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What Is Custodial Care and How To Pay For It

What is Custodial Care?

Custodial Care is a form of long-term care that helps seniors with their activities of daily living (ADLs), such as bathing and eating. The word custodial is defined as care that someone without medical training can safely perform. This care is needed when seniors have medical, physical, or mental conditions that prevent them from performing ADLs on their own.

This type of care can be provided in a long-term care (LTC) facility or by home health aides. In both cases, caregivers might have medical training but this is not required to provide Custodial Care. Instead of medical services, they help with activities such as dressing, eating, and toileting.

Duties of Custodial Caregivers

Custodial Caregivers help assist with a variety of activities, including:

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  • Preparing meals and grocery shopping
  • Lifting and carrying throughout the home
  • Driving to and from appointments
  • Dressing and laundry
  • Using the toilet and bathing
  • Periodic turning and positioning in bed
  • Incontinence care
  • General maintenance of colostomy and ileostomy
  • Supervision of exercises
  • Routine care with braces and similar devices
  • Medicine management

Custodial Care vs. Companion Care

Although similar, Custodial Care and Companion Care do have a few differences. The main different is Custodial Care helps with day-to-day tasks, while Companion Care focuses primarily on social and emotional support. Although you might see some Companion caregivers helping with ADLs, this is typically not required. Due to higher level of care, Custodial Care is often more expensive.

Custodial Care vs. Skilled Care

Custodial Care and Skilled Care are quite different. Custodial Care consists of any non-medical care, whereas Skilled Care offers medically-necessary services. While Custodial Care is provided by someone with no medical training, Skilled Care is performed by a licensed professional who helps with physical therapy, wound care, intravenous therapy (IV), monitoring vital signs, catheter care, and more. Additionally, Custodial Care can be provided at home or in a nursing facility while Skilled Care, often more expensive, is found at home or in a skilled nursing facility (SNF).

If you are looking for care for a loved one, it is important to know which type of care they need. According to The California Little Hoover Commission, at least 30% of all Skilled Nursing Facility residents only require custodial care. Most of these residents are overpaying. To prevent this from happening to you, it is important to understand which facility type is best for your loved one.

There are a few reasons why patients with Custodial Care needs end up in Skilled Nursing Facilities:

  • Most consumers aren’t familiar with their options and end up overpaying as a result
  • Despite nursing homes having the highest staff-to-resident ratios, most families have the assumption that they provide the highest level of care
  • Medical typically won’t cover care in another setting so families relying on this coverage will be placed in a nursing facility

Before you choose care for your loved one, it is important to fully understand their needs and know all of their options. Senior Care Center offers free services that help you find the perfect care for your loved one. We assess your individual needs and find the best facility within your budget. Check out our services today!

Custodial Care Costs

Custodial Care can get expensive. This care is generally paid for using private funds or savings, however there are a few other options that might make it more affordable. Although rare, Medicare, Medicaid, and private insurance might offer limited coverage.

The cost of your care will vary depending on a few factors:

  • Will the care be full-time, part-time, or on an as-needed basis?
  • Does your loved one have a memory disorder that will require special attention?
  • Are you looking for an adult day care, in-home assistance, or a residential community?

All of these will play a role in the cost of your care. Typically, you can expect to pay anywhere between $1,500 and $4,100. The monthly averages in 2017 were:

  • $3,994 for homemaker non-medial providers
  • $4,099 for non-medical home health aides
  • $1,517 for adult daycares

Payment Alternatives

Custodial Care is expensive and rarely fits into family budgets. Depending on your situation, you might be eligible for limited coverage through Medicare, Medicaid, or private insurance. These will help minimize the costs to make the care more affordable.

Medicare will help those who need help with custodial and medical care. This insurance only covers custodial care if there is additional medically-necessary care provided. It typically only pays for the first 100 days in a Medicare-licensed nursing facility. Coverage is only considered when medically necessary, authorized by a licensed physician, and takes place within a certified skilled nursing facility (SNF). If your loved one doesn’t need additional medical care, they will not be eligible for Medicare.

Medicaid might help those who have already expelled their personal assets and savings. This program covers custodial care as long as it is provided in a nursing facility, but additional requirements vary from state to state. Unfortunately, to be eligible, beneficiaries are required to first pay for custodial care out of pocket. Medicaid only kicks in when all assets and savings accounts have been used first.

Long-Term Care Insurance (LTCI) offers the most custodial care coverage for those who can afford it. Coverage is set for a fixed amount of time and policyholders are reimbursed a specified amount for each day of custodial care. Additionally, this insurance can occasionally be combined with Medicaid to offer even more coverage. Although this might offer the best coverage, Long-Term Care Insurance is expensive and most families can’t afford it.

Is Custodial Care Tax Deductible?

If your loved one is in a nursing facility, a portion of their expenses might be eligible for limited tax deductions. Generally, only medical components of senior care are deductible. This does not include assistance with ADLs. If your loved one is provided custodial care with no medically-necessary care, they are likely not eligible for tax deductions.

For those with other medical needs, there might be some deductions available. Facilities are responsible for providing residents with information regarding what portion of fees are attributable to medical costs. These fees can be deducted as an unreimbursed medical expense only if the taxpayer chooses to item their deductions.

Requirements for medical costs tax deductions include:

  • The taxpayer itemizes his or her deductions
  • The resident must be certified as chronically ill within the last 12 months (Chronically ill residents are anyone who is unable to perform two or more ADLs without assistance)
  • Unreimbursed medical expenses must exceed 7.5% of the taxpayer’s adjusted gross income

Best Settings For Seniors With Custodial Care Needs

If you are looking for care for a loved one, it is crucial to research and understand their individual needs. Depending on these needs, there are different types of facilities that might offer the best care at the right price. By contacting Senior Care Center, you can remove the stress from this process and get matched with a nursing facilities that meets your loved one’s needs.

For Custodial Care, Retirement Homes or Residential Care Facilities (RCFEs) are the most popular. These are small family homes with 4 to 6 residents, which provide a higher level of medical care for patients with skilled nursing needs.

RCFEs have one staff member for every three residents while Skilled Nursing Facilities typically have one staff member for every 17 residents. The lower staff-to-resident ratio found in RCFEs allows for more personal care that is more beneficial to seniors with general Custodial Care needs.

If you are looking for Custodial care for you or a loved one, give Senior Care Center a call today. We will help you find the perfect home that provides the level of care you are looking for.

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