wake-up call for him that his Plan A (himself as primary caregiver with occasional relief shifts from the caregiving agency) was based on some very dubious assumptions—for example, that an 82-year-old man with a history of heart issues and cancer could handle the stress, mentally and physically.

After he got out of the hospital, he went up to nearly full-time in-home care, including most nights. This wasn’t great for my MIL because she was confused and upset by the rotating cast of strangers coming into her home. She’s always been a sweet and easygoing person, but some of the caregivers rubbed her the wrong way—too bossy—and she’d mix it up with them. What my father-in-law didn’t understand is that with a dementia patient, one size doesn’t fit all with caregivers. Some of the people the agency sent just didn’t know how to deal with her.

Most significantly, the in-home care cost a fortune. The agency charges $35/hour. For 24/7 care, that would come out to a whopping $25,000/month. They have a long-term care (LTC) policy for her, and it pays a little over $4600/month both for in-home and residential care. When my father-in-law realized he’d need up to $20K/month out of pocket to pay for the in-home caregivers, he finally had to admit this wasn’t going to work.

We found a memory care facility that he liked. It’s affiliated with a local church, and her childhood friend is part of that church and on the board of the home. It’s a good fit. Thankfully, they had an opening quickly, and she moved into a private room there on May 15. She’s adjusted well and seems happier and more peaceful than with the chaotic in-home care situation.

The cost for this residential care is $8300/month, so after the $4600 from the LTC policy kicks in, that is quite manageable for them.

We’ve learned a lot from observing and being involved in this situation from a distance. Aging in place sounds good to most people, but if you don’t have family support nearby and if your condition is challenging (like Alzheimer’s), it may be too much to handle while staying at home. Finding good caregivers is tougher than one might expect, and paying for it…yikes.


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