To Place or Not to Place, That is the Question

The decision to move to senior living involves a variety of factors based on several circumstances, including finances.

Professionals across the country have different answers to the question of whether “to place or not to place” a loved one in senior living. Some feel that older adults should stay in their home with paid caregivers. Others think that older adults would receive enhanced care and retain a higher quality of life if they were with others their own age, with more activities and socialization.

The dilemma of why someone should move into assisted living can be mutually exclusive to making the actual decision in the first place. Family members can have all the reasons in the world their loved one should make a move, but that doesn’t mean they make the decision to place their loved one. Family members must find a balance between safety, finances, and common sense to make the decision that is right for them.


One study concluded that there were four distinct decision-making styles when it comes to deciding to place a loved one. These categories included Scramblers, Reluctant Consenters, Wake-Up Callers, and Advance Planners.

Families who utilize the expertise of a placement agent usually populate the Scramblers and Reluctant Consenters category types.

■ Scramblers are usually in a crisis situation resulting from a serious injury or a quick onset of an illness or disease. A sudden fall, stroke, or worsening of a pre-existing condition, along with the added pressure of a pending hospital discharge, can make the family feel the need to quickly find a senior living environment.

■ Reluctant Consenters are older adults who are “pushed” to make the decisions due to a noticed decline in their ability to function independently — perhaps because of a health condition. These older adults may not have been victim to an acute onset of issues, but a more constant decline of functioning from conditions like emphysema, heart conditions, dementia, or Alzheimer’s disease The family and the older adult may have noticed the decline for some time before any intervention was discussed.

■ Wake-Up Callers are usually victims of a “near-miss” situation. A severe fall may have kept the older adult on the floor  for hours, even without a fracture, for example. He or she may have suffered from dehydration or mild confusion resulting from the fall itself. This group tends to wait until several “wake-up calls” are received before making the final decision to move into senior living. This group is usually the target group for in-home caregiving services.

■ Advance Planners are those who have researched long-term care options for many years while they were very healthy. They have strategies for “if ” scenarios and are ready and committed to making the needed changes on the fly.


It is essential to know how today’s older adults feel about where they prefer to live as they age. A 2019 Harris Poll  concluded that attitudes have changed regarding senior housing over the years. Back then, an AARP study (2012) revealed that nine out of 10 older adults wanted to stay in their own home as they age. The recent Harris Poll showed that the percentage feeling the same way now about aging in place has dropped significantly.

Twenty-four percent of those polled reported that they prefer to move into an assisted living community at some point, rather than continue living in their own home. A startling finding was that only 5 percent indicated wanting to live with a family member. The lowest findings (1 percent) preferred a nursing home or the services of an adult daycare center.

Fifty-eight percent of respondents reported the reason for choosing assisted living was due to the professional care services offered. Other reasons published included not being a burden on families, wanting a familiar, consistent surrounding and the affordability of the care received.

Understanding the differences in decision-makers and older adults’ preferences is essential. Finances living due to medical reasons require at least eight to 24 hours of supervised or hands-on care daily.


At eight hours of private duty services at $25 to $28 per hour, families can expect to pay $200 to $250 per day, or about $6,000 to $7,500 monthly, to maintain a safe and somewhat independent environment at home. The 2019 Genworth Assisted Living Cost study (2019) showed that the average cost of assisted living nationwide was $4,051 per month. In-home caregiving services can cost 33 percent higher in cases that need more hours of supervision.

While some older adults have long-term care insurance that pays for private-duty caregiving services, many of these  policies have lifetime caps. This means that once the capitation lifetime rate is achieved, the long-term care insurance coverage stops, and actual private pay begins. It’s also true that depending where the older adult lives, care can cost much more than the insurance policy covers from the get-go. A policy may cover as little as a third of costs.


Understanding the finances behind senior living compared to staying at home is important when comparing dollars; the next dilemma is considering when a move makes sense. The most common reasons to make a move to senior living rather than staying at home with a paid caregiver are:

• Living alone and needing supervision and hands-on assistance with everyday activities, like showering, getting dressed, personal care and housekeeping.
• Meal preparation and proper nutrition is crucial to maintain an older adult’s health. When someone has difficulty cooking, preparing, or making healthy choices when it comes to nutrition, it could be a wake-up call.
• Medication management is vital, especially the more medications an older adult takes. Older adults who are hypertensive, diabetic or have other conditions can have serious health complications if their medications are forgotten or not taken on a timely basis.
• Loneliness and depression should be taken seriously. The recent death of a spouse can cause loneliness, depression and a need for companionship. Even if a spouse passed away years ago, depression could be caused by regretting plans that never happened. Assisted living holds with it the opportunity for a variety of activities and socialization.
• Health-related issues are the reasons for a move for Scramblers and Reluctant Consenters. Arthritis, failing eyesight, and a whole host of health-related deficits can make living at home a potential crisis.\

Referral and placement agents with the CSA® and CPRS credentials are overwhelmingly qualified to help families during their decision-making process. Their knowledge of local community care options makes their expert guidance invaluable. Referral and placement agents work with no cost to family members and are available nationwide. Families, as well as professionals, can find qualified and certified agents at and

In conclusion, the question “to place or not to place” is a significant decision for families and older adults to make. In a perfect world, families have time and will include their loved ones on all decision-making. However, life doesn’t always go as planned. Knowing the signs that extended care is needed, as well as the cost, can make the journey of long-term care easier. Getting advice from a qualified placement agent with professional credentials can make the transition into senior living a safer and easier route to take.

This article has been provided courtesy of the
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