In a perfect world, our loved ones would continue living at home as long as possible. However, as a senior’s care needs evolve, they may require additional support. Many family caregivers face the distressing decision of whether to hire in-home care or encourage a move to assisted living when a senior family member increasingly needs help at home.
Circumstances vary from family to family, and there are some instances where home care works out better than assisted living, and vice versa. As you grapple with the decision between assisted living and home care, consider what both care options have to offer, and note any similarities or differences.
Why choose in-home care?
In-home care is an increasingly popular option for seniors who need some extra help with daily tasks but want to age in place.
Home care services
Most home care agencies offer different types of care services, which include nonmedical home care and the medical-focused home health care.
Home care provides supportive services that don’t require medical skill, such as assistance with activities of daily living (ADLs) or household chores. Other nonmedical home services include:
- Laundry and light housework
- Meal planning and preparation
- Safe transportation to appointments or errands
Home health care, also called “skilled care,” provides medical support. Performed by health care professionals, such as a registered nurse (RN) or a licensed practical nurse (LPN), these services typically include rehabilitation or specific treatment following hospitalization or a sudden health decline. Home health care services are usually prescribed by a doctor.
Benefits of in-home care
Stress, guilt, and pressure can all take a toll on caregivers over time as an aging parent's care needs increase. In-home care can provide much-needed respite and support for families.
In-home care provides one-on-one attention in the comfort of home, while offering other benefits for seniors and family caregivers such as:
- The final say in the caregiver selection
- Flexible arrangements to accommodate different budgets, schedules, and care needs
- Additional oversight for evolving health or personal care needs
- Regular companionship and social connection
Cons of in-home care
While in-home care can help out with a lot of your loved one’s care needs, it may not be a perfect solution for everyone. Since care is being provided in a senior’s home, these factors will likely affect everyone involved:
- Families often have to make home renovations and safety modifications, such as walk-in tubs or grab bars.
- Families who hire an independent caregiver may have to step in to perform caregiving duties if the home care aide is unavailable.
- Services typically cost more as a senior’s care needs increase.
- Buying all personal care items and household supplies, in addition to the costs for in-home care aides, can become increasingly expensive.
Additionally, a senior who receives care at home may miss out on the socialization, activities, and community feel of an assisted living facility. Loneliness and isolation increase the risk of other medical concerns down the road, such as depression.
Why choose assisted living?
Moving a loved one into assisted living shouldn’t be seen as a failure or defeat on your part. In reality, you’re making good on your promise to ensure your loved one lives in a safe and supportive environment.
Assisted living services
Many assisted living communities offer the best of both worlds for seniors who want to continue living in a homelike environment and maintain their independence but can’t keep up with household chores.
Assisted living communities offer a maintenance-free lifestyle in a residential setting, where staff help residents with activities that have become more difficult with aging, such as:
- Personal care and hygiene
- Eating healthy meals
- Managing medications
- Getting to and from appointments and errands
Benefits of assisted living
Your loved one may consider moving to assisted living as a blow to their independence. However, assisted living communities actually encourage residents to enjoy as much independence as possible, while providing the support they need.
Most assisted living communities offer private and semi-private apartments with features such as:
- Full-sized kitchens or kitchenettes
- Dining and living room areas
- Private bathrooms, often equipped with safety features like accessible showers and grab bars
Assisted living communities make it easy to enjoy an active lifestyle with plenty of opportunities to enjoy socializing with others. Most assisted living communities offer an array of amenities, including:
- Chef-prepared meals in a communal dining room, though residents may opt to cook their own meals
- Housekeeping services and personal laundry
- Beauty and barber services
- Outdoor spaces with community gardens, courtyard areas, and walking paths
- Engaging activities, social events, wellness programs, and outings
Additionally, the move into an assisted living community offers some perks for family caregivers that aren’t available with in-home care, such as:
- Not having to make home modifications
- Avoiding the constant worry about keeping up with their caregiving duties
- Eliminating the need to schedule care or arrange for backup care
Assisted living cons
Assisted living isn’t appropriate for everyone. Moving is the main drawback, but some seniors in assisted living may also:
- Have difficulty adjusting to the new environment
- Feel overwhelmed by constant social interactions
- Experience less privacy or personal space, depending on the facility or accommodations
How to decide between assisted living and in-home care
Whether to move an aging parent into an assisted living community can be one of the most difficult decisions that caregivers face. Feelings of misguided guilt and memories of promising to never move them into a nursing home often emerge when someone struggles with this decision.
It’s important to set those feelings aside and objectively think about what’s best for your loved one. Is home care still the best option to meet their needs? Can your loved one afford to pay for increasing hours as their needs grow?
Additionally, it’s equally important to consider the effect that caregiving has had on you. Everyone has their own limits, and all too often they go unacknowledged and result in caregiver burnout.
Moving from home into assisted living
Helping a loved one continue living at home is admirable. Home care can help seniors remain at home for as long as possible. Yet, over time, your loved one's care needs may exceed what can be provided at home.
Moving into assisted living can be emotional for everyone involved, but sometimes it's unavoidable if it’s not safe for a loved one to live at home or if their quality of life is suffering.
The cost of assisted living vs. in-home care
It’s generally less expensive to receive care in an assisted living community than at home, but the cost of care can vary based on factors such as location and services provided.
Vary based on add-on services and amenities
Vary based on services and client’s needs
Both options accept private pay, but other payment options may be available, including:
Whether home care or assisted living is a better fit now, understanding the pros, cons, and services available with each option can help you make informed decisions as your loved one’s needs change. Planning ahead for the future can also make conversations about their long-term care wishes — and the transition into assisted living or other types of senior care — easier for everyone.
Genworth Cost of Care Survey 2021 (https://www.genworth.com/aging-and-you/finances/cost-of-care/cost-of-care-trends-and-insights.html)