Assisted living vs. home care: Which senior care option is better?

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Learn the differences between assisted living and home care, so you can make an informed decision on the best option for you and your loved ones.

Caregiver helping senior to get dressed

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Benefits of assisted living and home care for seniors

As people age, declines in their health can make it more difficult to perform daily activities, ranging from housekeeping and meal preparation to bathing and dressing.  Once people no longer can handle these activities on their own, it can be safer to get assistance from trained caregivers through either assisted living or home care.  This article will help you understand the differences between these two senior living options so you can make an informed decision for yourself or your loved ones.

What are assisted living and home care?

Assisted living and home care are similar in that they serve seniors who can mostly live independently, but need assistance with some instrumental activities of daily living (IADLs) and activities of daily living (ADLs).  Neither option includes medical care, which needs to be provided by medical professionals at a skilled nursing facility or a home health care agency.

What is assisted living?

Assisted living is a senior living community setting that provides a combination of housing, services, and personal care.

  • Housing:  Assisted living residents each live in an apartment-style unit that has been scaled down in size and features, but modified to be more physically accessible.  Many assisted living communities also provide shared common areas such as a dining room, activity room, exercise studio, patio, beauty salon, movie theater, or even physical therapy clinic.
  • Services:  Assisted living facilities offer services for many instrumental activities of daily living (IADLs). These usually include meals, housekeeping, laundry, group social and recreational activities, and limited transportation.
  • Personal care:  The key aspect that draws people to assisted living is the option to receive non-medical personal care for activities of daily living (ADLs) such as bathing and dressing from trained care professionals.  Residents also have access to on-call nursing staff and emergency help 24×7.

For people who want assisted living but prefer a more intimate home setting, there are residential care homes, which also may be called group homes, personal care homes, or board and care homes.  Residential care homes are typically private homes that have been converted to provide assisted living with fewer lifestyle amenities, but a higher staff-to-resident ratio so each person gets more individualized care and attention.

Another form of assisted living is respite care, which are short-term stays offered by some assisted living facilities.  This option is used by people who have temporary personal care needs, such as when recovering from surgery or a hospital stay.

What is home care?

Home care allows people to receive services and personal care in the comfort of their own homes. A home care aide typically visits for a scheduled shift of at least 3 or 4 hours, which could recur daily, biweekly, or somewhere in between.

Home care also can be provided to seniors who live in an independent living community.  While these senior communities already offer services such as dining, housekeeping, activities, and transportation, they do not provide personal care.  Some independent living communities even partner with a home care agency onsite; in this case, residents may be able to receive personal care services more economically in shifts as short as 15 minutes.

What’s the difference between assisted living vs. home care?

The key differences between assisted living and home care are:

  • Location:  Assisted living is delivered in a group community setting, while home care is provided in your own home.
  • Housing:  Housing, utilities, home maintenance, and repairs are provided in an assisted living facility, but not through home care.
  • Scale and personalization:  Assisted living facilities employ a staff to provide services and care at scale to many residents, while home care sends one caregiver to provide multiple services just for you.

Who should choose assisted living vs. home care?

Assisted living may be a better fit than home care for older adults who:

  • Need extensive or on-demand help with ADLs.  If someone needs assistance with toileting and transfers, or falls frequently, they will benefit from the 24×7 availability of caregiving staff.
  • Cannot update their homes for accessibility.  While a safe physical environment is important for all, it’s even more critical for people who rely on larger mobility devices such as wheelchairs.  They will benefit especially from the wider hallways and doors, lowered countertops and sinks, and ramps and elevators found in assisted living.
  • Want to live with others in a community setting in order to expand their social and support networks.  In the event of power outages, weather events, and other emergencies, residents can rely on onsite staff to help keep them safe, or even evacuate them to other senior living communities, if needed.

Home care tends to be a better fit than assisted living for older adults who:

  • Want to live in a private home environment, whether to stay in a familiar and comfortable long-time home, or to gain protection from COVID and other viruses because they are immunocompromised
  • Need only limited, scheduled assistance with IADLs and ADLs.  For example, bathing, housekeeping, laundry, grocery shopping, and meal prep are the types of care and services that easily can be batched up into prescheduled half-day shifts a few times a week for a home care provider.
  • Can remodel their homes for accessibility so they can age in place safely
  • Benefit from a strong support network where they live, both at home and in their neighborhood
  • Have ready access to transportation
  • Can manage home care providers or has a trusted person who can handle this
  • Or lives with a partner who is independent and does not need personal care.  In these situations, it can be difficult mentally and emotionally for that partner to reside in assisted living.  One possible compromise is for the couple to move to independent living and supplement that with home care services.  Another solution is for them to move to a continuing care retirement community (CCRC) or a community that offers independent living and assisted living combined.

For people who have advanced cognitive issues, need ongoing nursing care, or pose a danger to themselves or others, assisted living and home care generally aren’t sufficient.  They would be better served with home health care or in other long-term care facilities that provide a higher level of care such as a memory care community or skilled nursing facility.

This article, Assisted Living Vs. Home Care: Which Care Option Is Better?, has been written and published by Senior Wing.

Pros and cons of assisted living vs. home care

When comparing assisted living vs. home care, weigh the pros and cons below.

Pros of assisted living

  • Accessible housing, which provides safety and independence for people with mobility challenges, especially if they have larger mobility devices such as wheelchairs
  • Convenient onsite amenities such as a beauty salon, movie theater, pool, and therapy clinic (varies by community)
  • Full array of pre-arranged lifestyle services, including professionally prepared meals, table service dining, housekeeping, laundry, and limited transportation
  • Built-in community with organized social, recreational, fitness, and educational group activities
  • Flexible, on-demand personal care and emergency assistance provided by onsite staff and on-call nurses as needed

Pros of home care

If you or your loved ones receive home care in your own private home, these are the advantages:

  • Age at home in a familiar, comfortable, private, and more spacious environment that also provides better protection from transmissible illnesses such as COVID
  • Familiar neighborhood
  • Control over your lifestyle and home updates for accessibility
  • Continue living with other household members who don’t need personal care in an environment that also works for them
  • Select your own assortment of homemaker and personal care services and even customize them, such as requesting specific meals  
  • Deeper relationship and one-on-one care from your chosen in-home caregiver(s)
  • Deeper relationship and one-on-one care from your chosen in-home caregiver(s)

If you reside in an independent living senior community, the advantages of working with their onsite home care provider are slightly different:

  • No need to source and assess the provider, as the community already has vetted them
  • Receive services from onsite staff in convenient, affordable shifts as short as 15 minutes

Cons of assisted living

  • Disruption and stress of relocating to and living in a new, unfamiliar environment
  • Smaller apartment units with limited storage
  • Increased risk of transmissible illnesses in a group living environment
  • Community rules that may limit you in some ways, such as guidelines around pets, overnight guests, alcohol, and so on, depending on the community
  • Preselected lifestyle amenities and services, whether or not you make use of them
  • Predetermined menus, meal times, and dining styles, which may or may not align with your prior eating habits

Cons of home care

If you or your loved ones receive home care in a private home, here are the cons to consider:

  • Responsible for any maintenance and updates your home may need for safety and accessibility
  • Isolation in your home and neighborhood if mobility challenges make it difficult to get out
  • No onsite assistance in case of emergency, so you need to set up your own home and personal safety devices
  • Plan ahead and group your desired services into scheduled shifts, rather than getting help for each task on-demand
  • Hire and manage caregiving staff to provide your desired set of services and care
  • No group activities included

If you want to get home care services while residing in an independent living senior community, however, then none of the cons above apply.  They are all addressed by the nature of the senior living community itself.

Costs of assisted living vs. home care

Costs for assisted living and home care will vary based on geographic location, types of services and personal care provided, and quality.  When evaluating these two options against each other, however, make sure to compare apples to apples.  They differ significantly in these areas:

  • Housing:  Assisted living bundles in the cost of housing, utilities, home maintenance, and repairs, while home care does not.  To compare the two options fairly, remember to add these ongoing home-related expenses to your home care costs.  Also add in one-time remodeling costs if you need to modify your own home for greater accessibility, as well as the one-time move-in fee charged by the assisted living community.
  • Services:  Assisted living facilities provide a fixed set of services and lifestyle amenities for everyone (e.g. meals, housekeeping, activities, limited transportation).  If these amenities are valuable to you, account for their value when comparing assisted living against home care costs.
  • Personal care:  Assisted living charges a monthly fee based on the level of care needed by the resident. Home care charges based on total hours of care. Whether assisted living or home care is more expensive depends on how much help is needed.  If someone needs limited help with select ADLs, it will be more economical to continue living at home and get home care.  If someone needs extensive help for many hours a day, it will be more cost-effective to reside in assisted living.  These senior living communities benefit from the scale and efficiency of having a staff that provides care for many residents in one location. 

See specific costs nationwide and state-by-state in the Genworth Cost of Care Survey

How to choose between assisted living vs. home care

When deciding between assisted living and home care for yourself or your senior loved ones, focus on these key factors:

  • How much personal care is needed and whether it is needed on-demand
  • Which home accessibility modifications are required and whether you are prepared to manage them
  • Whether you or your loved ones can live in a communal setting vs. the strength of the support network at home and in the neighborhood
  • Budget

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