Assisted living convenient, costly

The Ingersoll Place assisted living facility on Consaul Road in Niskayuna is pictured Wednesday. Studies put the nationwide average cost of a one-bedroom apartment at an assisted living facility at $3,500 a month.

When living autonomously becomes difficult, moving to an assisted living residence can eliminate worries about household chores, transportation, personal care and even some medical challenges.

The residences often look like upscale hotels and offer many amenities, but they can also come with an unwanted extra: sticker shock.

The 2014 Cost of Care Survey, conducted by Genworth Financial, reports that the national median rate for a one-bedroom, single-occupancy assisted living apartment is $3,500 a month. New York state came in slightly higher, with a median monthly cost of $3,684. The study found rental cost in the Capital Region to be still higher, averaging $4,526 a month.

Figures in the Albany Guardian Society’s 2014-15 “Housing Options for Senior Adults in the Capital Region” contradict that, however. According to the society’s publication, base rates for single-occupancy apartments in local assisted living residences generally fall within a few hundred dollars of New York state’s average — some higher, some lower — but they can also rise well above it.

“Most assisted living [residences] provide all your meals, your transportation, outings, housekeeping, laundry, socialization, activities, all of those kinds of things. The prices start to fluctuate when you get into care, depending on your clinical issues,” explained Ruth Tietz, director of marketing and development at Baptist Health System.

Basic assisted living residences house people who are medically stable but may need help with toileting, bathing, grooming, dressing or eating. Residents need to be able to walk or use a wheelchair alone or with occasional assistance.

There are enhanced assisted living residences for those who need a slightly higher level of care. These are appropriate for people who need assistance with activities like getting out of a chair, walking, using the stairs or managing chronic incontinence.

Special needs assisted living residences — which provide the highest level of care — are meant for people with medical challenges like dementia, who must be in a secure environment and require a highly specialized care plan.

At the newly-built Judson Meadows facility in Glenville, run by Baptist Health System, someone who requires minimal care can rent a studio apartment with meals, housekeeping, transportation, Wi-Fi, cable and phone for about $3,900 a month.

The majority of the apartments at Judson Meadows are private pay — residents’ own resources pay for the care — but the facility also has 10 Assisted Living Program beds that are Medicaid-funded.

“We’re just in the process of screening applicants for those beds. There will be an extensive waiting list,” noted Tietz.

A basic assisted living studio apartment at Ingersoll Place in Niskayuna costs about $3,900. Included are amenities similar to those at Judson Meadows. All apartments are private pay.

The Home of the Good Shepherd basic assisted living facility in Saratoga Springs offers studio apartments, also with similar amenities, for $3,650 a month. They are also private pay.

“We do a sliding scale based on income,” noted CEO Denise Cote.

Paying more than $40,000 a year for room, board and help with personal needs can be a tough pill to swallow, and maybe an impossible one. Bill Ferris, state legislative representative for AARP, said he hears from many people who find the price of assisted living unaffordable.

“A lot of assisted living development in New York is private pay, and that means they don’t accept Medicaid or Medicare, so cost is very important,” he said.

Ferris said AARP is working to help shape state policy that will make assisted living more affordable.

Rick Iannello, executive director of the Albany Guardian Society, a foundation that works to improve quality of life for seniors, said he has seen a steady upward trend in assisted living prices. Every two years, the society publishes its directory of housing options for seniors that includes pricing and other information about facilities in the Capital Region.

“Institutional care is costly care, there is no question about it. Whether we’re talking about nursing facility care or assisted living care or adult home care, there are lots of costs involved in buildings. That’s the reality,” he said, ticking off some of the big expenses: heat, electricity, around-the-clock-staff, food service and maintenance.

Iannello said he believes the corporations that operate local assisted living facilities try to keep price increases to a minimum, so as not to price themselves out of the market.

“There are certainly new providers coming into the community and they are looking to capitalize on what they see as a growing elderly middle class population here in the Capital District, but it’s competitive. There are a lot of excellent providers who are already here, so new providers find it to be a competitive environment,” he said.

When considering a move to an assisted living residence, it’s important to find out what the base rent includes. Are meals, utilities and transportation service part of the price?

It’s also wise to inquire about whether different levels of care are offered, and if so, what the expense associated with an increase in assistance would be.

Judson Meadows offers tiered levels of assisted living care, so residents can age in place. Complex clinical care at the facility — for those with dementia or others who require specialized medical attention — could raise the rent as high as $8,650 a month.

That price is still nearly $7,000 a year lower than the average nursing home cost in the Northeast, which the state Department of Health estimates to be $110,544 a year.

“Tiered-level assisted living will never replace what a skilled nursing facility can ultimately do for someone, especially with end-of-life care, but it certainly can be a way to keep people out of nursing homes — skilled nursing facilities — that don’t need to be there,” Tietz noted.

Ingersoll Place includes a 17-resident special needs unit for people with memory impairments. Services include specialized dining options, cueing and hands-on assistance with daily living activities such as bathing, dressing, grooming and toileting. The monthly rent for a studio apartment in that unit is $5,351. There are no tiers or add-ons that could increase the price, said Ceil Mack, marketing director for the facility.

The Home of the Good Shepherd exclusively offers basic assisted living residences in Saratoga Springs, but the organization’s facility in Moreau offers enhanced assisted living for residents, including those who are on oxygen, need nebulizer treatments or colostomy and catheter care or have trouble ambulating. A studio apartment with that level of care costs $4,000 or $6,500 a month, depending on the level of care needed.

Planning ahead can help take the sticker shock out of shopping for an assisted living residence.

“Most people don’t spend a lot of time looking at this until they get to a point in life when they have to deal with it for one of their loved ones,” said Iannello. “I always tell people, ‘If you’ve got an older loved one who might require this care in a few years, it’s time to start becoming an educated consumer today. The more you know today, the better equipped [you’ll be] when that day comes when you may have to attempt to access those types of services. Planning ahead and knowing what your options are is the best thing you can do as a consumer.’”

Sandra Cross, director for the Saratoga County Office for the Aging, suggested talking to an Office for the Aging case manager about assisted living options. It’s also a good idea to call every facility of interest personally to learn about services offered and associated expenses, and to arrange a tour. Also, be sure to confirm the residence has been licensed by the state Department of Health.

Ferris advised building up a savings account and looking into long-term care insurance, which could help with assisted living expenses. He also suggested thinking about things that could make living longer at home an option, like hiring home health aides and adding improvements like wheelchair ramps and grab bars.

If that’s not a possibility, the home could be sold to pay for assisted living expenses.

“Think of how much maintenance goes into a home, even if your home’s paid for — taxes, maintenance, all that stuff,” said Tietz. “So, to be able to sell your house and fund a great style of living for yourself in the years that you most need it, it’s a great thing to offer yourself. That house is your asset.”