Q. I would like know what the cost difference is between nursing homes and a companion service where someone comes in the home, cooks, cleans and helps with other things around the house. I work for "Home a Better Place", a non-medical in-home companion service and every time I see a report, it seems the cost of nursing homes continue to rise. Could you help me out with any information?

A. Your question addresses a very important public health problem, providing quality care for an aging population. Current figures show there are over 6 million persons age 65 and over who need long-term care. Half of those over age 85 need some assistance with activities of daily living. The costs for providing such care varies widely in different states and locales.

The national average cost for 1 year in a nursing home is $65,000 ($168 per day), and the average length of stay is over 2 years! The range of costs is $88-347 per day. Average cost for an in-home health aide is $18 per hour (range @12-27) with a lot of variation by location. It is generally in the patient's best interest to stay at home if practical, and if resources are available, and finding good quality assistance is a challenge for many.

http://www.aoa.gov/NAIC/Notes/nursinghomes.html

Nursing home average monthly charges per resident and percent of residents, according to selected facility and resident characteristics: United States, 1977, 1985, 1995, 1997, and 1999 (National Center for Health Statistics, U.S. Centers for Disease Control)

http://www.cdc.gov/nchs/products/pubs/pubd/hus/tables/2001/01hus123.pdf

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