If you or your parents are discussing and debating the merits of at home or , it may be that you have a clear choice. Not everyone ages the same way, and you might be perfectly content to age in place and continue living at home, perhaps by making a few adjustments, such as hiring a . Or you may feel like assisted living is a much better answer.
Whatever you prefer is obviously the right choice, but which, between and , is the cheaper option? There really is no clear-cut answer. But if you’re weighing the two options by comparing the expense, generally, the rule of thumb is — home care is less expensive, the less help you need; but if you start to need a lot of help, assisted living becomes the cheaper alternative.
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Is Home Care Cheaper Than Assisted Living?
The short answer is it depends entirely on how many hours of care are needed per week. As a general rule of thumb, home care is cheaper if you only need minimal assistance, but assisted living becomes significantly cheaper once extensive or full-time care is required.
When , cheaper and what’s how much you pay depends on how much care you need, and whether you require medical help or non-medical assistance with things such as .
— Under 40 hours a week: Home care is cheaper. Because home care agencies charge by the hour (averaging around $33 to $35 an hour), hiring a caregiver to drop by for a few hours a day or a few days a week is highly cost-effective.
— 40 hours or more a week: Assisted living is cheaper. Once care needs stretch into full workdays or around-the-clock supervision, the accumulated hourly fees of home care quickly skyrocket past the flat monthly rate of a residential facility.
“Generally, home care is charged by the hour, by the week. So, for example, families will often start out with four to eight hours of home-care per week and work their way up from there,” says , managing partner at Senior Living Search Partners, a small, local senior placement service in the St. Louis area.
Koenig says that those costs, however, “can mount up quickly once someone needs a bit more assistance, and, in my experience, this is often when families make the switch to assisted living.”
Math backs up what Koenig says. The numbers below (such as $35 an hour and $90 an hour) come from .
Comparison of home care and senior living costs
| Care/Type Service | Estimated Weekly Cost* | Approximate Monthly Cost* | Context |
| Non-medical home care | $1,400 (40 hours a week) | $6,062 | $35 an hour |
| Skilled nursing care at home | $3,600 (40 hours a week) | $15,588 | $90 an hour |
| , medical and non-medical | $475 (5 days a week) | $2,058 | $95/day |
| Assisted living community | $1,550 (full time) | $6,200 | All-inclusive care, does not include a community fee that new residents are sometimes charged |
| Nursing home semi-private room | $2,395 (full time) | $9,581 | All-inclusive, full-time care at a facility |
| Nursing home private room | $2,699 (full time) | $10,798 | All-inclusive full-time care at a facility |
* The approximate weekly and monthly costs listed are based on hourly and sometimes monthly rates. Current median monthly
and a are $6,200 and $9,581 (for a semi-private room), respectively.
Living in a nursing home is cheaper than having a home health aide 24/7 at home.
But if you can live at home with professional help dropping by 40 hours a week or less, especially if it’s less, your wallet will fare much better.
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Home Care vs. Assisted Living: Cost Comparison by Level of Need
| Level of Care Needed | Estimated Weekly Care Hours | Likely Cheaper Option | Cost Conclusion |
|---|---|---|---|
| Minimal Assistance | 1 to 20 hours/week | Home care | Hourly rate is cost-effective for occasional help. |
| Moderate Assistance | 20 to 40 hours/week | Home care (initially) | Still cheaper than assisted living’s all-inclusive rate, but approaching a break-even point. |
| Extensive Daily Assistance | 40+ hours/week | Assisted living | Monthly flat fee typically covers 24/7 non-medical care more affordably than 40+ hours of hourly home care. |
| 24/7 Constant Care (Non-Medical) | 168 hours/week | Assisted living | Hourly home care rates ($5,544/week) are vastly more expensive than the average assisted living fee ($1,475/week). |
| Medical/Dementia Care | Varies | Specialized facilities offer dedicated medical oversight and security that home care may not easily replicate or afford. |
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Home Care Costs Considerations
is the CEO of Home Helpers Home Care of North San Diego. He says that many families have an approach to that fits several slots.
“Families can be caregivers, directly or use a home care agency. There are also trade-offs between all these options. We’ve seen a combination of these work well, to keep seniors aging in place as long as possible,” Van says.
Obviously being a caregiver for your parents is the cheapest way to go since you’re probably going to work for free, though it is possible to get paid as a caregiver. A may allow that, or your employer may give you paid time off to care for an aging parent.
Hiring somebody directly is the second cheapest route. Van says that the agencies cost more, but they do reduce your legal risk. If you hire somebody on your own, you’re their employer, and if your caregiver gets injured on the job, you could be liable. If you hire an agency, they’ll likely be well-insured if the caregiver is injured in your home.
But there are other hidden costs to consider with home care. A few to watch out for include:
— Home improvements. “It’s not uncommon to see families spend tens of thousands of dollars to renovate a home for this purpose,” Koenig says, citing items such as walk-in showers, grab bars in bathrooms, shower stools and wheelchair ramps. If you invest in expensive aging-in-place renovations, and then you start hiring a home aide, that can be a lot of money spent in a short amount of time.
— Utilities, food, transportation costs. These aren’t really hidden costs; you pay them every month. But when you’re trying to figure out if you have a budget for assisted living, or if you should stay at home, don’t forget to price in these daily expenses. And if you’re giving up your car, you’ll need to pay for transportation to places like the supermarket and the doctor (though grocery delivery can solve that problem, and sometimes cover trips to the doctor and perhaps the gym, and maybe family and friends can pick up the slack).
— . If family members are taking care of a senior, they too could soon have expensive health issues, or see their careers suffer, if they push themselves too hard.
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“Aside from the cost, there are other considerations,” Koenig says about aging in place and needing somebody to check up on you. “In areas where winter weather is bad, it’s possible that the home care provider may not be able to reach your residence. And, since many families either can’t afford or don’t utilize care services 24 hours a day, there are still times where your loved one may not have anyone around at all to help, particularly in the case of a or another urgent situation.”
You also want to know what you’re paying for.
“In addition to cost and logistics, people should also look closely at the depth of clinical expertise available to them,” says , a New York City-based practice president of personal care services at BAYADA Home Health Care, which has locations in 20 states. “Not all personal care services come with nurse oversight,” he says. “It’s important to understand what types of clinical services a provider can offer, how they coordinate with physicians and health systems, and how they adjust the plan of care as needs change.”
Of course, you may not need medical assistance, and maybe you never will. As noted, people age in all sorts of different ways.
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Assisted Living Costs Considerations
(in a way) mirror that of home care. If you don’t need much assistance, you may find the expense fairly reasonable. You’ll likely pay a community fee, a one-time fee, sometimes called an entrance fee or move-in fee, that covers administrative costs. You’ll also pay a monthly fee, and typically wrapped up in that fee are rent, utilities, meals and . ADL is an acronym for activities of daily living. The ADLS are generally described as bathing, dressing, eating and using the toilet.
As you would expect, the more help a senior needs, the more that they’re going to pay, and what you pay is based on the level of care you receive. That’s an actual term the industry uses, level of care, and there are typically pricing that you’ll find in assisted living:
— No assistance
— Low or minimal assistance
— Moderate assistance
— Full assistance
—
If you require a “no assistance” level of care at assisted living, you may still be working and driving — you just live in a facility where perhaps there is a dining hall, and if you have a yard, maybe it’s being mowed. But health-wise, you’re doing fine, and your monthly assisted living fee takes care of expenses such as your rent, utilities and meals.
You will naturally pay more as you get to a low or minimal assistance level of care (maybe you need help getting dressed or groomed in the morning, but after that, you’re good to go for the day). If you’re paying for “full assistance,” you need help around the clock with daily living activities. Memory care, as you would imagine, means that you’re suffering from a condition like or .
With each level, you’ll pay more. You also may pay a la carte, sort of like a menu, where you pay for certain services or if somebody needs to occasionally help you. That may be cheaper, or you may find the prices start to add up in a cost-prohibitive way.
According to the Cost of Care survey, the median price to stay in assisted living is $6,200 a month. A safe assumption is that you may pay considerably less than $6,200 a month if your care is at level one and considerably more if you require full assistance or . Obviously, the facility you choose impacts cost as well.
But the prices can vary greatly. For example, you can find in Mason, Ohio, (near where this writer lives) that start at and at .
And there are certain hidden costs with assisted living to be aware of. Not that a facility will try to trick you, but these are expenses that many people can forget about, such as:
— The entrance fee, or community fee. You may have to pay more than the monthly fee at an assisted living facility. There may be an entrance fee of, for instance, $300,000. It may be far less — or far more. Before you panic, not every assisted living facility has an entrance fee. They tend to be associated with . These are generally those sprawling, affluent retirement communities that offer all five levels of care, from independent living to assisted living to memory care.
— The elimination period. If you have , you’ll want to consider the “elimination period,” Kroll says. That refers to “how long someone must pay out of pocket before insurance starts to pay benefits.” It’s an expense that can surprise people — whether you’re dealing with assisted living or home healthcare — if they expect their policy to immediately start paying for healthcare expenses. You may have to wait a few months and spend some of your own money on care before your policy actually kicks in.
— Inflation. You may budget and decide you can afford assisted living today, but will you be able to down the road? If inflation continues to average 3.80% a year, which is what it currently is, in 20 years, according to a calculator, will climb from $129,575 a year to $273,025. Using the survey’s numbers and a calculator, the average cost of assisted living will go from $74,400 a year to $157,000. Granted, inflation will affect people aging in place at home as well. It’s also true that inflation can bounce all over the map, and so in the years ahead, it will likely be less than 3.80% and higher.
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So Which Is Cheaper? Home Care or Assisted Living?
Home care is cheaper if your needs are under 40 hours a week. If you are approaching 40 hours or more, for many households, assisted living starts to become financially safer in the long run.
Whatever you decide, however, it’s best if you try to develop a before you need one.
“The most important thing, when it comes to , is to be proactive and investigate choices before care is urgently needed,” Kroll says.
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