Senior Living Facilities vs In-Home Care Overview
Laura Herman, Dementia and Eldercare Professional
9 minutes read
Independent Senior Living
In a nutshell, senior living facilities offer care, companionship, community, and security while staying at home can feel more comfortable for those who highly value privacy, quiet, and autonomy.
Types of Senior Living Facilities
There are several types of senior living facilities, each with its own benefits and limitations.
Independent Senior Living
Seniors live without assistance in an apartment, house, or other dwelling located within a community of older adults.
- Benefits: Living in a neighborhood with easy access to social support. Some communities offer extra perks, like planned activities, transportation services, yard/home maintenance, a fitness room, or a community recreation center.
- Limitations: Personal and medical care is not included. Some senior communities limit visitors or which activities are allowed on the grounds.
- Costs: Approximately $1,500-$6,000 per month, depending on location and included services or amenities.
Group homes (sometimes called by other names like residential care, adult foster homes, or board and care homes) are small, homey settings for seniors who need staff assistance with personal care, meal preparation, and other activities of daily living.
- Benefits: A home-like environment with lots of opportunities to develop meaningful relationships with other residents and staff members. Staff assists with personal care and basic needs 24 hours per day.
- Limitations: Activities or support for medical needs may be limited.
- Costs: Vary based on factors like location and services included. Typically less expensive than assisted living, averaging around $3,500 - $4,500 per month.
Assisted Living Facilities
Assisted living facilities provide private apartments and shared common areas for residents to easily enjoy each others’ company. Staff is available to assist with personal care and other needs.
- Benefits: Residents live independently to a large extent, but staff is available to assist with personal care and other needs. Socialization with other residents is encouraged and supported. Transporation and other supportive services are often provided.
- Limitations: Can’t usually accommodate complex medical needs or extensive supervision for people with dementia.
- Costs: $4,500 monthly on average
Memory Care Communities
Memory care communities offer secure environments and specialized care for people living with dementia. Memory care is among the few settings that can accommodate significant wandering or exit-seeking behavior.
- Benefits: With the right support, people living with dementia can function at their best. Well-designed memory care environments and well-trained staff can support residents’ independence, reduce confusion, and minimize behavior challenges.
- Limitations: It can be hard to do memory care well, and you lose the benefits when it isn’t. People often resist moving to memory care due to concerns such as stigma or a reluctance to feel “locked up”.
- Costs: $6,935 per month on average.
Nursing homes offer the highest level of care available outside of a hospital setting. They’re able to accommodate the needs of individuals with complex medical needs and severely impaired mobility.
- Benefits: Medicaid covers long-term care in a nursing home more easily than in other settings. Nursing homes can meet the needs of most individuals, even when other types of facilities can’t.
- Limitations: People who need hospital-level care, or those with significant mental health concerns can’t be accommodated in most nursing homes. Some nursing homes can feel institutional or medical rather than home-like and residents may feel compelled to base their daily routines around the staff’s schedule. They can sometimes feel noisy or lack privacy.
- Costs: Average $7,908 per month (shared room) or $9,034 monthly (private room)
Life Care Communities
Life care communities (also called continuing care retirement communities) combine several of the other types of long-term care settings – independent living, assisted living, and a nursing home, for example – on one campus.
- Benefits: As residents’ health changes, they can receive most of the care they’re likely to need on one campus, with much less stress or disruption than it would take to find a new facility. They’re better able to maintain friendships as they age and experience changes in health because so many of their friends are still located right there on campus.
- Drawbacks: There’s often a large entry fee required to join a life care community.
- Costs: The entry fee varies quite a bit, but averages around $300,000. Life care communities use a variety of different contract types, which can greatly affect the overall charges. Learn more here.
Types of In-Home Care and Support
Remaining at home through the changes of aging is not without its challenges. Read more about the challenges of aging in place and whether it’s right for your loved one.
You may need to bring in additional support services, such as:
- House and yard maintenance assistance
- Meal services
- Care coordinators
Additionally, care services are available to assist with personal and medical care needs at home.
Home care aides can be hired privately or through a home care agency to come into the home to assist with a wide range of non-medical services, such as personal care, housekeeping, assistance with errands, and companionship.
- Benefits: Services and schedules are highly customized to your loved one’s preferences.
- Drawbacks: Home care aides usually do not assist with medical needs.
- Costs: Average $26.00/hour for agency-based home care. Privately paid aides usually charge about 30% less, but as the employer, you face hidden costs and exert a lot more effort.
Read more: Get the most bang for your buck with Strategic Scheduling in Home Care
Home health care provides certain kinds of physical therapy or medical care to a person in their own home.
- Benefits: Your loved one can receive the medical care or therapy they need in the comfort of their own home, without having to stay in a skilled nursing facility.
- Drawbacks: Home health is generally only provided on a temporary basis and under certain qualifying conditions.
- Costs: If your loved one qualifies, Medicare or insurance may cover some or all of the cost of home health.
Read More: What’s the Difference Between Home Health and Home Care?
Hospice and Palliative Care
Hospice and palliative care are invaluable supports for family caregivers.
Palliative care provides oversight and assistance to minimize symptoms of chronic disease to maximize the patient’s quality of life.
Hospice care provides support for the final stages of life – the last six months or so – and can make an enormous difference in how smooth and peaceful the dying process is for the patient and their family.
Both palliative care and hospice are generally covered by Medicare and other health care insurance. Any out-of-pocket that might remain is minimal and well worth it for the tremendous value they bring.
Nursing Home vs Home Care Costs
At $26/hr home care can become very expensive quickly. At this rate, round-the-clock care totals over $18,000 per month or $225,000 per year. Many home care agencies and private caregivers do provide a nominal hourly discount for 24-hour care, but the price tag is still staggering.
As a point of reference, nursing homes may start to become a more economical option than home care at around 350 hours per month (using the national average for a private room at around $9,100 per month) – although, of course, insurance, Medicaid, or other factors may also affect the final out-of-pocket costs.
Other types of senior living settings tend to be less costly than nursing homes – and aging in place in the comfort of home is invaluable for many – so there’s no single easy best answer for everyone. Weigh your loved one's needs, preferences, and financial options to determine the best choice for their particular situation.