Choosing a senior living arrangement can be a difficult, complicated decision. From comparing facilities to figuring out how to cover the high costs, the process can easily feel overwhelming. While many people presume that staying at home as long as possible is best, that’s not always the case. Each individual’s case needs to be evaluated independently. Before making a decision about where to live, you need to know the costs, assistance options and features available. Having an open conversation about your preferences also gives you some control over your life. Three of the most popular senior living options are assisted living, skilled nursing and in-home care. Making the choice between home care and a nursing home can be difficult to do on your own. Without consulting professionals and performing research in advance, many seniors and caregivers are inclined to make a knee jerk decision in the heat of a crisis.
“What usually happens is, it’s a crisis situation where someone is very sick and hospitalized, and the family realizes that they’re not able to provide the level of care their loved one requires at home.”
RITA CHOULA, DIRECTOR OF CAREGIVING, AARP PUBLIC POLICY
Comparing Assisted Living vs. Nursing Home vs. Home Care
In general, the biggest difference between an assisted living facility and a nursing home is the level of medical services available and included in
· Assisted living facilities are a better option for older people who don’t need medical attention on a regular basis but are looking for social interaction, general care and entertainment.
· Nursing homes are designed to be a more clinical solution, with around-the-clock medical care and specialized care like physical therapy.
This difference dictates a lot of the other features at these facilities. For example, nursing homes include architectural features to prevent wandering and maximize resident safety, like locked doors and alarms. This also means most nursing home residents are unable to move around the facility on their own. At assisted living facilities, residents have more freedom to walk around because wandering is less of a concern.
Expect to spend about twice as much for a nursing home stay versus assisted living. This is because the nursing home rates often include 24-hour medical care. With assisted living, most medical care is an additional cost.
Assisted Living Benefits
· Custodial care
· Limited medical care
· More freedom
· Apartment-like atmosphere
Nursing home benefits
· Medical care
· Specialized care
· More security
· Hospital-like atmosphere
· More expensive
Assisted Living Homes?
Assisted living homes are best for individuals who require very little senior care on a daily basis. This means that most assisted living homes provide residents with some help accomplishing various tasks such as organizing medications, but they don’t offer full-time long-term care
Assisted living homes are also referred to as boarding homes, congregate housing, adult congregate care, domiciliary care, or residential care.There are almost 30,000 assisted living homes in the United States. These facilities currently house approximately 1.2 million residents. Most of these residents are mobile individuals over the age of 65. Those who need a wheelchair to move around or suffer from behavioral or cognitive impairments are typically discouraged from moving to an assisted living facility since they require more specialized care. Although most assisted living residents eventually move on to nursing homes, some residents leave assisted living homes to return home or move to another assisted living facility.
Assisted living homes are also referred to as boarding homes, congregate housing, adult congregate care, domiciliary care, or residential care. There are almost 30,000 assisted living homes in the United States. These facilities currently house approximately 1.2 million residents. Most of these residents are mobile individuals over the age of 65. Those who need a wheelchair to move around or suffer from behavioral or cognitive impairments are typically discouraged from moving to an assisted living facility since they require more specialized care. Although most assisted living residents eventually move on to nursing homes, some residents leave assisted living homes to return home or move to another assisted living facility. In-Home Care The in-home caregiver is one of the fastest growing and most requested services in the United States today. Agencies providing in-home care offer a range of different services from simple companionship to supervision and personal care. In-home caregivers are appropriate for individuals who want to stay at home, but also need ongoing care that family members and friends cannot provide. It allows seniors to age in the comfort of their own home. Most in-home care plans include a combination of assisted living, or non-medical, services and skilled health care services. In the past, there was no significant difference between “home health care” and “in-home care”; however, many people now refer to home health care when skilled nursing care is involved and in-home care when only non-medical care is required. While those differences may seem insignificant, they are actually important since they help people understand the level of care being offered. This will, in turn, have a major effect on the cost of care and the sources of funding available to pay for these costs. Non-Medical Care Services Typically Include:
Insurance companies and in-home care agencies often use an individual’s ADL (Activities of Daily Living) rating to determine the needs of that individual. ADL ratings are based on six basic activities that show an individual’s abilities to provide self-care. These activities are:
Using the Toilet
Insurance firms use these activities to determine an individual’s eligibility for insurance benefits. In-home care agencies use them as an assessment tool to figure out the necessary charges for services and to ensure qualified caregivers are assigned to meet the individual’s needs. IADL, or Instrumental Activities of Daily Living, utilizes six tasks that determine the ability of an individual to live on their own in the home. These Six Tasks Are:
Managing personal finances
Using the phone
Shopping for food and clothing
Although it is important to understand the differences between in-home and home health care in today’s terminology, it is true that, in reality, most individuals who require one form of care will eventually require the other as well.
Financial Cost Senior living
There can be a significant financial difference between staying at home and moving into an assisted living facility. According to Genworth Financial’s 2021 Cost of Care Survey, the median monthly cost for an assisted living community is $4,500 – totaling $54,000 annually. Skilled nursing in a private room will set you back $9,034 per month, adding up to more than $108,400 per year. Prices can vary a lot depending on where in the country the community is located and which services a senior is using.
On the other hand, hiring a visiting home care aide or live-in care can also get expensive. Although millions of family members provide unpaid care to older relatives around the country every day, when we're talking about professional caregivers, fees can range widely.
In 2021, the median monthly cost for a private, single-bedroom in an assisted living community was $4,500. Similarly, in-home care averaged around $4,597 per month, according to the insurance company Genworth  and proprietary APFM data. That, however, is not the whole story, as the varying needs of an individual and their family can push these costs beyond their listed averages.
For seniors who need some daily assistance, but remain independent and prefer to age at home, home care may be a good choice.
However, if someone requires more than four or five hours of home care a day, assisted living may be the better choice financially.
Round-the-clock or 24/7 care costs about $400 per day across the U.S. The cost varies by state, but you can expect to pay $12,000 to 16,000 per month. This will vary based on the types of care needed, such as personal care, supervision, memory care, safety or behavioral needs, housekeeping, grocery shopping or medical treatments. While this allows a person to remain in their home, the cost is higher than a residential nursing home.” Bottom line: Home-care options can end up being just as expensive or more so than moving to an assisted living facility depending on a range of factors, especially as care needs change. Moving into a community can be more cost-effective in the long run.
While the decision to provide care at home or in a facility isn’t based solely on financial considerations, here is a general rule of thumb from the perspective of cost:
Home care is typically the less expensive option if the senior needs 40 hours or less of paid home care each week.
“Twenty-four hour care at home is universally going to be at least twice, if not three times as expensive as a nursing home facility.”
Spencer Brown, South Central Chapter President of the Aging Life Care Association
The world’s population is aging at a faster rate than ever before and people are living longer. Every day until 2030, 10,000 Baby Boomers will turn 65a and 7 out of 10 people will require long term care in their lifetime.b
The cost of that care varies based on care setting, geographic location of care and level of care required, among other things. Using Genworth’s Cost of Care Survey tool below, you and your family can calculate the cost of long term care across the U.S. Understanding what the median cost is today is a first step to helping you plan for it.
To calculate the costs of care in your city go to Cost of Long Term Care by State | Cost of Care Report | Genworth.