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Comparing in-home care and adult day programs

Robyn Carlyle
June 5, 2018

Nearly half of all older adults need at least some kind of help with everyday activities, according to a 2014 investigation by researchers at the University of Michigan. Whether it’s having someone on hand to assist with cooking, to take their arm as they get out of a chair or to help keep track of their medications, many seniors rely on others to help them navigate daily life. Relatives often step in to provide the brunt of this care, but when they need to work during the day or are managing other stresses, many families turn to alternative care options like in-home care and adult day programs for support.

In-home care involves having a caregiver come to your loved one’s home to help with a wide range of tasks, including personal care, such as bathing, dressing, cooking and medical care. How frequently the caregiver visits and what they do while they’re there depends on the needs of the individual senior. Adult day programs, on the other hand, are places where seniors can go while their regular caregivers are at work or are otherwise occupied during the day. These programs are specifically designed for older adults and often host classes and activities, provide meals and in some cases administer medical care.

Deciding whether to go with in-home care or adult day programs will depend a lot on the level of care your loved one will need and what your family can afford. Here’s what you need to know when weighing your options.

In-home care

What is it?

One of the biggest benefits to in-home care is that the amount and type of care provided can be personalized to each individual. Support can range anywhere from a full-time or live-in caregiver to one who visits only a few hours a month. For more independent seniors, nonmedical caregivers can assist with daily tasks like cooking, cleaning or bathing, while adults with chronic conditions or other medical needs might benefit from trained health caregivers, often known as visiting nurses, to administer medicines, check vitals or deliver other types of medical care.

Costs associated with in-home care

The cost of in-home care will vary widely based on how often the caregiver visits and whether they have advanced medical training. A live-in nurse will cost significantly more than a companion caregiver who comes by for a few hours every two weeks, for example. Typically, caregivers are paid hourly, though in some cases families might negotiate a fixed rate for each month. For full-time care, in-home caregivers generally are more expensive than adult day programs and even assisted living facilities, but it can still be an economical option for seniors who need less frequent care (fewer than 40 hours per week) or who live in inexpensive areas.

What to consider when weighing in-home care

Besides cost, a downside to in-home care is isolation. A number of studies have linked social isolation and loneliness with physical and mental decline in older adults, and having a caregiver visit or live inside the home can sometimes mean fewer opportunities to socialize or sustain relationships in the community.

Adult day programs

What is it?

Adult day programs (sometimes referred to as adult day care) provide a safe, interactive space for seniors to go during the day—sometimes at a fraction of the price of in-home care. For more medically vulnerable adults, adult day programs can delay the transition to an assisted living facility, which also helps save money.

These sites are specifically tailored toward older adults and can assist with a wide range of personal care tasks, including medication management or grooming. Some centers take it one step further and also offer computer classes and other kinds of trainings, as well as counseling or specialized medical care for those with advanced medical needs like dementia. They also provide opportunities to socialize, which can be a huge benefit of day programs over in-home care.

Costs associated with adult day programs

Like many other senior care options, the price tag for adult day programs can vary based on location and the level and intensity of care needed. Relaxed programs primarily geared toward social activities will be less expensive than highly specialized dementia care, for example. That said, adult day programs are often the cheapest option available for full-time care in many areas, costing significantly less than an assisted living facility or in-home caregiver.

Considerations when weighing an adult day program

Adult day programs tend to be less expensive and more accessible for many families, but they come with a tradeoff. While employees at these types of facilities are often highly trained and experienced in caring for older adults, one-on-one time with staff is limited, making them less than ideal for adults needing highly individualized care.

In-home care vs. adult day programs

Loved ones who need more one-on-one or highly specialized care might fare better with in-home care, but it can get expensive if caregivers are needed for 40+ hours a week or require medical training. Adult day programs are typically much cheaper than full-time, in-home care, but one-on-one time is limited.

While some centers offer specialized care for those with health concerns like physical disabilities or dementia, these programs are often better suited for adults who need only a mild or moderate amount of support or are simply looking for opportunities to socialize.

 

In-Home Care

Adult Day Programs

Accessibility

Available 24/7

Open during business hours only

Social Opportunities

One-on-one interaction with the caregiver only

Opportunities to interact one-on-one and in groups with other seniors

Independence

Type and frequency of care can be customized to the independence of the senior.

Programs are typically for adults who would benefit from mild to moderate supervision or care but are otherwise mostly autonomous.

Medical Care

Health caregivers are available to provide many levels of medical care.

Specialized centers are available, but otherwise medical care provided is  typically minimal.

Average Cost*

$21/hour

$72/day

Insurance

Many insurance plans cover in-home care, at least in part, if it is medically necessary. Nonmedical care may be available for low-income seniors through Medicaid.

Adult day programs are not often covered by insurance, though Medicaid might provide partial coverage for low-income seniors, depending on location.

*Costs are national averages from the American Elder Care Research Organization. Actual cost will vary by location.

Read next: How to choose an adult day center

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