Aging in Place – Know Your Housing and Care Options: 8-1-26 Podcast

Real Estate Matters has been the voice of real estate in Palm Coast and Flagler County, Florida, for more than 12 years.

Only 66% of U.S. residents age 65 or older have a will. 64-72% have advance directives and living wills. Only 15% have long-term-care insurance.

But the largest common denominator is a near-total lack of knowledge about available options. You cannot plan for what you don’t understand. I hope today’s topic opens your eyes.

Watch the Podcast and read the Show Notes below for more details.

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Be sure to check out the continually updated interactive Flagler County Map of Developments and Subdivisions.

Raw Show Notes

Our behind-the-scenes guide to the show’s flow, including topics we didn’t have time to get to on the show. This is raw and likely contains typos. Data reflects the date the show was recorded.

Show Notes for 8-1-2026

Recorded 7-30-2026

Welcome to the tranquil side of Florida. This is Real Estate Matters, the voice of real estate in Flagler County and Palm Coast for more than 12 years.

I’m Toby Tobin, publisher of real estate news website, GoToby.com, and a Florida-licensed Realtor with Grand Living Realty. I’m joined by Co-host Annamaria Long from the Flagler Homebuilders Association, one of our sponsors.

Thanks to Our Sponsors:

• Flagler County Home Builders Association
• Hammock Community Church – On A1A in The Hammock – Small enough to know you but large enough to serve you. North of the toll bridge with the message sign out front. It’s not just for Hammockians. Like me, many people cross the bridge.

Guest: Christine McGrath: Oasis Senior Advisors

July MTD results as of 7-24):

• Homes sold: 215 with 64 DOM vs 230 with 60 DOM
• Median price: $370,000 vs $358,445
• Less than $250K: 9 sold, 5 for cash, 17 DOM
• $1M+: 9 sold, 7 for cash, 113 DOM
• Listings: 1,124 vs 1,438.
• Pending sales: 385 vs 294. Pending list price $386K
• GINNdex: 2.9 vs 4.89
• Price increases in the past 7 days: 5
• Price decreased in the past 7 days: 104
• New listings in the past 7 days: 84
• New sales in the past 7 days: 61
• New pending sales in the past 7 days: 95

Main Topic: Aging in Place

You may not be a senior yet, but your parents are. You may be an active adult, but that will inevitably change. I’ll bet you have not thought about it enough.

As many of you know, I lost my wife in February after her long bout with Alzheimer’s. Life throws curveballs. We don’t always get to live the life we plan. We live the life we are given. My years in Palm Coast started more than 26 years ago when Shirley and I built our final home, a new pool home in Grand Haven. We were “active adults.” Today, my wife is gone, and I’m living in my third final home. It’s currently for sale as I navigate my remaining years. This person, who once single-handedly built a two-story addition to his house, must ask a friend to change a light bulb.

I have learned that:

• Grandchildren grow up. They get married. They begin careers. They aren’t interested in visiting grandparents in the summer anymore.
• Dot com and real estate bubbles can wreak havoc on accumulated wealth. So too can medical crisis and long-term senior care.
• Everyone’s late-life journey is different. Some of you will encounter fewer bumps in the road. Others will find more than I have, but most of us did not plan well for life’s final stages.

Only 66% of U.S. residents age 65 or older have a will. 64-72% have advance directives and living wills. Only 15% have long-term-care insurance.

But the largest common denominator is a near-total lack of knowledge about available options. You cannot plan for what you don’t understand. I hope today’s topic opens your eyes.

Christine McGrath is affiliated with Oasis Senior Advisors. She helps simplify the search for senior care, including residential options ranging from assisted living and independent living to skilled nursing and memory care.

Where do we go from here?

• What are the differences in level of care and costs?
• Do we have enough care facilities locally? What are we missing?
• Besides healthcare providers, what other special services should I seek? Legal, financial, emotional support, household help?
• What does Medicare cover? Medicaid?
• Does everyone have a planned caretaker?
• What should caretakers expect?

Comparing charges between residential home care facilities (such as Adult Family-Care Homes or small 6-bed ALFs) and traditional large institutions (large-facility ALFs or skilled nursing homes) involves examining pricing structures, what is included in the base fee, and overall monthly costs.

Cost Overview: Residential Homes vs. Traditional Institutions

Facility Type	Average Monthly Cost (Florida)	Care Ratio & Setting	Key Financial Characteristics
Adult Family-Care Home (AFCH)	$2,500 – $4,500	1 caregiver to 2–5 residents	Highly all-inclusive; low overhead translates to lower base rates.
Small Residential ALF	$3,500 – $5,500	~1 caregiver to 6 residents	Mostly flat-rate billing; includes high level of personal attention.
Large Assisted Living Facility	$4,500 – $7,000+	1 caregiver to 15–20+ residents	Lower base rent, but uses tiered care add-ons that drive up final costs.
Skilled Nursing Facility (SNF)	$9,000 – $12,000+	24/7 medical supervision	Highest cost; strictly for complex clinical and medical care.

Key Drivers Behind the Cost Differences

1. High “All-Inclusive” Value vs. Tiered “A La Carte” Fees

• Large Traditional ALFs: Often advertise lower initial “base rent” (e.g., $3,500/month), but charge extra for point-system care levels. Adding help with showers, medication administration, or escorting to meals can quickly push monthly bills over $ 6,000.
• Residential Care Homes: Typically use flat-rate, all-inclusive pricing. Because caregivers are already right there in the house managing a small group, help with bathing, dressing, meals, and medication management is usually built directly into the flat monthly fee.

2. Physical Overhead & Capital Expenses

• Large Institutions: Must support massive physical infrastructure—elevators, commercial kitchens, sprawling grounds, swimming pools, event staff, and administrative teams. These amenities drive up overhead costs per resident.
• Residential Care Homes: Operate out of standard single-family residential properties with standard utility bills, allowing operators to keep base room-and-board charges lower while concentrating resources on direct care staff.

3. Staffing Ratios & Personalized Care

• While a large institution might have a high total headcount, the staff-to-resident ratio during a shift can easily be 1 staff member for 15 to 25 residents.
• In a 5- or 6-bed residential care home, a single caregiver oversees just a few residents. To get that same level of 1-on-1 supervision in a large institution or via in-home aides (which run $30–$35+/hour in Florida) would be prohibitively expensive.

How Payment & Funding Options Compare

• Private Pay: The vast majority of small residential care homes rely on private family funds or private long-term care insurance (LTCI).
• Medicaid Long-Term Care (SMMC-LTC): Florida’s Statewide Medicaid Managed Care program can pay for care in licensed small residential ALFs or AFCHs for qualified low-income individuals. However, Medicaid generally covers only the care services portion, while the resident (or family) must still cover the basic room and board fees.
• VA Aid & Attendance: Veterans and surviving spouses can apply this tax-free benefit (often providing up to $2,000–$3,000+/month) directly toward small residential care homes.

Bottom Line: Small residential care homes are often 15% to 30% more cost-effective than comparable care tiers in large institutional facilities, while offering significantly higher staff-to-resident individual attention.

 Wrap-up:

Video podcasts of Real Estate Matters are available on GoToby.com. Click on Podcasts on the top navigation bar. Show notes are included so you can see what we didn’t get to on the show. Also, on GoToby.com, the Flagler County Interactive map of residential developments and subdivisions is updated regularly. Currently viewed over 11,000 times.

Let me be your consultant, at no additional cost to you. Owners’ associations and Florida’s property tax system are largely misunderstood by buyers and sellers, leading to undesired outcomes. I have served on homeowner and condo association boards and a CDD commission. I served for more than ten years on the Flagler County Value Adjustment Board. I understand the world of deed-restricted communities.

If you are thinking about buying or selling property in Flagler County, call me first. Based on your goals, I’ll connect you with an appropriately qualified Realtor or builder and serve as your consultant throughout the transaction, at no additional cost to you. Call me at 386-931-7124 or email me at Toby@GoToby.com.