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Comparing In-Home Care and Nursing Homes

Ronnie Friedland
March 22, 2018

How to safely age at home.

Most elders would prefer to stay in their own homes, where they know their neighbors and can associate memories with each piece of furniture and object around them, rather than move to an institution as they age.

Things that can make "aging in place" -- the term for staying in one's own home as one ages -- problematic are tasks such as cooking, cleaning, toileting, shopping, doing laundry, and driving, as well as falls.

Support Systems

  • Help could come from family members, friends, or neighbors, who take care of the specific thing the elder has trouble with -- such as doing laundry or shopping.
  • Or, some elders turn to their religious community, as often there are volunteers willing to enable a senior to age in place.
  • Another option is to call the local Agency on Aging HIDDEN) to see if there are programs that help elders age in place. In some areas, "villages" have been created, whereby local merchants have banded together to provide the services seniors need to stay there, and seniors who pay a fee can make just one phone call to arrange for the necessary help.
  • Finally, in-home care can be hired to provide the extra help needed for the senior to be able to age in place. In some cases, expenses will be reimbursed by Medicare, but seniors will need to check with the home care agency to find out about this possibility. Care.com is a website that lists people throughout the United States who provide care to seniors, includes photos and descriptions of their experience, and does free background checks for members. You can search by zip code. For specific listings, go to Care.com.

Preventing Falls

  • Certified Aging-in-Place Specialists

    You can now hire a Certified Aging-in-Place Specialist -- someone who can assess a home to determine how to make it as safe as possible for a senior, and who can then make the necessary repairs. These specialists have been trained to add a wide range of safety features that can enable an elderly person to live independently. They can be found on the internet at CAPS by clicking on the Education tab, scrolling down to Designations, then selecting Certified Aging-In-Place Specialists.

  • Home Care Agencies

    Most home care agency employees have received training in how to assess a senior's home to determine what about it could pose a risk of falling. The senior would then have to make her own arrangements to have her home adapted.

  • How to prevent falls
    • Rearrange the furniture to create an unobstructed passageway into and around all rooms
    • Make sure no rugs or carpets bunch up or have frayed edges that could be tripped on, and that all rugs and carpets are securely anchored to the floor.
    • Install grab bars in the bathroom and railings in all stairwells
    • Add lighting so that all stairs, exits and entrances are well lit and pose no hazard.
    • Tape all cords to the wall.
    • Warn seniors to only carry very small loads in their arms, as larger ones could cause them to lose their balance.
    • Check footwear to see that the soles of shoes worn in the home don't stick to the carpet and are not likely to cause falls.
    • Reduce the number of medications the elder takes, as taking four or more can affect a person's sense of balance.

New Technology Can Help Seniors

  • Electronic devices are now available to help monitor whether or not a senior has taken his or her medication -- and if not, to remind the senior -- or to determine whether a senior has opened the refrigerator.
  • Emergency buttons can be worn around the neck and pressed if a health or other emergency should occur, in which case a person will speak to the senior through the device, assess the situation, and call for appropriate help.
  • Cameras can be installed to track a senior's movements, allowing adult children to monitor the senior and be assured that he or she is functioning well.
  • New devices are constantly being invented, and they can make an enormous difference in a senior's ability to age in place.

With all of these options available, aging in place is an increasingly viable choice. Seniors and their loved ones need to assess whether this alternative is indeed best, the risk being that the senior may become too socially isolated despite being in familiar neighborhoods and homes.

Helpful Links:


Aging in Place Checklists

Ronnie Friedland is an editor at Care.com. She has co-edited three books on parenting and interfaith family issues.

May 24, 2015

I have had the opportunity to see my Mother, brother in law and sister in nursing home care.or careless I might say. It is the worst thing I have ever witnessed. I pray God takes me before that happens to me. My Mother didn't know me when she said \

May 8, 2015

I'm glad I came across this website because it really helped answer some of my questions and give me some incite. My grandma lives at home by herself, and so my parents aren't sure on what they want to do with her. I personally think it would be nice to have someone come in to her home, and help her their. That was she always has someone around her to help her when is needed. And she is in the home she grew up in, which would be nice. Thank you for talking about how in some cases, expenses could be reimbursed by Medicare. That would help out a lot with money. So thank you for talking about this, you were a big help.

July 9, 2014

I would suggest in home care. I worked in a nursing home a few years ago. It amazed me how uncaring the CNAs, and other staff members treated those people.my Dad got really sick and worried that he would end up in one. I made him a promise and hard as it was working a full time job. I made sure he stayed at home and was taking care of. My mother in law was put in one. With out our input. It wasn't so bad for her, because she could do things for herself. If you have to put a parent or family member in one of those places. Please visit often and check you family. For bruises, and sores.

May 22, 2014

My only concern with home care is that often the house is not set properly for it.

Oct. 9, 2013

I would strongly recommand home health as a pose to nursing home. Ive seen patients go down hill quickly to being institutionalized and depressed. I think one on one care is the best simply because quality of care is important!

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