In-home care vs assisted living
Families usually call us right after someone has said “assisted living” out loud. It tends to follow a fall, a hospital stay, or a few months where one person has quietly been carrying too much. Underneath the question is a different one. Has Mom reached the point where she can no longer stay at home?
Most of the time, the answer is no. What has changed is how much help she needs, not where she is able to get it.
What each one provides
| Care and support | At home with Generations Home Care | Assisted living |
|---|---|---|
| Bathing, dressing, grooming | Yes | Yes |
| Meals and grocery shopping | Yes, cooked to their taste | Yes, on the community's schedule |
| Medication reminders | Yes | Yes |
| Medication given under a nurse's delegation | Yes | Yes |
| Housekeeping and laundry | Yes | Yes |
| Transportation to appointments | Yes | Usually on a set schedule |
| Companionship | Yes, one to one | Shared staff and organized activities |
| Overnight supervision | Yes | Yes |
| Around the clock supervision | Yes, in scheduled shifts | Yes |
| Dementia support | Yes | Yes, in memory care units |
| Skilled nursing and therapy | Home health, in own home | Home health, in the assisted living facility |
| Familiar home, bed, kitchen, neighbors | Yes | No |
One caregiver, one person
Nearly everything in that table is available in both places. What differs is how much of a caregiver’s day belongs to your parent.
In assisted living, one aide is responsible for several residents at once, so help arrives when it can. At home, the caregiver is there for one person. Bathing happens at the hour your mother prefers rather than the hour the schedule allows. Lunch is what she likes. If she is having a hard afternoon, the whole afternoon can slow down for her.
That is also why families are sometimes surprised at how much can be handled at home. When someone tells us their parent has outgrown home care, they are usually describing a need for more hours, not a need for a building.
What it costs
Our care is billed hourly and the starting rate is published on each location page. It runs from $34 an hour in McKinney to $46 an hour in Spokane, and it varies by the length of the shift, because shorter shifts pay caregivers a premium.
Assisted living is billed monthly, usually as a base rent plus care levels that increase as needs increase. Ask for the full schedule of level fees rather than the advertised starting price, because that is where the difference between two quotes usually hides.
Do the arithmetic with your own numbers. Take the monthly assisted living quote, divide it by our hourly rate, and that is how many hours of care at home the same money buys. For most families needing daytime help a few days a week, home costs less. When the need is genuinely around the clock and permanent, a facility is often cheaper.
When a move is the right call
We would rather tell you this than have you find out after a deposit.
A move is usually the better choice when someone needs skilled nursing around the clock, which means a nursing home rather than assisted living, when a home cannot be made safe and cannot be modified, or when round the clock care is needed permanently and cost is the deciding factor. Some people also simply want the company of a community, the meals and the activity, and that is a good reason on its own.
Short of that, most of what sends families toward assisted living is a care need that can be met at home.
Questions worth asking before you decide
- What does the monthly price include, and what is billed on top of it as needs increase?
- How many residents does one aide look after during the day, and overnight?
- What happens if care needs increase, and at what point would a resident be asked to move again?
- Can our parent keep their own doctor?
- What would it cost to have care at home for the hours we actually need?
- If we tried care at home first, what would tell us it is not working?