In-home care versus assisted living

Whether to choose assisted living or in-home care is a big question to consider as we age. For families, the debate can bring out strong opinions, conversations about distance or finances, and most of all, the desire to make sure that loved ones are safe and cared for.  

There is no one answer for everyone, but since the majority of older adults wish to age in place, in-home care is usually a top choice. In this article, we’ll be exploring some of the costs and benefits to both options. For many older adults, different times in their lives may call for one or the other—or even for a combination of the two. 

In-home care: the basics

In-home care covers non-medical personal care needs, including assistance with ADLs, or Activities of Daily Living. In-home care offers the most flexibility of any aging care services, as caregivers can be chosen and hired by the family or care recipient, and care can be tailored to a person’s individual needs and situation. As care needs progress over time, caregivers can blend their support with other care professionals’ services, including as CNAs (Certified Nursing Assistants) and home healthcare practitioners, who deliver medical support in the home. 

In many ways, in-home caregivers provide similar care to what a family member is able to provide, with the exception of administering medications and helping with medical decisions. For this reason, family caregivers often choose to hire in-home caregivers to provide respite at night, during work hours, or so that they have time to take care of themselves and other life obligations.

Cost of in-home care

The cost of in-home care, like the type of care and scheduling, can be tailored to fit individual needs to a certain extent. With a national median of around $20 per hour, cost varies by city and state, level of care, and experience of the caregiver, but, using a platform like Herewith, families are able to set their own budget and choose a caregiver and number of hours that work for their situation. 

Benefits of in-home care for older adults

Change is hard for most of us, but for older adults, especially those with complicated medical or cognitive issues, change can be disruptive or distressing. Receiving care in familiar surroundings builds a sense of security and comfort, especially when changes in health and abilities create daily challenges.

Social and emotional benefits of in-home care include:

• Independence, freedom, and privacy 

• Emotional attachment to a longtime home 

• Social connection with neighborhood friends and local community resources

• Familiarity with surroundings, especially helpful for people with dementia or mobility needs 

Assisted living: what to know

An arrangement for older adults who don’t need 24-hour nursing care, assisted living can range from fully independent to semi-independent living. Living spaces tend to be condos or apartment units designed for accessibility and easy maintenance.

Cost of assisted living

Each assisted living community is a little different. In some, seniors will pay an all-inclusive rent that covers housing, meals, access to communal space, scheduled social activities, housekeeping, some assistance with ADLs (Activities of Daily Living), utilities, and even transportation. Other assisted living communities operate in a tiered program, where seniors can opt into and pay for just the services they’d like to use.

Skilled nursing, memory care, and companion care are not included, but some assisted living communities offer additional support for added cost. The national median cost of assisted living in 2023 was $4,500 per month, with memory care, for example, costing an additional $1000-2500 per month.   

When is assisted living worthwhile?

The decision to move to assisted living depends on the care needs, preferences, current housing situation, and finances of each individual, plus how much support is available from children or other family members. 

Some seniors prefer to move to assisted living earlier, while care needs are still minimal. This can give them the opportunity to sell their home and downsize to a place of their choosing. This can also free up finances and household responsibilities for more traveling and other retirement plans, while still having access to support later on when it’s needed. Other seniors may wish to stay in their own home for as long as possible, bringing in family and/or professional caregiving as needed. 

Sometimes, however, there are reasons that long term in-home care isn’t possible, and assisted living may be the best option:

• Level of care: Some older adults may want or need a high level of care, including medical support such as medication supervision or help managing certain conditions, like dementia

• Safety and accessibility: Home modifications, such as ramps, lifts, and other specialty equipment might be too expensive to install or not feasible because of space limitations

• Cost: The cost of in-home care may exceed the price of assisted living, or the sale of the home may be necessary to finance retirement and care 

• Social isolation: There may be a risk of isolation at home, even with the weekly companionship of a caregiver, while assisted living offers easy access to peers and socialization

• Transportation: Paying for on-demand transportation services or rideshares may become expensive or may not be accessible depending on location 

Bringing in-home care to assisted living

Despite the care available in assisted living, many families opt to add in-home care services. Assisted living staff can’t accommodate personal preferences, companionship, and other quality of life services that families wish for their loved ones. 

Professional caregivers, like the ones on the Herewith platform, are accustomed to traveling to older adults and caring for them, whether they live in a traditional single family home, an assisted living condo, or even a room in a nursing home or rehab facility. If family members live far away, caregivers can help cover gaps in support from home health care or assisted living staff, providing peace of mind that someone is watching out for their loved one and supporting their wellbeing.

Additional resources on planning for senior care:

• 6 Benefits of aging in place 

• How to plan for aging parents' care with your siblings 

• How to talk to your parents about in-home care

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