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Assisted Living vs. In-Home Care

Assisted living or home care? This is the question you may someday be asking yourself, and when you do you will see that selecting a type senior care is not easy. The two major types of senior care, assisted living and home care, have very different offerings so it is important to look at the advantages and disadvantages of each.

Assisted living

Assisted living is a type of senior care that serves a specific group of seniors; particularly seniors who need assistance with some daily tasks but are not looking for daily medical assistance. Seniors live at an assisted living community in separate or shared rooms and generally participate as part of a community routine. Communities often provide transportation, housekeeping, laundry, and some healthcare services.

Assisted living facilities are designed for the mobility and safety of residents, and to be cost efficient in providing support and assistance. Residents in assisted living have less privacy and autonomy. Seniors may also experience emotional distress in the transition of leaving their homes and families.

Home care

Home care is a type of elder care for seniors who would like assistance in daily tasks in the comfort of their own homes. Home care costs vary depending on the level of assistance needed. Care is often paid for by the hour and by the type of care provided; home care services can include housekeeping, personal assistance, or medical assistance. Adult day care is a separate service for seniors who need supervision during work hours and is often provides recreational and social opportunities.

With this type of care, married seniors can receive care in place, preventing a move to a community when their spouses do not need care. In-home care allows seniors to more freely choose their schedules and is more private and comfortable, however this style of care may be intrusive or burdensome on other family members.

In-Home Care

Assisted Living

Advantages

- Allows a person to "age in place" with family

- Privacy and comfort

- Socialization and recreation in adult day care

- Independence and control in scheduling and routine

- Affordable

- 24-hour support and supervision available

- One monthly cost (minus any extra fees)

- Facilities designed for safety and mobility

- Nutritional and fitness support

- Housekeeping, laundry, meal preparation, and transportation

- Limited on-site healthcare

- Socialization and recreation

Disadvantages

- High costs

- Can be burdensome or intrusive to other family members

- Support and supervision limited to hours designated

- Separation from home and family can cause emotional distress

- Low independence and control over schedule and routine



Costs and Coverage

When weighing assisted living against home care, assisted living is typically more affordable than in-home care. The all-inclusive fee of assisted living also often covers most bases, including housing and utilities, food, daily assistance, and recreation and social opportunities. Medicare benefits are limited for this type of care, but Medicaid benefits may include some health and support services. Room and board is generally not covered by either.

Home care is generally more costly than assisted living. However, because home care is paid on an hourly-basis, costs can vary widely based on the type and duration of care provided. Regardless, home care costs only cover services and do not include room and board, or many other amenities provided in assisted living. Medicare and Medicaid cover some home care services, and Medicaid covers some adult day services; however coverage with both is limited and varies by state.

In-Home Care

Assisted Living

Housing, water, utilities, trash, etc.Not included$37,572 annually
FoodNot includedIncluded
Assistance with ADLs$64,240 annually (8-hours per day of home health aide, 7 days per week)Included
Day-time supervision and recreation$17,420 annually (adult day services 5 days per week)Included
MedicareGenerally not coveredLimited to some medically necessary health-related services by certified providers. Adult day services are not covered.
MedicaidSome services may be covered by certified providers; services covered vary by state. Other housing/service costs are generally not covered.Some services may be covered by certified providers; services covered vary by state. Adult day services may be covered; varies by state and eligibility.
Medigap InsuranceNot coveredNot covered
Long Term Care InsuranceMay be accepted; coverage varies by policyMay be accepted; coverage varies by policy
SSIMay be accepted by certified providers for eligible seniorsMay be accepted by certified providers for eligible seniors
Veteran's BenefitsMay be accepted; varies by eligibility and state.May be accepted; varies by eligibility and state.
Private Funds, Life SettlementsGenerally acceptedGenerally accepted

Costs and amenities are yearly estimates based on 2009 national averages by the MetLife Market Survey of Long-Term Care Costs. Level of care, amenities, floor plan, location and other factors may determine a higher or lower cost.

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