As adults enter their golden years, many begin considering their options for retirement and long-term care. While many wish to retain their independence and live in their own home, ongoing medical concerns, mobility difficulties and deteriorating vision can make it unsafe for an older adult to live at home. For those who don’t want the hassles of home maintenance, assisted living may be a good option, while those who wish to remain at home might be happier with in-home care.

Determining which option is best for you, your spouse, or your loved one involves taking an honest assessment of your level of independence. A trip to the doctor for a thorough assessment of your health needs can also help when choosing a home health care service or assisted living.

In this guide, we explain what assisted living and home care providers are, including an overview of what each type of care provides. We also look at the costs for each and who should consider this type of care.

Assisted LivingHome Care
SettingSocialPrivate homes
Care ProvidedHelp with ADLs, Medication Management (Etc.)In-home assistance with ADLs, Medication Management (Etc.)
CostAverage of $4,300 per month in the U.S.Average of $4,481-$4,576 per month in the U.S.
Who Should Consider ItIndividuals who need help with ADLsThose who need help with ADLs and medical care but wish to age in place at home

Assisted Living

Assisted living combines apartment-style living with a social calendar and light personal care. Residents have private accommodations, and many places offer two-bedroom apartments or companion suites. The living quarters often have a small kitchenette for resident use. They’re designed with the mobility needs of seniors in mind, from open floor plans and larger hallways to grab bars and emergency buttons in the bathrooms. Maintenance, light housekeeping and linen services are often included with the monthly fees.

In addition to the home itself, assisted living communities also provide meals with nutritional needs in mind for residents and special meals for those with dietary restrictions, including low-salt, diabetic-friendly, vegetarian and Kosher. Often, assisted living communities provide snacks and sometimes have a coffee shop and a bar for happy hour celebrations.

The social aspect is one of the reasons many seniors opt for assisted living instead of in-home care. Activities directors schedule different events throughout the week, including games and music or drama programs, hobby group meetings of various interests, from woodworking to gardening, book clubs and arts and crafts. Holiday celebrations and birthday parties are often popular events. In addition to structured activities, assisted living communities also have various amenities for seniors to enjoy on their own or with friends. Fitness centers are popular, and many homes have fitness classes geared towards the elderly, such as Silver Sneakers, Tai Chi and chair yoga. Many places allow small pets, and seniors may choose to walk their dog on the community grounds. Pools, hot tubs and outdoor patios are also common amenities.

Residents in assisted living often need help with the activities of daily living. To accommodate this, professionally trained staff are on-site all hours of the day and night to help with bathing and grooming, mobility and escorts to meals or activities, lifts and transfers, feeding, using the bathroom, redirection and reminders. A trained nurse is usually available during business hours to diagnose illness, provide light medical care and oversee medication management.

The average cost per month for assisted living is $4,300, according to Genworth Financial’s Cost of Care Survey 2020. However, the costs for these homes vary widely across the country. In addition, within each city, assisted living fees vary depending on the amenities each provides.

Assisted living communities are best for seniors who cannot live independently on their own and desire a social living situation.

Homemaker and Home Health Care Services

Homemaker and Home Health Care services are in-home care options for anyone who cannot fully take care of themselves. Although both types of care are delivered in the home, they differ from one another, so we’ll look at them separately.

Homemaker Services

Homemaker services, or in-home assistance, includes personal care and help around the house. These agencies offer custom care plans for participants based on each individuals’ needs and capabilities. For example, some people may need assistance with personal care and grooming more than those in assisted living do but may have family or a companion in the home who can take care of household chores, running errands, and meal preparation. However, other people, especially those living alone, may need help with personal care and home care.

Homemaker services are booked by the hour, and individuals can pay for the number of hours they need each day. Some days, recipients may need more time if they have errands to run or a doctor’s appointment. Other days, the homemaker may come for an hour in the morning to help with bathing, dressing and preparing breakfast, and then again at night to help the individual get ready for bed and ensure they’re safe.

Many homemaker services also offer companionship for seniors who may otherwise be isolated. Companions can help with errands and may play games or read a book to their clients. The average hourly cost for homemaker services is $23.50, according to Genworth’s survey. Monthly costs, using an average of 44 hours per week, are about $4,481 per month. However, some agencies may charge more for transportation services, and the average hourly and monthly costs vary depending on the recipient’s location.

Homemaker services are best for individuals who don’t need medical care but need help around the house to safely and independently age in place.

Home Health Care

Home health care is in-home medical care administered by a licensed nurse or certified nursing assistant (CNA). Individuals who have chronic medical needs, a complicated medication management routine or who may need treatment several times per day need this type of care. Many of these service providers may work with the patient’s medical treatment team or require a letter from the doctor stating the patient’s needs and the type and dosage of all medications.

Home health care can help when an individual is recovering from surgery or a lengthy illness, so some seniors may not need the services after they’re healed. In-home nurses can also help with regular diabetic check-ups, such as blood sugar testing and insulin injections or maintenance of insulin pumps. People who have a feeding tube, are on oxygen or need medication through a port to treat a disease can also benefit from care services at home.

The average hourly cost for in-home medical care is $24. Using 44 hours per week as an average, the U.S. monthly average for in-home health care is $4,756. This type of care is best for those who don’t require a nursing home level of care and would prefer to remain in their own homes.


The decision to move into assisted living can be difficult. Some individuals may benefit from in-home services to help them feel a greater sense of independence. However, those without close family or friends may prefer assisted living, both for the social aspect and the supervision from trained staff members.