As people age, their ability to care for themselves often decreases, prompting family members to explore senior care options. Home care and assisted living are effective choices for supporting seniors and providing peace of mind for families.
Both options focus on personal care activities, including dressing, bathing, eating, and grooming. Having help with such tasks allows seniors to maintain their safety, quality of life, and independence for much longer. With assisted living, care is provided in a shared facility or community, while home care happens in the senior’s own home. There are other differences, too, which may determine whether home care or assisted living is the best choice for your loved one.
Here, we go over the details to help families decide between home care and assisted living when considering what best suits their loved one’s current and future needs.
Determine the type and amount of care you need
Let’s begin by talking about the care provided in home care and assisted living, as this is the reason for considering these options. Assisted living and home care offer many of the same services, although there are some differences in the specifics.
| Service | Home care | Assisted living |
| Personal care assistance | Provided | Provided |
| Household management (support with some chores, including cleaning and laundry) | Provided | Provided as individual services (e.g., laundry service). Residents may have to pay extra for housekeeping services. |
| Cooking and meal prep | Sometimes provided | Provided in shared dining rooms. Meals may be delivered to individuals as well, sometimes at an extra cost. |
| Medication reminders | Provided | Provided |
| Companionship | Provided. Even if the caregiver isn’t hired specifically to provide companionship, the one-on-one time they spend with the senior has some of the same effect. | Not directly provided. Seniors receive social interaction with residents and staff, but not the same one-on-one companionship that a home care worker can offer. |
| Transportation | Sometimes provided. This may come at an extra cost, especially if the caregiver uses their own vehicle. | Provided to varying degrees. Group transportation is common, and some facilities offer individual transport, which may cost extra. |
| Overnight monitoring | Sometimes provided, but can be expensive, as you’re still paying by the hour. | Provided |
| Security and built-in safety features | Not provided. Family members will need to take care of any safety and security features in the home. | Provided |
| Social programs and activities | Not directly provided, although caregivers can accompany the senior to social events | Provided |
| Amenities (e.g., beauty salons, community gardens, pools, dining halls, and fitness centers) | Not provided | Provided |
Essentially, assisted living is an all-encompassing service that includes not only support with personal care but also social programs, activities, amenities, and various safety features. Home care is less inclusive and relies heavily on features in the senior’s home and community.
Health care needs
Assisted living and home care are both nonmedical services, so they’re not great for people with considerable medical needs. Still, there are some options for medical support in both the home and an assisted living facility.
- People living at home can hire home health care services. Although home health care sounds similar to home care, it is an entirely different care type. These services can help with many health needs, including IV medication administration, wound care, and physical therapy.
- Assisted living facilities often have an on-site nurse and emergency service connections. This allows them to respond to small health issues and emergencies. Some facilities also allow residents to hire third-party home health care services.
Home care vs. assisted living care services: Which is best?
Due to the similarities in care services, many seniors have the option to choose between home care and assisted living.
The decision often comes down to the amount of care needed. For example:
- A senior who is mostly independent and needs only a few hours of support per day or week may be best suited to home care.
- In contrast, a senior who needs help with more aspects of daily living could benefit from assisted living. Care in this setting would provide ample assistance and easier access to social connections and activities.
Analyze cost differences
The next thing to consider is cost, which varies dramatically based on geographical location, care needs, facility or home care company, and specific services offered.
According to CareScout, the national median hourly cost for home care was $33 in 2024, with 40 hours of care per week resulting in a median monthly cost of $5,720. In comparison, assisted living had a median monthly fee of $5,900.
These figures suggest that if your loved one needs around 40 hours of care per week, both options are comparable when considering costs. If they need fewer hours, home care is likely best. If they need more, assisted living could be the way to go.
However, it’s a little more complex than that.
Living costs and hidden costs
If the senior is currently living in their own home, home and living-related costs should be considered. Such costs might be eliminated if the senior moves to assisted living and sells their home.
Examples of costs that will likely be eliminated with a move to assisted living include:
- Utilities.
- Home maintenance.
- Groceries.
- Home insurance.
- Emergency home repair.
- Rent/mortgage.
- Entertainment.
Another consideration is that family members often act as unpaid caregivers to reduce home care hours, but doing so comes with hidden costs, such as lost income for a caregiver who must take time off work to provide care. There are also potential emotional and health impacts on the caregiver.
Home care vs. assisted living: Variations in care affecting cost
Home care is highly customizable, making it useful in various situations. Families can adjust home care as needed, such as:
- Increasing home care hours in the short term to provide respite for a family caregiver.
- Increasing hours while the senior recovers from an injury or illness, then decreasing them after they recover.
- Having the home care worker start with mostly companionship and activity-focused tasks, then transition to care-related tasks as the senior’s needs increase.
The amount of care for assisted living can also vary, but you’re paying the same price regardless. If needs are variable, it may be best to start with home care.
Assess the living environment and social opportunities
With home care, the senior remains in their own familiar environment with access to the same social network and activities they have always had. However, people who remain at home often become isolated, as getting out becomes more difficult, and they may lose social connections due to death or illness.
Assisted living is powerful here, as residents are surrounded by a community of people and have easy access to many activities and amenities. Still, seniors at home will get one-on-one interaction from home care workers and may even develop a strong bond with their carer.
As such, it’s essential to consider the senior in question. Do they still get out regularly and stay connected? If so, they may be getting enough social engagement at home.
If the senior is already isolated, the connection from a home care worker might not be enough. Such a senior could benefit from the social opportunities at assisted living.
Consider family involvement and responsibility
Home care offers many benefits, but it doesn’t cover all senior care tasks. Because of this, family members often must fill the gaps, which can be stressful and difficult.
With assisted living:
- Staff are primarily responsible for the senior, which includes responding to emergencies, providing care, and organizing schedules.
- The family may help with the initial move, developing a care plan, and advocacy, but they aren’t directly involved in other aspects of care.
With home care:
- The family is responsible for planning and organization, especially when there are multiple home care workers.
- Family members may help with tasks that the care workers cannot perform, such as medication administration or wound care.
- Family members may also provide care to keep costs down, but this role can easily become bigger than intended.
When deciding between the two, think about the amount of care the senior’s support network can provide. Can the family reasonably cover any gaps? Do they have the emotional and practical resources to manage home care? Are there backups if anything unexpected happens?
Home care vs. assisted living: Other differences to consider
If you’re still unsure about whether to turn to assisted living or home care, here are some other differences to think about.
| Feature | Home care | Assisted living |
| Setting | The senior’s home (or the home of a family member) | A residential facility |
| Type of care | Personalized and flexible care from one or a few care workers | Structured and comprehensive around-the-clock care from a team of trained staff members |
| Cancellation | Can be canceled with a few days’ notice | Canceling services is more involved, and the resident would need to find somewhere new to live |
| When it begins | Within as little as a few days of hiring services | May be a wait list for openings |
| Level of personalization | Highly flexible, allowing people to choose the exact services and timing they wish | Tailored to individual needs, but flexibility is limited |
Home care vs. assisted living: Making the right choice
Choosing between home care and assisted living is a personal decision that depends on your loved one’s needs, preferences, and support system. While both options offer valuable services, they differ in structure, cost, flexibility, and the role of family caregivers. Home care can be ideal for seniors who are mostly independent and want to age in place, while assisted living provides a more comprehensive environment for those needing consistent support and social connection. By carefully weighing the pros and cons of home care vs. assisted living, families can make an informed, compassionate choice that prioritizes safety, quality of life, and peace of mind.
