Home Care vs. Nursing Home: What’s the Difference?

These decisions can be overwhelming, so we’ve created a guide to help you navigate the best care options for your loved one. Our advice comes from specialists across the senior care spectrum, but, as always, you should make your decision based on your loved one’s immediate needs and what is doable for your family.

Read on to learn about the differences between home care versus nursing homes, the pros and cons of each, how much they cost, and more.

Let our care assessment guide you

Home care is care provided within an individual’s own residence. In-home care options range from a few hours a week to round-the-clock care. Most seniors who have home care receive approximately 44 hours of care or less per week.^[01]

This option best serves those looking to age in place with the added support and safety of a home care aide. Home care aides can provide support with some activities of daily living (ADLs), companionship, and many other helpful services.

Home care aides typically provide the following additional services:

• Assistance with bathing, dressing, or toileting (ADLs)
• Mobility assistance
• Meal delivery or preparation
• Transportation to appointments and events
• Light housekeeping
• Medication reminders
• Exercise encouragement

Home care aides aren’t typically licensed to provide medical services, however, home health care aides are.

Home health care: skilled nursing services at home

Home health care, otherwise known as in-home nursing care, is medical care provided by a licensed nurse within a client’s home. Home health care aides are essentially medical caregivers that can typically provide an array of skilled nursing services.

Home health care aides can provide the following types of services:

• Medication and injection administration
• Monitoring of vital signs
• Chronic disease management (e.g. diabetes, arthritis, heart disease, etc.)
• Wound care and pain management
• Physical therapy
• Respiratory care (e.g. oxygen therapy, breathing exercises, etc.)

Live-in care vs. nursing home: 24-hour care at home

If your loved one requires 24-hour assistance, live-in home care may be a good option. Live-in care means the caregiver lives within a client’s residence and provides around-the-clock care. They sleep at the residence in case emergencies or medical needs arise overnight. Some home care agencies also provide options where multiple aides will provide continuous care in alternating 12-hour shifts across 24-hour periods.

There are many conditions that might make live-in home care necessary. Here are just a few examples of some situations where a live-in caregiver could provide a safety net:

• Sleep problems. If your loved one is prone to falling off the bed, has night terrors, or has insomnia, they may benefit from having someone present overnight.
• Nighttime wandering. A sleepy, confused state can pose risks of a fall or injury. An overnight aide can provide assistance to the bathroom, grab a glass of water, and more.
• Seizures. If your loved one has chronic obstructive pulmonary disease (COPD), or other medical conditions, they may be at a higher risk for strokes and seizures.^[02] A live-in caregiver can take the proper measures to help and contact medical professionals, if necessary.

What are the pros of home care?

• Build a personal relationship with a caregiver. As opposed to having multiple staff members take care of your loved one in a nursing home, home care enables your loved one to build a meaningful relationship with one or a few caregivers. Some agencies even perform personality assessments to help ensure a good match.
• Remain in a familiar setting. Moving into a nursing home can cause relocation stress syndrome, a condition in which a senior feels anxious, confused, hopeless, or lonely after a move to a long-term care facility. Home care can help minimize the stress that comes with aging.
• Maintain independence. In a nursing home, residents may have to give up more of their independence. For example, if your loved one wants to change up their mealtimes or prepare their own meal, it may no longer be an option.
• Additional privacy. In a nursing home, residents typically have to share spaces, like living and dining rooms. They may also only have access to them during certain hours each day, and only under supervision. With home care, your loved one can enjoy their home whenever they please, with or without supervision, as home care aides will step back when requested.
• Save money in some cases. In earlier stages of care, or when medical needs are minimal, home care might be a more affordable option. This is especially the case when you or another family member are splitting care responsibilities with an aide.

What are the cons of home care?

• Loneliness. While a caregiver can provide some companionship, remaining at home could get lonely, especially when your loved one doesn’t live near friends or family.
• Less security. Nursing homes tend to have 24-hour surveillance, staff, and security which help prevent external threats and promote safety. With home care, you’d have to install a costly security system, hire around-the-clock care, and more.
• Higher expenses with medical care. Home care can get pricey once your loved one’s medical care needs start increasing. For example, if they start to require home health care or live-in home care services, a nursing home might become cheaper than home care.

A nursing home is suitable for seniors who aren’t able to care for themselves or aren’t safe alone in their homes due to medical care needs. If your loved one has a significant physical or mental health condition that requires skilled nursing and personal care, a nursing home might be the most suitable option, especially if they need ‘round-the-clock supervision and immediate access to medical staff.

A nursing home may also be a good option for those recovering from medical treatments or surgery. They can provide short-term, rehabilitative care that may be less costly than hiring a home health care or live-in aide.

What are the pros of a nursing home?

• 24-hour care and supervision. Security staff and medical professionals including nurses, doctors, therapists, and other licensed health care professionals are available to meet the scheduled and unscheduled needs of your loved one.
• Skilled nursing, rehabilitative, and hospice services. Residents can benefit from physical therapy, occupational therapy, speech therapy, orthopedic rehabilitation, social and psychological services, palliative and hospice care, and more all under one roof.
• Specialized care for memory loss. Nursing homes provide extra security for dementia patients who are prone to wandering and provide some specialized care services for them. Some have a separate memory care unit altogether.
• Social opportunities. Scheduled activities and common areas promote gathering and socialization. Not all nursing homes provide social programming, so be sure to be on the lookout for these kinds of homes if that’s important to your loved one.
• Wellness programs. Nursing homes often host exercise and wellness classes to keep residents active, healthy, and happy. Depending on the nursing home, this can range from group activities and exercise classes to walks with a staff member around the facility.

What are the cons of a nursing home?

• Less independence and personalization. Nursing homes often designate times for meals, limit hours for shared spaces, and handle a lot of household tasks for residents. They’re also often furnished and don’t allow much room for personalization.
• Causes relocation stress. Moving can cause stress that leads to anxiety and depression, especially in the earlier months after the transition. If readjusting to new environments is hard for your loved one, moving to a nursing home may be challenging.
• Less privacy. Some seniors prefer a private and quiet environment. A nursing home’s rotating staff members and other residents in close proximity may cause more anxiety.
• Less affordable for higher quality homes. Nursing homes with higher quality, person-centered medical services, dining services, and diverse lifestyle programming tend to have significantly higher costs.

Talk with a Senior Living Advisor

There is no one answer for this. In fact, your loved one may require home care at one point and a nursing home at another. For example, if your loved one has a condition that makes it hard to perform a few daily activities or they’re just seeking companionship, home care might be a better fit. If they have a progressive medical condition, their needs may increase and you might consider home health care or a nursing home later on.

Your loved one’s situation might also be the opposite. If they currently live in a nursing home and their condition becomes terminal, they may wish to spend their remaining time with family in the comfort of their own home. In this case, you may consider switching to a home health care service that provides hospice care.

Home care may be the right option if your loved one has the following characteristics or preferences:

• Has a hard time readjusting
• Prefers receiving care from one person
• Prefers the comfort of their own home
• Wants caregivers to tailor services to their lifestyle

A nursing home might be a better fit if your loved one has the following needs:

• Needs rehabilitation after surgery, medical treatment, or a hospital stay
• Needs constant medical observation due to a chronic condition
• Would benefit from everyday access to physical and behavioral therapies
• Has a chronic medical condition but would also enjoy social programming

If you’re wondering how you can start narrowing down choices, you’ll want to compare costs, local nursing home facilities, and local home care agencies.

Nursing home versus home care costs

To remain within your estimated budget, it’s important to consider the costs of home care services and nursing homes. At a nursing home, costs can increase due to factors like a private room, higher level or person-centered services, and diverse programming. With home care, prices will increase due to higher levels of services and care, such as home health care and live-in care. Nursing home and home care agency prices will also vary greatly depending on location.

We’ve compared the national average nursing home versus home care costs for you here:

• The average cost of a nursing home ranges from $7,908 to $9,034 per month.
• The average cost of home care ranges from $4,957 to $19,656 per month.

Talk to an expert for local advice

Finding a good fit for your loved one may have you scouring many options. Senior Living Advisors at A Place for Mom can make this process easier. They can share their expertise to find long-term care solutions for your aging loved ones. They can help you compare services and costs at local home care agencies and nursing homes to help you make an informed decision — all at no cost to you.

Make the best senior care decision