Home Care versus Assisted Living

What are the options when considering Home Care versus Assisted Living?  Many people consider assisted living to be the primary choice for seniors who need assistance with the activities of daily living.  However, home care is a viable alternative for many people.  The short article below helps to compare the two options.

Assisted Living

Assisted living provides a room, meals, personal care, and housekeeping services to seniors within a residential setting.  However, each resident shares their caregivers, nurses, amenities, and perhaps even their room(s), with other residents.  The purpose of assisted living is to help adults live independently in a safe environment.  The types of assisted living fall between an independent living community and a nursing home, in terms of levels of care offered. A typical assisted living home might offer 24-hour personal care monitoring and medication administration or bathing, while providing more freedom and privacy than a nursing home.

Characteristics of Assisted Living

The physical characteristics range from a house or small building with just a few beds to a large senior living campus with multiple buildings and hundreds of beds.  Most senior living facilities offer a high level of privacy. Despite the 24-hour trained staff, residents find the same amount of privacy as they would within a standard apartment complex. Decorated and personally arranged rooms give residents the comfort of home.  Since there is no need for nursing home type equipment, assisted living care homes offer more of a community type atmosphere.  Assisted living facilities will generally charge a monthly rate.  This rate can go up or down depending on the lelve of support you require and the number of ancillary services you may need.

Type I – Assisted living facility

The facility provides a safe and clean living place with three meals a day. A resident may require minimal assistance with activities of daily living (ADLs), including significant assistance with up to two ADL’s.  Residents in a Type I facilities:

  • Evacuate the facility under his own power (be mobile).
  • Have stable health and free from any communicable disease.
  • May receive assistance with medications or have medications administered by a nurse.
  • May receive home health services through individual contract with home health agency.
  • Receives 24-hour general monitoring, 7 days a week.
  • May receive general nursing care according to facility policy.
  • Participate in developing a service plan

Type II – Assisted living facility

The facility provides full assistance with activities of daily living (ADLs).  Residents in a Type II facilities:

  • May require the assist of one person for transfers or to evacuate.
  • May receive assistance with medication or have medications administered by a nurse.
  • Receive general nursing care from facility staff.
  • Be free of communicable diseases that could be transmitted to others through the normal course of activities.
  • Receive 24 hour individualized personal and health-related services, 7 days a week.
  • May receive home health services through individual contract with a home health agency.
  • Participate in developing a service plan

Home Care

Home care includes support services that allow someone to remain safe and independent in their home.  In-home care can help someone who is managing chronic health issues, is aging and needs assistance to live independently, is recovering from a medical issue, or has a disability.  Generally, professional caregivers provide long-term care in the home, depending on a person’s needs.  With home care, seniors retain the emotional comfort of remaining in their home.  Within their home, even seniors who with chronic medical problems or memory loss can still enjoy safety and independence. In addition, because they have a dedicated caregiver, seniors with home care enjoy personalized care plans that consider their preferences, physical status, and lifestyle choices.

Generally, home care is purchased in hourly blocks.  Although some agencies do provide a daily or live-in rate, most agencies will charge their clients an hourly rate.  Many agencies do require a minimum number of hours per shift.  It is difficult to find a caregiver to traveling to your home for short period of time.  Therefore, some agencies do require minimums.  Ask when you are interviewing agencies.

Needs Review

Most home care agencies will first perform a Needs Review.  During this visit, the agency will learn about your currentNurse talking to patients situation and the type of home care you need.  Each client is different, so it is important the agency gets to know you.  During this visit, the agency should tour your residence and learn about your concerns and challenges.  Finally, the agency should inquire about your current healthcare team so they can complement your current providers.  The Needs Review visit is also a good time to discuss your financial resources and any community resources that might help pay for your home care. There are many programs that can help offset the costs.  To understand the different payment options, click here.  Also, if you are a veteran, or a surviving spouse, you may qualify for the VA’s veterans home care benefit.

Nurse Assessment and Oversight

In many agencies, Nurse Oversight is an important part of home care because monitoring your health and changing needs allow them to serve you better.  If you decide to proceed after your Needs Review, a Registered Nurses will perform a thorough nursing assessment. This assessment is critical when designing your individualized care plan.  The care plan will become the blueprint for your home care services.

After you start home care services, a Nurses will continue to visit you periodically.  During these visits, they will perform follow-up assessments and record any changes since the last visit. If your condition changes significantly, the Nurse will revise the care plan and coordinate with your caregiver.

Home Care Services

Once the Nurse has designed your customized care plan, your care can begin and the caregivers are available to help you with all the Activities of Daily Living, including:

  • Personal Care and Hygiene.  To enhance your overall feeling of well-being, caregivers can assist you with things like bathing, showering, shaving, dressing, skin care, and dental care.
  • Walking Assistance, Transferring and Positioning.  Sometimes you may need a little help and encouragement to move around your residence and find a comfortable position in your favorite chair. Caregivers can also help with any devices you may use like canes, walkers, and wheelchairs.
  • Meal Preparation and Assistance with Eating.  Many clients need help preparing meals and eating. From food shopping to meal preparation, to assistance with dietary restrictions, your caregivers should be able to help you.
  • Assistance with Toileting.  From reminders to assistance, caregivers can help.
  • Light Housekeeping and Errands.  Caregivers can help with light housekeeping chores such as organization, straightening up, de-cluttering, washing dishes, and vacuuming.  Home care aides can also help with organizing mail, trips to bank, trips to the pharmacy, escorting you to medical appointments, and helping you coordinate with any community-based programs you may use.
  • Laundry and Linen Washing.  Caregivers can help with washing your clothes, linens and towels, folding clothes, and making beds.
  • Safety Monitoring and Companionship.  Sometimes clients just want someone to whom they can talk.  Homecare caregivers can help ensure you are secure in your residence and lend an ear when you want to talk.


There are pros and cons to both home care and assisted living. One benefit of assisted living is that seniors have the opportunity to socialize with their peers, something that may become increasingly difficult at home.  Also, assisted living communities are designed to be easily navigated by people with canes, walkers and wheelchairs, while multi-story family homes with stairs, thresholds, and deep bathtubs might be difficult to age in.

On the other hand, if a senior is living in a community with family members, moving into an assisted living community might mean they see less of them than before. And although many assisted living communities allow pets, there may be weight limits or additional fees: staying at home means staying close to furry friends.  The decision to stay at home or move into a senior living community will depend on each seniors’ individual needs and circumstances. Consider making your own pros and cons list if you’re trying to decide.

If you need help understanding the differences between assisted living and home care, contact one of our local offices to talk with one of our senior care consultants.