Assisted Living vs. In-Home Care: Exploring the Differences

Making the choice in a loved one’s life about how they’re going to spend their golden years is a critical decision that is not to be taken lightly. These can be difficult for the family members, and something that needs to be planned for, not done in haste and at the last minute. In fact, there are several considerations to be made and needs to be thought through.  

What is the level of care that the senior needs? Is it the simple tasks of grocery shopping and running errands, or is it the administration of medications? Does the individual need help with hygiene assistance, or help with wound care or feeding tubes? These are the considerations that need to be made, and that will help in assessing and determining the direction of the care and what is best for the senior.

One also needs to consider what the senior is comfortable with and wants for themselves. After all, they’re going to be the one experiencing the situation, and their satisfaction is ultimately going to make the difference between a happy or an unhappy senior. We want someone who is going to be happy with their living situation, and not someone who is regretful about the choices they made. 

While there are other considerations to explore, let’s take a look at the differences between what we’re going to discuss today: assisted living vs. in-home care.

The main difference between the two options are the settings: assisted living offers a living situation at a facility where care and social activities are provided in a dedicated residential community, while in-home caregiving allows the senior to age-in-place at home and be around familiar surroundings. 

What Is Assisted Living All About?

According to the National Center for Health Statistics, there are approximately 41,465 assisted living facilities in the US, with about 1.4 million licensed beds. 84% of residents are aged 75 and older, and more than half are aged 85 and older. About 70% of residents are women. In addition, about 40% of residents live with Alzheimer’s disease or some form of dementia. 

Approximately 20% of US adults aged 85+ say they need or currently receive help with activities of daily living such as bathing, eating, and taking medications. Most residents of assisted living move in between the ages of 75-84.  

What does assisted living specifically offer to the residents? As a long-term residential care option for seniors, one of the main advantages to assisted living is that it allows the resident to retain their independence while receiving assistance with certain activities. This can do wonders for the senior’s well being and mental state! They don’t have to forgo many of the kinds of activities they were used to doing for a long time and keep a healthy body and mind. For many, keeping that independence can be the difference between having a great experience and an unsatisfactory one. 

Assisted living services can include:

• ADLs (Activities of Daily Living): This can include help with bathing, toileting, eating, and grooming

• Medication monitoring

• Around the clock 24/7 supervision and availability

While living in a unit such as a studio or a one-bedroom, the senior gets access to 

several amenities, including housekeeping and laundry services. It also offers access to other activities, including entertainment, dining, and transportation. 

Who is the ideal resident for assisted living? Someone that doesn’t require all the medical services that come with in-home healthcare or a nursing home. It is also that person that wants to retain their independence, but also one who doesn’t want to live alone and experience the isolation and loneliness that comes with it. There is something about having a community of like-minded people who enjoy socializing with others.

There is also the benefit of having 24 hour security that one doesn’t receive with in-home care. There are also emergency response systems, grab bars, and secure entrances. 

Another important thing to note is that assisted living does not offer skilled medical care. While some assisted living facilities have nurse’s aides or CNAs available overnight, other types of medical professionals are not available.  

So what are the costs associated with assisted living? The national median average cost is about $6,200 per month, which is $74,400 annually. This can run less than in-home care, and all depends on what part of the country you live in. 

So how does Medicare and Medicaid figure into this? Medicare and Medicaid don’t cover most assisted living costs, and don't cover non-medical care. However, they do cover home health services. They do need to be provided by a Medicare-certified home health agency in order for Medicare to cover them. 

Medicaid covers the costs of medical care and some types of long-term care for people who have limited income and meet other eligibility requirements, and varies by state to state. 

What are other methods of paying for assisted living? Many use private funds, long-term care insurance, life insurance, private insurance, retirement money, and veterans benefits. 

Depending on what the senior needs, such as more care overnight, it depends on what the community is licensed to provide. Certain regulations designate what services can be provided according to the state. 

Assisted living isn’t for everyone. Some may have no choice but to leave due to escalating concerns about one’s health, or maybe need a higher level of care. Others may find it more comfortable to go home and receive in-home care or healthcare. It is important to read the facility contract for move-out periods, as well as rules regarding care needs.

There’s also the mental state and desires of the senior to consider. Family members need to be aware and watch for signs from their loved one. Are they ready to move out of the facility? Do they want to leave the facility? What factors are important to them to make a healthy decision about their care? Should the decision be left up to family members?

How Does In-Home Caregiving Compare?

In-home caregiving offers a completely different experience than assisted living does. If a senior wants to age-in-place and feels more comfortable at home, then in-home care may be the better option. 

Many seniors have fond memories of their home life, whether that was having families and raising children, spending time on their hobbies, or having friends over for dinner. They may want to keep having family over or spend independent time with their friends without the setting of an assisted living facility. If this is the case, then in-home care may be the best option for them. 

So how does in-home care work? 

This situation is perfect for the senior who wants to keep their familiar surroundings, and only needs assistance for certain tasks, such as transportation, medication reminders, housekeeping, hygiene assistance, meal preparation, companionship, among other tasks. There is also the option of Alzheimer’s and dementia care if that is needed. 

Why should a senior consider in-home caregiving? A family member can determine whether their loved one should use in-home caregiving services. The warning signs they might look for include:

• When the senior has declining physical safety and mobility issues, such as recent falls and trouble walking

• Missing medications or confusion over prescriptions 

• Trouble with ADLs (Activities of Daily Living) such as bathing, grooming, and getting dressed

• Basic housekeeping tasks aren’t completed

• Changes in mood or memory

• Driving risks, such as delayed reaction times and unexplained car dents

Care plans are tailored to each individual and support whatever tasks are needed. These help with both physical and emotional support, and can make the difference between a happy senior or one that isn’t satisfied. 

In-home caregiving also provides the one-on-one, focused engagement that seniors need so often. You can’t receive that from a nursing home, since the other caregivers and medical professionals have to spend time with other residents. This is the nice component of companionship. The senior more than likely lives by themselves and would appreciate the added support of having someone to talk to. This also offers mental stimulation that is so important, especially in older adults. In-home caregiving can offer the needed companionship and engagement the senior wants. 

However, oftentimes the families need to consider costs of in-home caregiving. The financial impact can make the difference on selecting whether in-home caregiving is a feasible option. Monthly in-home caregiving costs can average about $6,436 (assuming 40 hours of caregiving per week). Part-time services (20 hours/week) are estimated at about $3,218 per month.  

If specialized care is involved, such as for those with Alzheimer’s or dementia, hourly rates can go up to $55/hour. 

Other Types of Care

What other types of care are available? It is specifically geared toward medical care, which include nursing homes and in-home health care. However, these types of care do require medical supervision. Nursing homes offer 24/7 skilled medical care and works just like a medical facility, while in-home healthcare operates just like in-home care but without the assistance of a professional healthcare provider.

Why do people consider options such as nursing homes and in-home healthcare? Usually it’s because of escalated health reasons and requires the supervision of a medical professional. 

With a nursing home, oftentimes the senior needs intensive physical, occupational, or speech therapy that requires advanced medical skills. There is also the required medical help available when it comes to handling complex health conditions such as diabetes or heart disease. Those seniors that require constant supervision when it comes to bathing, grooming, and other hygiene assistance when mobility is an issue is also available. Nursing homes also offer the needed support for those with Alzheimer’s or dementia-related issues. 

In-home healthcare also offers a good opportunity for the senior to be in comfortable surroundings while receiving the medical treatments they need. First, it alleviates the sterile and uncomfortable setting that comes with being in an institutional facility. It also decreases the likelihood that infection may occur with coming from a nursing home. 

Some seniors still want to retain the independence they were so accustomed to for many years, so being in an in-home healthcare situation would give them the best of both worlds, having treatment for their illnesses while also living at home. 

Which Is the Best Option?

Talking through options with family members close to the situation and early enough to make smart decisions is the best course of action. This will give the chance to know where everybody stands and ultimately, what is best for the loved one.