Reviewed by Natalie May, senior living expertNatalie May is a Senior Living Advisor at A Place for Mom with almost 30 years of experience in the senior care industry.
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Nursing homes provide around-the-clock skilled nursing care and assistance with activities of daily living (ADLs) for seniors who have significant medical conditions. In some cases, home health care may be an alternative for seniors who prefer to receive rehabilitation services in the comfort of their own home. Additionally, nonmedical home care provides assistance with daily tasks that can help seniors remain independent while living at home. Understanding the pros and cons to each option will help you determine which is more fitting for your loved one.
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Home care is flexible, allowing individuals to age in place and choose how frequently they receive care or companionship services.
Nursing homes provide around-the-clock residential care with access to medical professionals like nurses, doctors, and therapists.
Home health care allows seniors to recover at home with skilled care provided by a doctor-prescribed care team.
Home care may be a good fit for a senior with a chronic health needs, but they may eventually need nursing home care as their condition progresses.
The pros and cons of home care
Home care is customizable and helps seniors remain independent and safe while continuing to live in the comfort of their own home. However, it may not be the best care option for older adults who require a high level of care.
Pros of home care
Encourages independence. Home care enables seniors to age in place while receiving help with activities of daily living (ADLs) such as bathing, dressing, walking, and toileting.
Flexible. Home care is often scheduled and billed by the hour. This flexibility allows seniors to increase or decrease care frequency as needed.
Personalized. One-to-one home care enables seniors and caregivers to build a personal relationship. This can boost a senior’s mental health, and caregivers may be more likely to quickly identify changes in a senior’s overall health.
Cost effective. Depending on the level of care a senior needs, home care may be a less expensive option than other care types.
Support for family. Home care can provide family caregivers with the peace of mind that their loved one is receiving care in their absence. It may also offer family caregivers the opportunity to take a break from caregiving.
Skilled care at home. Home health care is available for seniors who wish to recover in the comfort and privacy of their own home after a hospital stay. Medical professionals like nurses and therapists can provide skilled services such as wound care, medication administration, and rehabilitative therapies.
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Cons of home care
Supervision limitations. A senior with a progressive condition like dementia may eventually need more supervision and a more secure environment than what home care can provide.
Isolation. While an in-home caregiver can provide companionship, beneficial social opportunities with friends and family outside the home can be challenging if a senior is homebound.
Expensive. Home care can be more expensive than other care types for seniors that require a higher level of care. For example, the median monthly cost of a full-time in-home caregiver is $5,720, which exceeds the median monthly cost of $4,995 for assisted living.[01] For a senior who requires around-the-clock care, the cost of 24/7 home care often equals or exceeds the cost of a nursing home.
Limited insurance coverage. Medicaid and Medicare may cover some nonmedical home care and home health care services. However, a senior must meet very strict eligibility requirements to qualify.
Nursing homes provide 24/7 care for seniors who have a significant physical or mental health condition and aren’t able live independently. Nursing homes can also provide short-term rehabilitation for seniors recovering from medical treatments or surgery.
Pros of a nursing home
24-hour care and supervision. Nurses, doctors, therapists, and aides are available to meet the scheduled and unscheduled needs of your loved one.
Skilled nursing, rehabilitative, and hospice services. Residents can receive physical therapy, occupational therapy, speech therapy, orthopedic rehabilitation, social and psychological services, palliative care, and hospice care.
Services and security for seniors living memory loss. Nursing homes may provide specialized memory care programming and secure grounds for seniors who are prone to wandering.
Social opportunities. Scheduled activities and common areas promote gathering and socialization. Not all nursing homes provide social programming, so be sure to ask about it when touring if that’s important to your loved one.
Wellness programs. Many nursing homes offer exercise and wellness classes to help residents maintain physical and mental health.
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 may not allow much room for personalization.
Relocation stress. If adjusting to new environments is hard for your loved one, moving to a nursing home may be challenging.
Less privacy. A nursing home can be a busy place with rotating staff members and other residents in close proximity.
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.
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How to decide between home care and nursing home care
A senior’s needs will typically determine the type of care that best supports their needs. And it’s important to keep in mind that needs may change over time. Your loved one may require home care at one point and nursing home care at another.
Home care may be the right option if your loved one has one or more of the following needs or preferences:
They prefer the comfort of their own home.
They mainly need help with nonmedical daily tasks like bathing, dressing, or meal preparation.
They’d benefit from companionship and social engagement.
They prefer services that are tailored to their lifestyle.
They have short-term medical rehabilitation needs that can be addressed in an in-home setting.
A nursing home might be a better fit if your loved one has one or more of the following needs:
They require short-term rehabilitation after surgery, medical treatment, or a hospital stay.
They need constant medical observation due to a chronic medical condition.
They’d benefit from daily access to physical and behavioral therapies.
They require significant assistance with activities of daily living.
Get help finding the right senior care option
Finding the right senior care option can be a challenge for many families, but Senior Living Advisors at A Place for Mom can help simplify this process. While we don’t refer to nursing homes, our Senior Living Advisors will listen to your loved one’s needs and connect you with local home care providers, assisted living communities, or memory care communities — all at no cost to your family.
Nirali Desai is a senior copywriter at A Place for Mom specializing in memory care and life enrichment topics. Previously, she worked in marketing and social media, edited a regional senior magazine, and wrote for the American Red Cross. She holds a bachelor's degree in journalism from the University of Kansas.
Marlena Gates is a senior editor at A Place for Mom, where she's written or edited hundreds of articles covering senior care topics, including memory care, skilled nursing, and mental health. Earlier in her career, she worked as a nursing assistant in a residential care home for children suffering from severe traumatic brain injuries. Marlena holds a master's degree in nonfiction writing, plus a degree from the University of California, Davis, where she studied psychobiology and medical anthropology. While there, she worked as a research assistant in the psychobiology department.
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