Seniors who need extra help with day-to-day tasks typically have two options: they can hire a personal care aide to help them remain in their own home, or they can transition to a long-term care community designed for older adults. Today, there are many options for seniors who want to maintain their freedom and independence while accessing medical care, physical therapy and other services as needed. Some things for families to consider include safety, comfort and cost. Additionally, the feasibility of these options depends on the level of care that’s needed.

In-home care includes medical and nonmedical services ranging from help with personal tasks to cooking and cleaning. Nursing staff can assist with more advanced needs, such as respiratory therapies and certain medications. Seniors who need around-the-clock monitoring, are prone to wandering or are too frail to live on their own may be better candidates for long-term care, such as assisted living, memory care or skilled nursing. These communities provide meals, accommodations and recreational activities in a social atmosphere that offers a variety of benefits for older adults. This guide will give you an overview of in-home versus institutional care, including what services are offered and average prices.

Home Care

Long-Term Care Facility

Setting

Residential

Social/clinical

Care Provided

Help with ADLs, errands and light medical care

Help with ADLs, skilled therapy and housekeeping

Average Cost

$4,957 per month/$26 per hour

$4,500-$7,908 per month

Who Should Consider It

Adults who need occasional assistance and want to remain in their own homes

Individuals who need access to 24-hour care or medical monitoring

Home Care

Home care is one of the fastest-growing sectors of the medical industry, and it’s easy to see why. According to surveys, nearly 80% of older adults say that they want to remain in their own homes. Home care agencies can make this possible. Plus, many in-home medical services are covered by Medicare, which is a bonus for those over 65. Disabled adults and seniors who have limited resources may be eligible for financial assistance through Medicaid.

Another advantage of home care is that it’s flexible. Seniors can request as much or as little assistance as they need. Home care aides are typically booked in four-hour increments, but it’s up to you if you want to have someone come every day, once a week or several times a week. Home care agencies can provide extended care, but this can become very expensive. Attendants can help with personal needs, such as bathing, dressing and grooming. They also prepare meals, pick up prescriptions and do light cleaning. Agencies that employ licensed or registered nurses may provide limited medical care, including help with IV medications, breathing treatments and wound care.

According to national data from the Genworth Cost of Care Survey, the average cost of in-home care is $26 per hour or $4,957 per month. Home health care services, which include more extensive medical support, average around $5,148 per month, or $27 per hour. Seniors must also factor in the cost of basic living expenses and home maintenance. In some cases, it may be more affordable and convenient for seniors to transition to a long-term care community. Home care can also be used to supplement the support that’s provided by a spouse or relatives. However, at some point, this level of assistance may not be enough, and a move to a long-term care facility may be the best decision.

Home Care

Home Health Care

Care Provided

Help with personal care, chores and errands

Medical monitoring, physical therapy and help with medications or medical equipment

Average Monthly Cost

$4,957

$5,148

Long Term Care Facility

There are several types of long-term care facilities depending on your needs. Licensing options vary by state, but here are a few of the most common types of care.

  • Assisted Living: These residential communities provide housing, meals and social activities for older adults. Residents receive assistance with medications and activities of daily living (ADLs). However, one-on-one care is typically limited to just a few hours a day.
  • Memory Care: Certain assisted living facilities are licensed to care for patients with Alzheimer’s, dementia and advanced cognitive needs. These facilities have additional security features, specially trained staff and specialized activity programs.
  • Skilled Nursing: Nursing homes provide 24-hour, physician-supervised medical care. These facilities are best for adults who are very frail or need skilled therapy and rehabilitation.
  • Continuing-Care Retirement Community: Many long-term care facilities offer multiple levels of care to accommodate a variety of needs. This also allows seniors and couples to stay in the same community even if their health changes.

Long-term care facilities range from luxurious villas with resort-like amenities to clinical facilities with hospital-quality medical equipment. Facilities are designed to meet residents’ daily needs, which vary according to the level of care provided. Each resident is assessed as part of the admissions process, and their plan of care is updated regularly. Assisted living residents typically receive three daily meals plus snacks, but they usually have access to their own kitchen or kitchenette. Memory care units and nursing homes don’t offer this amenity, but they still offer community meals and social activities.

Assisted living is a good choice for older adults who are living alone or want to downsize. Nearly 25% of seniors are socially isolated, which puts them at risk for a variety of physical and mental health conditions ranging from high blood pressure to dementia. Residential communities can minimize these concerns while giving residents access to around-the-clock assistance when needed. Seniors who don’t require any day-to-day help may be better candidates for independent living. Individuals who require help with multiple ADLs may benefit from an enhanced assisted living plan, or they may be able to obtain additional services from a visiting home health provider. Hospice care is also available through third-party agencies. In general, long-term care facilities are appropriate for seniors who require around-the-clock monitoring.

Assisted Living

Memory Care

Skilled Nursing

Setting

Social

Social/clinical

Clinical

Care Provided

Help with ADLs, medications and housekeeping

Assisted living services with enhanced staffing, security and therapeutic activities

24-hour medical monitoring, skilled therapy, physician-supervised care

Average Monthly Cost

$4,500

$5,625

$7,908

Frequently Asked Questions


How do you know what type of care is right?


If you’re unsure of the best way to meet your needs, speak with an options counselor at your local Area Agency on Aging. These services are free to disabled adults and seniors aged 60 and older.


What should you do if you need help paying for long-term care?


Financial assistance for long-term care is typically provided by Medicaid. Additional resources may be available through veterans organizations and nonprofits.


How can you find a qualified long-term care provider in your area?


Your state’s health care licensing agency maintains a directory of all long-term care facilities and home health providers. You can also use resources like Caring.com to find reviews of local providers.