For the adult child, watching their parent’s age is hard. Thoughts like, “Is Mom eating? Should Dad be driving? Are my parents able to stay alone?” These thoughts linger in the minds of adult children. It is hard to know where to turn. Can my parents stay in their home? Do I need to look at Assisted Living? What options do I have? These questions can become overwhelming, especially when this is a new journey for the family. Often families only have a general idea about home care and a surface-level understanding of assisted living. This article will break down the differences between the two and hopefully help clarify what is best for their loved ones.

It’s essential to weigh the pros and cons of each option. Let’s start with what most people think is their only option – assisted living. This option is the new shiny penny and often attracts residents with ice cream shops, movie theaters, and endless activities. While this may be attractive to some, families must determine if this is the desire of their loved one. Not all senior adults are looking for a new social life. Many seniors prefer more familiar surroundings and people they know. Congregant settings are not for everyone, and families should discuss with their loved one what their desires are. Do they want to consider assisted living, or is this out of the question? The advantage of an assisted living facility is that they have staff available 24/7. While this can provide peace of mind for the family, knowing a professional is nearby, families should ask questions about the availability and level of care available overnight and on weekends. What most people think assisted living facilities will do, doesn’t necessarily match the agreement signed. Another advantage is that the dining facility provides three hot meals a day. Some plans only include one meal a day. The family needs to understand how many meals will be included in the monthly fee and the additional cost should the senior want to add a meal. Compare the senior’s current living situation to what they will have in assisted living. Typically there will be the option of a one-bedroom or two-bedroom apartment-style residence. The size can limit the number of personal belongings a person can bring. Limiting sentimental items during a significant life change can be difficult for seniors, causing stress in their new home.

A good question to ask when considering assisted living is the average amount of time staff will interact with residents daily. Typically, a caregiver will have 15+ residents they take care of each shift. Therefore, depending on the needs of the resident, they may only see a staff member for minutes each day. If the senior is not outgoing and willing to participate in activities, this could lead to isolation. The senior may experience bouts of depression due to feeling lonely and in an unfamiliar place. It is essential to look at the fine print and understand what is included, what you can expect, and the additional fees that can be added.

The monthly fee does not include everything offered. Things like housekeeping, laundry, meals in their room, overnight visitors, additional bath visits, and transportation could have extra fees. One thing most families do not think about is that a senior can be asked to leave. If the resident causes issues, is a threat to themselves or others, or requires substantial care, the resident can be discharged. Families should always have a backup plan should this occur. Pets are an important part of many seniors’ lives. Not all assisted living communities will allow pets. If the senior has a pet, this should be discussed prior to making a decision.

Home Care is not usually a family’s first thought. Why? Because they think it’s too expensive and only for the wealthy. Actually, home care can be more cost-effective than assisted living. Adding technology along with home care can provide the same type of coverage as assisted living. For example, 20 hours of home care plus an emergency response system and medication dispenser can offer a similar experience to a 24/7 nurses station at an assisted living facility. The cost difference can be nominal, depending on the location. Another option is vitals monitoring. For those who have to take weight, blood pressure, glucose, or blood oxygen daily readings, an easy-to-use, vital sign monitoring system is available at a reasonable price. Many home care agencies have partners who can offer this type of service. Meal delivery services beyond Meals on Wheels can be a resource for quick, healthy meals. Silver Cuisine, Hello Fresh, and Freshly offer microwavable meals for around $9.00. These are nutritionally prepared with special diets in mind. Other options include thermal monitoring, which tracks movement without infringing on the senior’s privacy.

The advantages of home are vast. The senior will remain in the home they know in the community with which they are familiar. Staying in their home provides a sense of independence. Seniors fear the loss of independence more than they do death, so increasing their feeling of freedom is a huge advantage. Feeling independent can boost their mental state, reducing the chance of depression. Home care provides a one-on-one caregiving experience, personalized care, and customized meal plan. The client can develop a professional relationship with their caregiver, who can encourage taking walks, playing games, or watching a favorite movie together. The family and the home care agency decide on how they will care for the senior. Everyone’s tastes are different, and with home care, the client chooses what types of food they like versus cafeteria-style set meals in assisted living. Another big difference between home care and assisted living is that an assisted living facility can restrict visitation during COVID or flu season. With home care, the family is free to visit and make those decisions.

There may come a time when the home is no longer safe for the senior. At this point, home care can still be an option in combination with assisted living. Home care can fill the gaps where assisted living does not provide those services without additional fees. Check with the assisted living staff to determine if they allow outside home care to provide services.

When families are faced with making the difficult decision between in-home care and an assisted living facility, it is essential to consider all of the factors. Home care and assisted living fulfill a need, but key factors differentiate the two, and it is vital to know what they are. It is up to the family to decide what is the best option for their loved one, both personally and financially. Make sure you have evaluated all of the pros and cons of each option. It can be challenging to navigate the process, but vital that everyone involved feels comfortable with the decision.

Posted in Care for Aging Veterans
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About Cheryl Hammons CFE, CSA

Cheryl Hammons is an experienced home care professional, published author, and frequent speaker. She has held several roles throughout her 12 years in the home care industry, including training, support, and operations. She currently serves as Strategic Partnership Director at Veterans Care Coordination where she focuses on building value-driven relationships, developing revenue-generating programs, and creating educational materials for home care partner companies. Cheryl is the author of "Embracing a New Normal: Dealing with Grief" and "Respecting Religious Differences in Home Care."