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Amanda Guerrero, Spring 2013 Students

Elder care: Cost and culture influence living choices for seniors

By Amanda Guerrero

Roughly 76 million U.S. seniors are faced with the question of where to live as they approach their later years.

Options range from in-home caretakers from companies like the Skylark Home Care to complete-care facilities, but the decision of whether of not to pursue specialized care can be influenced by cost, as well as cultural values.

The Rose of Poway is an assisted living facility for seniors with memory loss conditions. A staff of trained caretakers provides the facility’s six senior residents with meals, care and furnished rooms. In addition to receiving basic care, residents at the Rose enjoy activities such as exercising, solving puzzles and gardening.

Activities Director Hoang Hua said she enjoys getting to know about the residents’ hobbies so that she can tailor the daily schedule to suit them.

“I spend so much time with them one on one,” Hua said. “It really makes a big difference.”

Hua said she enjoys her job at the Rose, especially after working in a nursing facility, where she said she didn’t have enough time to get close to her many patients.

At The Rose of Poway, Activities Director Hoang Hua said she tries to help each of the six residents to maintain active and comfortable lives.

But affording this type of personal care can be difficult for many families, and others are uncomfortable with their senior family members living in facilities.

Paying to live in a residential assisted facility

The $3,400 monthly cost for a shared room in The Rose of Poway compares to the national average of $3,131 to stay in an assisted living community, as reported by data released by MetLife in 2010.

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Data from and MetLife

This is more than triple the national average monthly rent for an apartment, which Reis Inc. marked at $1,091 in July 2012.

Costs include meals and on-site assistance, but some simply cannot pay for the care. Facilities can also charge extra for additional levels of care. Medicare usually does not cover of long-term care options. Neither does Medi-Cal.

Expenses for specialized care total $36,000 on average. Even seniors who made more than the 2010 average median income of $20,388 would likely need additional funds.

Southern California senior placement agency specialist John Boucher works with seniors and their families to find suitable facilities they can afford.

“We take into consideration a person’s care needs and then we determine what their budget is,” Boucher said.

Despite his title as a placement specialist, Boucher said when it comes to finances, it’s best for seniors to maximize their time outside of facilities.

“I do encourage people to stay at home as long as possible,” he said. “If needed, you can hire licensed caregivers to come into the home.”

And there are services for seniors who don’t need serious levels of care. ElderHelp of San Diego is a nonprofit organization that helps seniors who can still live at home with “social services,” such as driving, grocery shopping and housekeeping.

“The goal is really to keep people out of facilities for as long as possible,” ElderHelp member services director Anya Delacruz said.

Cultural values within certain ethnic groups may be just as impactful as the cost of residential care, however.

Boucher said he’s noticed that most of the seniors being placed in residential care facilities are Caucasian. Delacruz noted a similar observation, saying the majority of seniors using ElderCare are Caucasian.

“We have really few Asian, black and Hispanic seniors,” Delacruz said. “It’s probably under 10 percent.”

U.S. sees increasing amount of multi-generational homes

While the cost for assisted living increases, so does the number of multi-generational households in the U.S., which sits at about 4 million. Although the umbrella term “multi-generational” encompasses a variety of living arrangements, the U.S. Census Bureau examined the three most common forms of multi-generational households:

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Data from the U.S. Census Bureau

  • Householder, householder’s parent/parent-in-law, householder’s child
  • Householder, householder’s child, householder’s grandchild
  • Householder, householder’s parent/parent-in-law, householder’s child, householder’s grandchild

The U.S. Census Bureau took a closer look at the 4 million multi-generational households in the country, breaking down the total by ethnicity.

Native Hawaiian/Pacific Islander households topped the list at 13 percent.

Non-Hispanic white homes rounded out the bottom at 3.7 percent, about half as much as mixed households, which was the second-smallest percentage of 7.6 percent.

Household income and race may affect likelihood of living in residential care facilities

Ethnic differences may contribute to certain seniors’ living arrangements, but money is still a deciding factor. Data from the U.S. Census Bureau showed that households with greater income were more likely to have at least one grandparent in the home for all races.

The likelihood in Asian homes with incomes of $100,000 was more than double any other racial groups. Conversely, Caucasian households were most likely to not have any grandparents, correlating positively with household income.

Data showed that grandparents lived in less than 12 percent of all homes. Asians and black households sat at roughly 14 percent each. Overall, Caucasian households were less likely than any other race to have grandparents as residents, regardless of income.

Poway residents Mark and Jody Campillo converted an extra room in their home to create a private apartment for Jody’s mother, Dorothy Morgan. Jody said Morgan moved out of need – but not because she couldn’t take care of herself.

“Our situation is very unique to others’,” Campillo said. “Most people find themselves with aging parents who need to be moved in.”

Rather, Morgan moved into the Campillos home so she wouldn’t have to commute to her daughter’s house every day to take care of her grandson.

Dorothy Morgan drove from her home in North Park to Poway to take care of her grandson. To ease the difficulty of commuting, Morgan moved into her daughter and son-in-law's home.

However, gerontology and sociology expert Vern Bengtson noted a “transformation” in multi-generational American households.

Bengtson proposed the idea that such households are becoming “increasingly important to individuals and families in American society,” as well as “increasingly diverse in structure and functions.”


About Amanda Guerrero

Amanda Guerrero is a copy editor for the Orange County Register. Guerrero has also worked at KPBS, Mira Mesa Living Magazine,, The Daily Aztec and The Seattle Times. She is a San Diego State journalism and media studies alumna who spends her free time reading, playing music or knitting.


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