There will come a point where seniors will require care and support on a daily, or even 24/7 basis. For family members, coming to the realizing for their loved one needs more care than they can provide can be difficult. Adding to this difficulty, not knowing what type of care your loved one needs can create feelings of confusion, stress and unwanted anxiety. When it comes to senior care, there are different options available. Three common types of care are:
- Assisted living
- Nursing home care
- In-home care
This article will discuss how to make a decision between home health care and assisted living. To learn more about facilities where a senior can reside while receiving care read, Assisted Living vs Nursing Homes.
Assisted Living vs Home Care
Assisted living and home care (also known as “home health care” and “in-home care”) are two very common forms of care that are designed to help seniors. Both assisted living and home care offer support to seniors who need help completing “Activities of Daily Living” (ADLs). ADLs are the most important tasks an individual must complete in order to survive and have a high-quality of life. Basic categories ADLs include all activities associated with:
- Mobility
- Bathing
- Personal hygiene
- Eating
- Dressing
- Toileting
An easy way to understand the difference between assisted living care an in-home care is how/where the care is being provided. With assisted living, a senior will reside at an assisted living community where staff is available to provide support to seniors. With in-home care, a home care aide will travel to wherever a senior resides to provide support with ADLs.
Assisted Living Care
Assisted Living care is designed for seniors who need help with ADLs, but don’t require 24-hour skilled nursing care. Assisted living offers a unique community experience which is geared toward making residents feel more at home. In addition to offering full support with ADLs, assisted living community staff will also offer support with “Instrumental Activities of Daily Living” (IADLs). IADLs are a type of ADLs, but these are activities that greatly impact a senior’s overall wellbeing, but are not considered personal care. An example of this could be housekeeping or laundry which can impact the quality of life of a senior, but does not involve their personal care.
In-Home Care
In-home care is also designed to help seniors complete essential ADLs and IADLs. However, in-home care can be provided wherever the senior resides. This can include a private residence, assisted living community, nursing home or other facility. In-home care can be utilized at different levels. This means that if a senior does not need constant care and supervision, then an in-home professional can provide support only during the times needed. In-home care can also provide support on a 24-hour basis, if needed. It is also not uncommon for in-home care professionals to provide support to seniors while they reside in an assisted living community.
Assisted Living vs Home Care – Mobility and Fall Prevention
A significant benefit of assisted living and in-home care is that seniors will have more physical support. This is essential for senior safety. The extra support provided by assisted living staff or in-home care professionals can help to decrease the likelihood of a senior fall or other accident which can have a serious negative impact on a seniors health. For example, assisted living or in-home care professionals can help with activities such as getting ready for the day, changing, and general mobility throughout the day.
Designed for Senior Safety
Many assisted living communities are specially designed for senior safety. This means that the facility itself may offer design features that are usually not available in a private residence. For example, an assisted living facility may offer an on-call nursing system that allows for seniors to have quicker access to staff in case of emergency, bathrooms that are designed for seniors and other safety features. Although in-home care also focuses on safety, it does not come with this type of support.
Determining the Safest Option
If you are thinking about which type of care is most suited for a senior in your life, it is again important to consider how much assistance they require and what is the safest location for them to reside. Assisted living care is designed to always offer 24/7 support with ADLs, while in-home care can be adjusted for 24 support, if needed.
The Impact of Fear of Falling
The fear of falling and loss in confidence has been shown to increase the likelihood of an accident actually happening. Because of this, an assisted living community may help senior to feel more at ease knowing that there are always staff available should a fall or accident occur.
Social Stimulation and Companionship

Both in-home care and assisted living communities may offer seniors a desirable level of emotional support. In-home care is also usually considered, “companionship care.” An in-home care professional can become a welcomed friendly presence in the life of a senior when they are present to provide support.
Being Part of a Community
Assisted living facilities are able to offer a more community feeling to seniors. Some families find that having their loved one in the company of other seniors helps to combat feelings of isolation. This is because seniors have the opportunity to interact with more people, and to develop more than one long-term connection over time.
Assisted Living vs Home Care – Cost
When it comes to payment of assisted living vs home care, there is no “one size fits all” solution. The payment structures for each type of care is different. In-home care is paid for on an hourly or daily basis, depending on how the agreement with the in-home care agency is structured.
The services provided by an in-home care professional will also determine cost, and more involved care can be more expensive than simple companionship care. Assisted living care is almost always a flat monthly fee that includes all ADLs, IADLs, and living expenses.
Assisted Living vs Home Care – Coverage
Understanding coverage for assisted living and in-home care can be complicated, and families should discuss the different payment options with a care provider before making any decisions. Assisted living care is generally not covered by Medicare and Medicaid. In-home care may be eligible for Medicare and Medicaid coverage. Both assisted living and in-home care may accept long-term care insurance and private health care insurance but many times costs are assumed by the individual or family.
Final Takeaway
The most important questions to ask when deciding on what type of care a senior needs are, “What are the seniors needs?” and “Which option is the best for overall safety?” These questions will help to identify whether a senior needs incremental or continuous support, and what the safest option for them will be. Families should also keep in mind that seniors can begin with more incremental care, and then transition into a setting that offers 24/7 support. Talking with senior care professionals can help families to determine which option makes the most sense for their loved one.