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The differences between assisted living vs. home care are extensive, so knowing what each entails is key when it comes to making the best choice for yourself or a loved one. In an assisted living setting, folks live in an apartment-like setting, where they receive help with daily activities of living (ADLs), explains Samantha Loy, owner of Always Best Care in Alamance and Guilford, North Carolina. “With in-home care,” she continues, “older adults receive support services in their house.”
The differences between home care vs. assisted living go beyond location, though. From price points to potential benefits, here’s what to consider when deciding between in-home care and assisted living.
Key takeaways
- Assisted living offers daily support and social engagement in a community setting.
- In-home care provides flexible, personalized help at home.
- Costs and care levels vary, so the best choice depends on individual needs, safety and budget.
What is assisted living?
Designed for folks who need some support with daily living, assisted living communities are a long-term care option for older folks who need personal care, housekeeping, transportation, meals and social engagement opportunities but who also value their independence.
“Assisted living is designed for seniors who need help with daily tasks like bathing, dressing or taking medications, but don’t require 24/7 medical involvement,” explains Macie Smith, a gerontologist at Synergy HomeCare, who adds that residents live in private or semi-private apartments.
Put another way: Assisted living communities are a medium between independent living and a nursing home.
Assisted living communities almost always put a heavy emphasis on included social activities and wellness programs, and some, Loy notes, offer memory care sections for those with dementia or significant memory impairment.
Assisted living communities typically conduct a comprehensive assessment before admission to determine the appropriate level of care and create a personalized care plan. The cost of assisted living is generally proportional to the level of care received.
Benefits of assisted living
One of the biggest advantages of assisted living is social engagement, which, studies have shown, is a significant determinant of subjective health among older adults. Social activities may include movie nights, group fitness classes and more.
“Social connection is a big benefit of assisted living,” Loy notes, adding that this is “especially true for older adults who may be isolated at home.”
Other benefits, according to Loy and Smith, include:
- Support with ADLs.
- 24-hour staff availability.
- Meals.
- Independence.
- Relief from home maintenance and chores.
“Assisted living also provides peace of mind for families,” Loy says, “knowing their loved one is safe and engaged in a supportive community.”
What is home care?
Home care, which can take on a variety of forms — companion caregiver, home health aide (HHA), nurse — is support that’s provided in an adult’s existing home. “It can range from a few hours a week to 24/7 support,” notes Smith.
Benefits of home care
Since home care support can look different for everyone, benefits are subject. That said, overall advantages, per Loy, Smith and Todd Houghton, president and CEO of Homewatch CareGivers, include:
- Ability to age in place.
- Help with ADLs.
- Customized schedule
- Adaptable support.
- One-on-one attention.
- Relief and peace of mind for family caregiving members.
For individuals with dementia, mobility issues or complex routines, Loy notes that in-home care may be a good choice, as it can “reduce confusion, anxiety and falls.
Cost of assisted living vs. in-home care
When it comes to the cost of assisted living compared to the cost of home care, assisted living is typically more expensive — particularly if you’re only utilizing the latter part-time or intermittently, “due to bundled services, amenities and facility overhead,” Houghton notes. (Residents can’t use assisted living on a part-time basis.)
That said, a variety of factors, including location, scope of service and hours worked, can affect the price of either. “The median monthly cost of assisted living, which includes housing, meals and basic care services, is around $4,500 to $5,500,” Loy says. “But additional services, such as incontinence care and medication management, may incur extra fees.”
In-home care, on the other hand, is typically billed hourly, she continues, and rates range from $30 to $35 per hour. For someone needing, say, 20 hours a week, that’s around $2,000 a month. But 24/7 care at home can exceed $15,000, which is often more than assisted living.
It also bears noting that Medicare does not cover either assisted living or in-home care costs.
Assisted living vs. home care: How to choose what’s right for you or a loved one
Choosing between assisted living and home care is a big — emotional, physical and financial — decision, so it’s important to take stock of the big picture. “The answer ultimately comes down to lifestyle, safety, budget and health needs,” Loy says.
Here are a few questions, per Loy, to consider before making a decision:
- Is the aging adult safe at home? Look at mobility, medication management, fall risk and isolation.
- What’s the level of care needed and how often? Do they need occasional support or 24-hour supervision?
- Is family nearby and available to help? If not, assisted living may be a better choice, as someone is always available.
- What does the senior want? Consider their preferences and comfort with change.
- Is the aging adult isolated? “Assisted living communities can be a social lifeline, if so,” Loy notes.
- Financially, what’s sustainable? “Run the numbers for both scenarios,” Loy says. Don’t just compare monthly costs, but also look at long-term projections.”
It’s also smart to consider potential future needs, notes Houghton. “In-home care can often scale with the individual, from basic assistance to more specialized support,” he notes. “However, if complex medical care becomes necessary, transitioning to a facility with more comprehensive services might be required.”
Do your research
Once you’ve zeroed in on which living option works best, your work isn’t done. “It’s important to visit assisted living facilities and see how you or your loved one feels about it,” notes Smith. “Talk to staff and other residents and see how they like it. Similarly, when choosing in-home care, do your research and ask questions about what services they offer and if they can tailor to your specific situation.”
And keep in mind: Your decision may not be permanent. “Some families start with home care and transition to assisted living later in life,” says Smith. “Overall, the right choice is the one that supports their personal well-being, safety and quality of life.”
